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Allergies board


I know exactly what this is - it's Laryngopharyngeal Relfux (LPR) which is a form of Acid Reflux. There is a ton of information on the web about this condition and we have an acid reflux board here at Healthboards where about 90% of the posters have LPR.

It can't be cured, but it's easily treated, so you wind up treating the symptoms, not the cause.

First, the cause: the esophogous has 2 areas of pressure known as the upper esophogeal spinchter muscle and the lower esophogeal spinchter muscle. Neither are really muscles, but areas of pressure that keep acid out and in the stomach where it belongs. When the LES goes haywire, people get bad heartburn because a lot of acid escapes the stomach and irritates the lower esophogous. It is believed that with LPR, only a little acid escapes the LES, but it moves higher up the esophogous because the UES is compromised. The UES is basically the same thing as the larygeal/pharyngeal area. This area has no protection against acid, and you wind up hacking like crazy. See, the stomach acid has a PH of 2 - it's hydrochloric acid, which is great for dissolving steak, but wreaks havoc on the delicate tissues of your larynx and pharynx. To make it worse, some acid gets into the throat, and the throat mucous spreads it around the nasal passages and sinuses, creating erosions everywhere that feels like chronic sinusistis and you get really stuffy and can't breathe through your nose.

To treat it, you must take 2 doses of a maximum strength prescription Proton Pump Inhibitor (PPI) each day and you need to take them together, first thing in the morning.

Your choices are:
Nexium, 2 40 mg capsules per day
Prescription Prilosec, 2 40 mg capsules per day
Prescription Generic Prilosec called Omeprazole, 2 40 mg capsules per day
Prevacid, 2 30 mg capsules per day
Aciphex, 2 20 mg capsules per day

Please don't try Prilosec OTC or Protonix. Neither work for LPR.

You can have your PCP prescribe the PPIs for you, but you will want to visit a top-quality ENT to scope your throat. Usually ENTs in cities are more familiar with this problem, especially if they see a lot of singers. To confirm the diagnosis, all they need to do is a quick in-office procedur where they insert a thin wire with a camera at the tip up your nose and down your throat. Reddness and swelling in the larynx area is usually very obvious and is confirmation of LPR.

However, LPR is considered to be such a debilitating condition, there is no need to have the scope done in order to start treatment. Just get a prescription for Nexium at the dosage I stated and begin taking it right away. Relief of symptoms is actually considered sufficient diagnosis of LPR in many cases.