how do you know if you have lpr?? i am not even sure what this is. Someone on here kindly pointed me in this direction. I have had a cough slowly getting worse for 4 yrs now, i have never suffered from indigestion/heartburn, all i know is that i cough day and night but not all the time, its worse at night and sometimes if i lay down i feel its difficult to breathe. I now have constant phlegm in the back of my throat that wont come up or go down, if i cough it often comes up and chokes me but does not come out. I find that sometimes my voice gets deep, and now i can only talk for so long as i find i start to cough and cough so much i actually throw up. You can imagine if you are at work and talking on phone to someone and cough so much i just cannot talk to the person, then run to be sick, how embarressing. I have also noted that some foods tend to touch a spot in my throat that feels sort of raw (but nowt sore) and then i really really choke, I.E. pickle onion, and other things. I have had a camera down my throat into my stomach for bowel probs and did ask them to look as they went down but they found nothing. I have recently felt like an air bubble in my chest/throat sort of like a pressure feeling and it is uncomfortable. At work one day when i drunk a cup of tea, i went to pick up my pen from the floor and i felt the whole cup of tea coming straight back up??? I constantly need to clear my throat. And i find now it is much easier to sleep sitting upright but i cannot get to sleep as i slip down the bed. My family really get cheesed off with me as i often keep them awake where i cough so much. Went to drs a month ago as breathing at night got bad, she said to sleep sitting upright, and gave me a month of some sort of ant acid tablets, and this did help. She felt my stomach acids were coming up into my throat and irritating everything, even though i dont get indigestion. Any ideas anyone. if it is this lpr thing is there anything i should be concerned about. both my neice and my nephew have gerd.

Hi cazajacks,

A persistant cough is thought to be the first sign of possible LPR along with enamel erosion and cavities. When the main symptoms present such as something stuck in throat feeling, constant throat clearing, mucous, burning throat and mouth the cough has often lessened or gone altogether. I do not think that LPR would have taken years to present itself following the cough. If you have these other symptoms then most likely you have LPR if you do not the they ar either still to present or you do not have it. Food regurgitating could be a symptom but could also be a problem with esophaegal motility ie the muscle forcing food and drink down he esophaegus is not working properly.

LPR relates primarily to acid reflux from the stomach which bypasses the esophaegus and goes right into the larynx and pharynx. If you are not experiencing acid reflux then you do not have LPR. The cough could be the result of this poor motility and of food and drink not making it to the stomach and returning upwards irritating the vocal cords en route. If none of the acid reflux symptoms in mouth,back of throat or nasal passage then no LPR.

Hope helps

An ordinary ENT can tell if you have LPR because your larynx will present as red, enlarged, and/or inflamed - all signs of irritation by acid. Your ordinary PCP will probably not perform the procedure to check this out, so schedule an appointment with any old ENT (ear nose and throat, known as an otolaryngologist). The ENT will have you quickly inhale some numbing gas into your nose. Then he will insert a long probe up your nose and into your esophagous (sounds worse than it is - it really doesn't hurt). The probe has a small video camera at the end, and typically it will send the picture back to a computer screen. Voila - you'll know if you have a messed up larynx. Please note that many run-of-the mill ENTS STILL have not heard of LPR, and these morons will probably say "Oh, you have some reflux," and then prescribe just one PPI per day. If you get stuck with one of these idiots, tell him about LPR, and that standard treatment is 2 PPI a day. Then ask specifically for Nexium, which is what I take and do very well on. If the doctor argues, tell him to go check his medical journals as he is clearly not up-to-date.

Glad to help!

Hi and thank you for your replies. I am going to wait a short while and if things dont get better i will go to my drs. I have suffered all over christmas but it is probably down to all the rich food etc. i cannot lay down in bed at night as it feels like something is coming up?? and it hurts and is terribly uncomfortable. I had bad heart burn when i was pregnant 12 yrs ago and this is nothing like it at all so it cant be heart burn. I have this constant pressure in my thoat/chest at night and bed time, i have to sleep sitting upright and it is so uncomfortable, i just slip down. I have noticed i chest a bit wheezy in the chest/throat and i a bit sort of phlemgy inthe throat, and cough for England all night. I am cheesed off with it all to say the least.I have noticed some foods are getting stuck in my throat but most of all my daily medications feel as though they are stuck in an open hole in the back of my throat?????
My throat/chest does feel sort of acidy but not burning at all?? i done understand all this but i know it gets me down as i am suffering terrbly from a bowel disorder which is making life absolute hell and i do not need this added problem as well. thank you for your replies
cazajacks

Cazajacks,

If you have been suffereing from this cough for 4 years, why wait any longer? What is preventing you from going to an ear nose and throat doctor and getting this simple exam? The medication can be very effective in treating this condition, which, in my opinion, has every hallmark of being a glaring case of laryngeal reflux. By the way, you are right in that an acidy/wheezy feeling in your chest is part of laryngeal reflux. That is the small amount of acid that goes up to your larynx which comes back down and gets into your lungs. You are aspirating stomach acid into your lungs, and it shouldn't be there. This commonly gets misdiagnosed as asthma, but all the asthma drugs in the world won't help you. Only 2 PPIs a day will. Please please please see an otolarygologist.

Thanks aswander, it helps to hear from someone else, do you suffer from this condition,if so how did you know, what were your symptoms. I am going to try to make time to go to my gp, i know it sounds like an excuse but i have a child going into hospital for an operation soon,( will be laid up for a week or two) my dad is dying of copd and i am going to look after him from the weekend to give my sis a break, and i am suffering like hell with a bowel disorder ( another thing i cannot get diagnosed ) and it is making my life hell as well as this chest/cough thing. i also have a child at home with autism and she has a tutor who comes to the house so i cannot leave the home on these days, and try to work 2 days a week as well. isnt life just grand.
Can you honestly tell me can this condition ever become dangerous.
thanks very much
cazajacks

Cazajacks,

I understand that you feel overwhelmed right now, but please take your health into your own hands and at least schedule the appt. You do not need to see your GP, you need to see an ENT (an otolaryngologist, known as an "ear nose and throat doctor". They are very common and you shouldn't have to wait too long for an appointment. A GP is not going to have the equipment to scope you in their office - you have to see the ENT. This is an easy diagnosis if you have LPR - they just need to see redness and swelling on your larynx.

Yes, your symptoms were the same, horrible severe, chronic and unrelenting cough with weird lung symptoms - kind of like asthma, but not really. I could literally feel the acid in my lungs and a very low, rumbling kind of gurgling. This went on for maybe 9 months before I was diagnosed, and I must have seen 25 doctors who had no clue.

If left untreated, the condition will get worse. The acid is causing erosions throughout your esophagous and sinus passages which will casue pain, dripping, stuffiness and extreme sensitivity to smells. Long term diagnosis is not good - you could be looking at esophageal cancer in the long term if you don't treat this now. Esophageal cancer has one of the lowest 5-year survival rates after treatment, which is between 5% and 30%.

This is serious stuff. Go to the doctor. If it's LPR, you can start the meds right away, and if you fortunate, you will be one of the people who respond to the meds immediately.

When I began 2x daily PPI treatment, my symptoms went away in 30 minutes because the med turned off the acid pumps in my stomach. That way, no acid was jumping up to my larynx.

I'm sorry that your life is so complicated, but you're not helping the people who need you most right now if you don't make this phone call.

Here are the latest stats on esophageal cancer:

Note: Estimated new cases and deaths from esophageal cancer in the United States in 2005: [1]

New cases: 14,520.
Deaths: 13,570.


You can also get laryngeal cancer as well - I don't know as much about that.

Hi aswander, thanks so much for your reply, it does help to know all these details. i have just got back from looking after dad for 4 days, one of my kids is ill with a virus. She also goes in for an op next wednesday(18th) so am tied up all the end of next week. I have coughed the whole night through whilst staying at my dads house, ( had to lay almost flat as not many pillows) well this made me cough, and now it feels like i have hurt my chest, i think i have pulled muscles in my back and chest and ribs, boy it is uncomfortable. what i am going to do if i dont feel any better by monday, if the stiff/sore chest is not gone i will go see a doc, as i am having constant treatment for fibromyalgia, heart probs and severe bowel problems i feel a right idiot to go back and now say, oh and there is something else wrong now. it embarreses me that i have so many illnesses, i am always moaning about something or other. all my friends hardly get any illnesses so i must have their share. any way i will go monday if no better, thanks so much for your info.
cazajacks

Have been to my dr today, she has given me another prescription for the strongest dose of a sort of antacid tablet, it lasts for 24 hours each one tablet, also a steroid nasal spray, also some gaviscon advanced. She is arranging for a baruim swollow and a chest xray. If the meds dont work by 3 weeks time i am to go back. i finally went as i am FED UP TO THE BACK TEETH of spending my nights awake coughing, and now to my embaressment sometimes when i cough i am throwing up grren things?????????????????YUK YUK YUKY YUK so i am going to try all this. will see how this goes.

what antacid tablet was that?

From what I've read, LRP is predominantly a daytime, upright reflux, while GERD is a nighttime, horizontal reflux. If you're having the majority of your problems at night when you lay down, most likely GERD is more of the problem. But I guess you could have both. I'm going to post a good article on GERD/LPR which may help clarify some of the symptoms, especially with LPR.

The anti acid things are called Omeprazole capsules 40mg. It states they are gastro resistant granules, but are in a caplet. I have only taken 1 so far so cant say if they have worked. The doc did say it was a high dose, also i have to take 8 puffs of this nose steroid spray when really you are not meant to take any more than 4 sprays at the most. So i am not going to run back to the doctor straight away, i will do this for 2 to 3 weeks, which is the maxuim amount of time the doc said i can take this extra dosage, then put myself down to the normal dosage for a few weeks then go back to her.I will then see if my symptoms come back, i cough both day and night, but cough is much worse at night. Also very phleghmy and feel a raw patch in my throat and if a bit of food touches this raw patch i really choke????

oh, omeprazole is not really an antacid per se. what that is is a PPI, like Nexium.

so if its a ppi what is the doc giving me this for, what is it she has in mind it could be. An having this barium meal test thing on the 20th Feb, but have to wait up to 10 days for results.