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  • LPR/Silent Reflux diagnosis & not convinced on cause

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    Old 04-10-2016, 09:12 PM   #1
    sickguy37
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    Unhappy LPR/Silent Reflux diagnosis & not convinced on cause

    I was recently diagnosed with silent reflux by an ENT who scoped my throat to confirm it was inflamed. I think his diagnosis makes a lot of sense, but I'm concerned because I've been on a pretty low acid diet for the last couple of years, and the appropriate meds for LPR for about 2 months prior to that visit and I'm still having pretty severe symptoms. I'm looking for some advice on what I might be missing.

    I've had many of the classic symptoms in the long term - persistent post nasal drip, occasionally sore throat, and occasional symptoms of GERD.

    Less frequently, I've had the feeling of a lump in my throat and trouble breathing. I had one acute case of this about 9 years ago that was treated as GERD (tho the lump was my only symptom) and eventually resolved by taking acid reducers. Early this year, I had another acute event like this - it included the breathing problems as well as an occasionally sore throat and hoarseness (the later two I might attribute to inhalers I was put on with the thought it could be asthma)

    So, after diagnosing me, the ENT recommended the book 'Killing me Softly'. I checked it out and it's actually given me some doubt. The thing is, I've been pretty careful with my diet in general due to various other health problems (namely prostatitis) made worse by acidic or spicy foods as well as alcohol and caffeine. I've been even more careful with this in the past 3 months, because I knew GERD was my ultimate diagnosis the last time this happened. So when I saw the ENT I was already 2 months into taking Ranitidine and Protonix as well as watching what I was eating.

    I admit I wasn't aware of quite how acidic certain foods were, and I did continue to drink a single cup of coffee for a time (before the ENT). So my symptoms were pretty much up and down since January, and when I saw the ENT they were not too bad. Yet, I started adhering to the diet much more carefully at that point - basically following the menu listed in the book to a T. So it worries me that in the last week I've actually had a spike in my symptoms.

    If I have had LPR for almost a decade, why would it have spiked at a time when I was watching what I ate pretty well, and wasn't under much stress (compared to normal)? And if we attribute it to some random combination of factors that flared it up - why am I actually getting worse while on this diet? I could understand it taking a while to heal - but I would expect at least a stabilization when I've removed the irritants.

    If anyone has had a similar experience, I'd love to hear about it! I'm definitely concerned about my apparent lack of control here. I definitely never abused the things that seem to be the typical source of LPR, so it seems strange that I'd have such a bad case of it.

    Thanks

     
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    Old 04-11-2016, 04:02 AM   #2
    rainbowsrock
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    Re: LPR / Silent Reflux diagnosis & not convinced on cause

    That is baffling

    To be being good with diet and taking medication you would think you'd be fine

    Have you been checked out for mechanical faults ie Hernia?
    Also a lax LES sphincter and Pylori sphincter can let stomach contents up where they shouldn't be

     
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    Old 04-12-2016, 06:37 PM   #3
    sickguy37
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    Re: LPR / Silent Reflux diagnosis & not convinced on cause

    How do they diagnose the mechanical faults? I assume endoscopy?

    About 3 years ago, between the two incidents, I had an upper endoscopy done where htey went all the way down and looked into my stomach. That found some damage 'from GERD' in my esophagus, but nothing concerning enough to alter my treatments or trigger requests to change my diet.

    More recently, I've had breathing tests as well as the endoscopy at my ENTs office that went thru my nose and just looked a bit in my throat. I'm not actually sure if there were other things he was looking for, but he came out of it saying my throat was very inflamed and that I had silent reflux.

    My plan is to stick to the diet religiously for a full 6 weeks, and then go back in to see him. I imagine if I still have symptoms at that point, he'll scope me again. Hopefully at that point he'll suggest other testing and possibly shed some further light on this. Like I said, in that initial appointment, he was pretty dismissive of my concerns because he's probably so used to people coming in that drink 5 cups of coffee every morning and eat pizza every night. Not so with me.

    The one thing I later discovered is that a medication I have been on is a major trigger. That is a med for low bone density. I actually just finished a year long course of it 3 weeks ago, so if it was causing damage, I'm only now getting to heal from that. I'm on a few other meds that are listed as acid producing in some people, so I also suspect those are at play. I've been on most of those for many years.

    Other than that, my diet was occasionally more acidic than I thought because I didn't realize how bad things like Apples were. And I did have one cup of coffee each morning, tho it was bold which I understand is generally lower acid. The last bad habit I've picked up more in the last year is eating a small amount 1-2 hours before bed. Obviously I've stopped all of that since I got the new diagnosis 2.5 weeks ago.

    My symptoms actually have improved slightly in the last few days. So they got worse about a week into the diet, then improved again at about 2 weeks. Today I've had a small set back that I'll have to keep an eye on. I think that could be stress related.

    Thanks for the feedback!

     
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