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LINX / TIF / fundoplication - LPR

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Old 07-20-2012, 08:30 PM   #1
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LINX / TIF / fundoplication - LPR

I've been suffering from LPR for 7 years and have been trying different meds, diet change, voice therapy, etc, but none of those helped. So Iím considering the LINX. I've been thinking:

- LPR is controversial; some doctors do not believe LPR does exist even though there are tons of information available on the internet

- If your doctor is not a LPR believer, even though you have tried different things, meds, diet change, etc, he/she might still not recommend a surgery even though you have all the symptoms, if your number of reflux happens to be within "normal" (based on GERDís standard). However, for LPR, from what I've read, even one episode of reflux can cause symptoms because the throat does not have the protective lining as the esophagus does

- GERD: loose LES

- LPR: loose LES and UES

- For a normal person who has a normal LES, reflux is normal if under a certain number.

- If my understanding is correct, the surgery is to reinforce the tightness of the LES; this should significantly reduce the number of reflux episode. But, it might not (my guess is it will not?) eliminate reflux completely. So even if the LES tightness had become normal or above normal after the surgery, reflux can still happen? And if it does, even the number of episode has dropped significantly, the surgery is not a 100% "cure" for LPR as just one single episode can cause symptoms. I guess thatís why there are people still having symptoms after a surgeryÖ

- If meds, diet change, surgery, etc donít help, where does that leave us with LPR??

- For LPR, the key seems to be the tightness of the UES

- Iíve read that some LPR patients found the UES strengthening exercise like the Shaker exercise to be helpful.
My personal experience is that simulating that movement when upright is quite effective in terms of suppressing the belching. I felt like the end of the movement (head down) kind of acts like closing the UES. It is possible that the Shaker exercise can strengthen the UES overtime

- Iíve read that some LPR patients found the vitamin D3 to be helpful. They had one thing in common; vitamin D deficient/insufficient. The theory is that the D3 can strengthen the muscle in some way. The LES and UES are muscle. Theoretically, the D3 might be able to strengthen the LES and the UES.

My vitamin D score is at 89 nmol/L (35.6 ng/ml). The report said ďNormalĒ being from 75 - 150 nmol/L (30 Ė 60 ng/ml). So Iím low normal. I notice that the reference intervals found on the internet are not very consistent. So Iíd consider the optimal level to be somewhere around 75 Ė 200 nmol/L (30 Ė 80 ng/ml).

I had been taking an additional 3000 IU daily for a week or so prior to the blood test, as well as a few days of 30 mins + sun exposure; around 50000 IU in total, and the test was done in summer. So there is a good chance that I was below normal before this summer.

My observation after taking an additional 3000 IU of D3:

ē Bloating / gas

ē Still often have the need to burp, but suppressible most of the time. Most burps before D3 would just come out

ē Burps now are often mini comparing to the long air releasing burpppppp before

ē Often feel like air (or whatever that is) coming up and got stuck in the throat (suppressible) Ė because the UES is tighter after D3?? If so, then the D3 isnít doing much to the LES yet as the air/reflux can come up to the throat

ē Less throat clearing

ē Less phlegmy / mucous

ē Taking deep breath seems to encourage burping

ē Although Iíve read that the D3 can be taken all at once, doing that might have contributed to my bloating / gas problem. I tried to space it out twice a day as suggested by my doctor, and it seemed like I got less bloating / gas. However, this could be just my body was starting to get used to the D3.

Note that the above is just my personal experience, it might or might not work for you. Iím not saying everyone with LPR should try it, but for the ones who have tried everything even a surgery, but to no avail, it might be a good idea to get your D score checked. If it happens to be deficient / insufficient, there might be a connection. I personally think itís safe and worth it to bring the D level up to high optimal for a potential symptom alleviation (or even a ďcureĒ, Iím hoping!).

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Old 07-21-2012, 06:50 AM   #2
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Re: LINX / TIF / fundoplication - LPR

One thing to keep in mind: The surgery tightens the LES, but it's possible for the LES to be too tight. This leads to swallowing problems and food getting "stuck" in the middle of the chest.

So, I do NOT recommend surgery for anyone who had a normal pH study. Without objective evidence of loose LES through pH study or manometry, the gain is probably not worth the risk.

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