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  • Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

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    Old 07-06-2007, 01:27 PM   #1
    bow57
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    Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    I posted this over on the Ear, Nose & Throat board but got only one response. Perhaps this is the better venue for it:

    I've had a strange throat disorder for nearly a year now. It started with a head cold that turned into a cough -- and the cough, basically, has never gone away. First thing in the morning I can feel my larynx quivering and spasming, leading to a dry, painful, nonproductive cough. The area is contantly hypersensitive and hyperreactive. It feels as though there's diseased tissue down there, or an enlarged glottis or criccopharyngeal muscle, or an inflamed thyroid. The area is constantly burning and cinching and spasming. Mere inhalation or yawning triggers coughing. Sometimes an intense tickling seizes the throat in a paralytic vise, requiring a big gulp of water and cough drops. One ENT doctor was sure it was laryngeal or gastroesophageal reflux, but a regimen of Prilosec, Prevacid and a no-acid diet did not ameliorate the symptoms. Nasal sprays for post-nasal drip haven't helped at all. I have what's commonly referred to as "globus" -- a maddening feeling of trapped phlegm that needs clearing, and a sensation of a disc or some other object caught at the base of the tongue. One endoscopy revealed no esophageal abnormalities, though examination of the larynx via flexible scope did show acute inflammation. I'm constantly hoarse, and my voice waxes and wanes. I had an allergy panel (dust, etc.) that was negative, but I haven't been tested for possible food sensitivities. I have some more esophageal tests scheduled (24-hour PH monitoring, motility, etc.). I haven't had any sinus scans, and the upper trachea and bronchi don't seem to be involved. Does any of this sound familiar? Does anybody have a success story that might give me hope? Thanks, Dave

     
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    Old 07-06-2007, 05:51 PM   #2
    Sara459
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    Re: Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    Hi Dave, Yes, your story sounds very familiar! Almost 2 years ago now I got a very bad cold. The cough lingered on. I was put on antibotics and it didn't help. My throat is irratated most of the time and tickles. It seems the cough comes from the throat - not the lungs. If I lay down at night on my left side I'll cough a couple of times but if I roll onto the right side forget it. I cough and cough. I clear my throat constantly and it always feels like PND.

    When I wake up I cough and clear my throat and my nose runs like a faucet for nearly an hour and then I'm pretty good until lunch time when I start coughing again. Sometimes it seems talking irritates it. Laughing makes me cough. Strangely enough when I work out, I don't cough.

    I've been told I have everything from LPR - they wanted me to have the Nissan (but I wouldn't) to asthma to allergies. Mainly the ENT wanted to throw Nexium at me and send me away. I tried the double does and it helped but didn't clear things up 100 percent. And it gave me migraines and other side effects so I stopped. They like to say being overweight causes GERD/LPR but I weigh 125 @ 5'6" so I don't think that's the issue.

    I've tried going to a naturopath who gave me various supplements. Sometimes things seem to help for a little while and then stop. It's so tiring to be clearing my throat all the time and stiffling a coughs in public places.

    I don't have any answers for you - but many people here have had their condition start at the end of a bad cold or after a bout of antibiotics. Coincidence? Doctors don't seem to want to work with you they just want to push the RX. It could be that it's a combination of LPR and allergies. Anyway I feel your pain and I wish to heck we could all find relief. I would give anything to go back 2 years before this all happened.


    Sara

     
    Old 07-06-2007, 08:55 PM   #3
    inacarr57
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    Re: Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    Both your posts sound exactly what I went through last year and started after a bad cold. This is what my doctor advised and has helped me. Take Prilosec at least one hour prior to breakfast. Do not eat or drink (including water) after 7:00 p.m. Use Flonase for post nasal drip. When I first started the Prilosec, I was taking with food and I was drinking water after 7:00 and was still having severe symptoms. I followed the above advise and was helped tremedously. However, whenever I try not to take the Prilosec, I'm right where I started.

    Last edited by inacarr57; 07-06-2007 at 08:57 PM.

     
    Old 07-07-2007, 11:47 AM   #4
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    Re: Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    Thanks for your replies, sara and inacarr. I'm going to be having a laryngoscopy under sedation to see if they can find any visible pathology (granuloma, etc.) I'm still awaiting results from a 24-hour PH probe, a motility test, an endoscopy and a videoesophagram. I also had a sinus CT scan and a food allergy panel. It's all getting very tiresome, of course. Oh, to have a normal throat again! I'll keep you posted. And good luck with your own situations. Dave

     
    Old 07-08-2007, 12:31 AM   #5
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    Re: Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    This is very similar to what I have been experiencing since a cold I had back in 2001. I cough constantly and sometimes it becomes so violent that I experience cough syncope (pass out cold). I've seen pulmonologists, allergists, neurologists, ENT's, speech therapists, GI's, and a cardiologist. I've had my sinus's carved up, my uvula removed, sleep studies, videostroboscopy, lungs scoped, GI scoped, one year of allergy shots, etc and nobody was finding a cause. Then by a stroke of luck, I was perscribed a drug called Diltiazem for a heart condition that was totally unrelated to the cough. For some reason, the cough was still there constantly, but it was not so violent. Eventually, I met up with a GI doctor that specialized in motility. I went in for a motility study and found that I had distal esophageal spasms that he believes is the cause of the cough. The initial treatment is Diltiazem. Bingo! I still have the cough and I have just tried to live with it. There are some options still to be tried if I want ( Botox injections in the esophagus, and/or lacerations in the esophagus that are supposed to do something...not sure ). Good luck to you. I'll sure be keeping an eye out on this thread to see how things work out for you.

     
    Old 07-10-2007, 01:53 PM   #6
    bow57
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    Re: Could this be an especially bad case of laryngeal/pharyngeal acid reflux?

    Well, all of my gastro tests came back negative --- endoscopy, 24-hour PH probe, motility test, videoesophagram (man, that barium stuff tastes awful!). The doc said acid reflux doesn't appear to be the main culprit behind my compromised larynx. However, he did say that even a little bit of acid -- either by itself or in combination with mucus or allergies or whatever -- can inflame the delicate laryngeal region, and that a "normal" PH reflux test still doesn't rule out acid as a possible cause of the discomfort. (The larynx is much more fragile and sensitive than the esophagus.) So the news was both good and ... frustrating! I still have a food allergy test scheduled, as well as a direct laryngoscopy. SOMETHING's down there, gagging and choking me. Perhaps granuloma or lesions or a swollen cricolaryngeal muscle or ... I'll keep you posted. Thanks and peace to all ... Dave

     
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