Hello,

I was just diagnosed w/GERD by an ENT. (Have had "lump" feeling in my throat for a few months, and terrible acid taste in my mouth off and on for two weeks.) I had a throat CT that came back negative, and my voice box is red, so that's how the ENT came up w/GERD.

Anyway, I have made HUGE changes in my diet over the past few weeks and I'm not seeing any great change. I was taking Zantac 75 1x per day, plus Tums if needed, but that wasn't working. Then I switched to Zantac 150 2x a day, which worked for a few days but now isn't.

To make a long story short, I've had this vile acid taste in my mouth plus a burning throat for 36 hours and it won't go away!

Please help!

You need some stronger meds, it sounds like. I'm surprised the ENT didn't put you on a PPI. You could give Prilosec OTC a try. If that doesn't work after a few days, you'll probably need to go back to your doctor and get a script for something good, like Nexium.

Good luck!

-Karen

Hi Sandy,

Sorry you had to get this and find the board, but you've found a great place to learn about GERD and people that are going through the same crap, so there's support here.

I agree that a PPI (proton pump inhibitor) would probably help, it has really helped me with the lump in throat and burning. Also good that you've made major diet changes-no spicy foods, no caffeine, no smoking, no citrus, no onions or tomatoes, no soft drinks or chocolate. Also, try elevating the head of your bed 6-8 inches, this really helps a lot of people. Also know that stress is related to GERD-the more stressed or anxious you are, the worse it gets. Stress can actually be the trigger that brings on GERD-I know it played a large role for me. Also, I sip water when the lump is bad and it seems to help, so do "slippery elm" throat tablets, available at a health food store. Some people swear by drinking aloe vera juice, it soothes. Good luck, Skylar

Hi Sandy,

I second KJH Chemist's opinion. I am truly surprised that your doctor didn't put you on a prescription PPI. Usually doctors will at least tell you that if the Zantac (H2 Inhibitors) don't work, they'll switch you to a PPI. But not to tell you about PPIs is a complete lapse of judgement on your doctor's part - or else total incompetance and ignorance. You really ought to switch to an experienced doctor at a major university hospital who knows acid reflux. Sorry to be so strong about his - but you're suffering when you don't need to be, and that's not acceptable.

You will probably need to switch to a PPI, like KJH Chemist said.

There are 4 brands, I believe of PPIs available by prescription. Nexium, Prevacid, Aciphex and Protonix. Prilosec is a PPI that is available OTC.

Nexium is the most recently launched PPI and has excellent results in many laryngeal reflux sufferers, but it doesn't work for everyobody. Prilosec is the first PPI that was launched, and seems to be effective for heartburn sufferers, with more anecdotally mixed results for laryngeal reflux sufferers. If you have insurance, start with the prescriptions. If you don't have insurance and can't afford them, then give Prilosec OTC a try. If, once you're stabilized, you feel like trying the other brands, by all means to do, but start with the ones that are most likely to get you better.

I think you have larygopharyngeal reflux since your larynx is red. Most local yocal doctors don't know it has a name - they'll just say "Oh, you have some reflux". Laryngopharyngeal Reflux (LPR) describes the reflex that occurs when acid leaves your esophogous and enters your throat. This is in contrast to GERD, which is characterized by esophageal erosion and heartburn. For those who just have GERD, the lower esophageal spinchter muscle is flaccid. For those of us with LPR,the upper esophageal spinchter muscle is flaccid. But you can also have a combination of the two.

However, people with LPR need to be treated differently than people with GERD. The acid goes higher, so you need an extra dose of PPI every day. If you had GERD, it would be fine to take 1 PPI per day. But with LPR, you need 2 doses per day. I take mine together in the morning, but there are individuals on the board who take one in the morning and one at night. I personally take Nexium and have had an excellent recovery. For people who don't tolerate Nexium well, a comomon complaint seems to be that it makes them dizzy or nauseous. At 2 pills a day, I'm fine, but when I accidentally took 3 at one time a few months ago, I felt dizzy and nauseous too.

You may need to explain all this to your doctor when you ask for a prescription for a PPI (one of the 4 that I mentioned). Remember to ask for a prescription for 2 a day. If she argues, just tell her that you'll reevaluate your meds at 1 month, but want to start with a more powerful dosage. (Please note, many insurance companies require special approval for 2x a day PPIs). I got a special approval through United Healthcare, though it took a little while.

When I finally found my diagnosing doctor, she gave me an excellent article on LPR that explained everything. It was published by the Official Journal of the American Academy of Physician Assistants in 2002 and was titled "Laryngopharyngeal reflux—It’s not GERD". You can find it easily, and you might want to bring it with you to your next appointment.

Best of luck!

Thanks so much everyone! I live near several university hospitals so I'd think I could find a good doctor. Should I look for an ENT or a gastro? I'm going to buy Prilosec OTC tomorrow and see if it helps!

Hi all!

This is my first post - I've been reading a lot of the posts. I was also diagnosed with LPR. It seems that anxiety led to the onset of my symptoms, approximately 3 1/2 months ago. Since that time, I've had a constant feeling of a lump in my throat (no signs of heartburn). The lump only felt better when I ate, and if I could eat all day, I would have no feeling of a lump!!! but I would also be the size of a house!!! I was literally going out of my mind, and knew I couldn't live like this anymore. I was impossible to live with, and was just miserable.

Anyway, my ENT prescibed Nexium, which I took for two weeks, with no easing of the symptoms. I began to do a lot of research, and also got a second opinion from another ENT, who confirmed the first ENT's diagnosis. I don't mean to step on anyone's toes here, but I am not a big fan of taking medication, as I believe that taking medications long term can lead to other problems (of course in many situations there is no way around medication).

But I honestly felt that if this problem was due to too much acid, or weak acid, with the addition of improper digestion, I thought there had to be a way to beat this without meds.

To make an even longer story short!, i decided to try taking digestive enzymes and acidophilus, and DGL (Licorice Root), to help with my digestion and the acid in my stomach. Well, after one week, the feeling of the lump in my throat was greatly diminished. Now it is almost 2 weeks, and I have days that I feel totally normal again, and I can feel a significant difference. I am actually smiling again, which I haven't done in 3 1/2 months.

So for anyone who wants to try give the "natural" route a shot, the names of the supplements that I'm taking are: Twin Labs Super Enzymes (I bought them from Mrs. Greens, but I'm sure you can get them wherever they sell Twin Labs vitamins), NSI CandidaClear (acidophilus), and Ezymatic Therapy (licorice root). The latter two I got online at vitacost.com.

I honestly do not represent any of these companies. I just know how horrible it is to have LPR and thought I'd share my experiences. I really didn't believe this was going to work, but wanted to try it before going on meds.

Good luck to everyone

Laura

Sandy,

You could see either an ENT or a Gastro.

The ENT will be able to perform a throat scope during your visit. It is very simple, and though it may sound unappetizing, it is really minimally uncomfortable - no pain, I promise. You will inhale a numbing spray into your nose, then the ENT will insert a wire with a miniature camera on the tip up your nose and down your throat so he can view your larynx. Confirmation of LPR is typically a red and swollen larynx. This procedure is not a biopsy and cannot confirm cellular changes that lead to Barrett's. The scope also doesn't enter your esophogous.

During your first visti to a Gastro, he'll just talk to you without any tests. But he'll recommend that you schedule a procedure called an endoscopy - which he usually performs himself. This is an outpatient procedure that requires anasthesia, because the gastro will insert a scope into your esophogous to look for erosions, and biopsy for cellular changes.

I go to both an ENT and a Gastro, and in my opinion, the ENT knows more about LPR, but I have to have an edoscopy done every 2 years by the gastro to monitor for Barretts. So see them both, if you can. The only thing is, and I think most people on this board will agree, that many doctors really can't help you that much with reflux except for prescribing PPIs. They really don't have any magic up their sleeves. And your PCP can prescribe PPIs for you just as easily as an ENT.

One other thing - don't schedule an appointment, even a a major University hospital, with a new or young doctor. THey are too inexperienced. When I went to Columbia-Presbyterian in NYC, the doctor I saw was very young, and while he identified reflux, he didn't even know to put me on a PPI. I trekked into NYC 2x and all he did was have me take OTC Zantac, which was useless. I discovered, after I was diagnosed properly at Yale, that not Columbia-Presbyterian actually has it's own unit, in the ENT department that this doctor worked in, devoted just to LPR, called "The Voice and Swallowing Center" - it has it's own webiste! But this idiot couldn't even be othered to ask his colleagues. The next year, he left to become a Plastic Surgeon - so I knew he never really cared and was just there for a little experience. I learned my lesson with this guy and now only see seasoned doctors.