upset with burning throat

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New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 7/31/2009 7:01 AM (GMT -6)   
I am new to here and please help me.
I found out my stomach pain a month ago and then the sore throat,post nasal drip and clogged ears.
GI doctor gave me an endoscope 2 weeks ago and mentioned my pylorus was wide open. So my gastritis was likely related to bile. There was edema and erythema of the GE Junction without associated ulceration. The esophagus was normal.
I noticed that I don't have any chest pain and all my symptoms go away during night time. Acturally,the sleeping time is the only time I feel comfy! I wake up every morning as a healthy woman as before but soon I feel the burning throat.  
My GI doctor said that she thought my pylorus has been like this for a long time and my body was used to it but something must have triggered (stress,anxiety etc.) my gastritis recently.  
I asked her if it is possible  that bile  triggered my upright reflux and she told me she has no answer for me.
(Can bile reflux cause LPR?  My GI dr said she never heard about LPRD. neither my family doctor. mad )
Gee, now i even feel i have problem to swallow food. And the burning feeling of my throat really adds stress to my everyday life. As a 31 year old mom of 3 young kids, I really wish I could get well ASAP.
My GI gave me Carafate and Nexium(40mg per day).  After 3 weeks, I really don't see any improvement. In a few nights, I even tried to rush to emergency room because my burning throat was about to kill me.
Went back to her office yesterday, she simply told me that she had no answer for me and Nexium+carafate is the best she can offer.  She even said 99% of the people would response to this combination and she didn't understand why I won't feel  better. shakehead
I think I will need to find another GI doctor. 
Anyone here from Maryland? Any good GI doctor recommended?
Is LPRD curable? Is bile reflux curable? rolleyes
Thanks a lot!

Forum Moderator

Date Joined Apr 2007
Total Posts : 32602
   Posted 7/31/2009 7:40 AM (GMT -6)   

Hello and welcome to HealingWell and the GERD/Heartburn Forum. 

I am very glad you found us.

I agree you need to seek out a second opinion.  I am posting a link for you re the difference between GERD and LPRD and I hope it helps you.  I am sure other members will have some input for you too.

Just click on the link.

Kind Regards,



Moderator: Osteoarthritis, GERD/Heartburn
Anxiety/Panic, & Depression
*~* *~*
"When you find peace within yourself, you become the kind of person who can live at peace with others."
Not a mental health professional of any kind

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 7/31/2009 8:06 AM (GMT -6)   
Thanks a lot Kitt.

I've been in this forum for a while at the very begining when I just found out my symptoms.(Google lead me here!:)) Thank God!
And thanks to the knowledgeable members like you, kitt, I've been followed so many links and read the articles about GERD and LPRD.With the information gathered here, I even thought about to go to NYC to consult Dr. Jamie K.(too bad she doesn't accept any insurance.)

One of my family doctor pointed out one thing that my voice is still good which led him draw the conclusion that my ear&nose&throat problems are caused by my stress. I do have muscle spasm around my neck and shoulder. (Had my MRI done yesterday and will go back to my othopedics next week for further discussion.)
Another famuly doctor who also doesn't know LPRD had the same impression that my reflux happends at daytime only because I am way too stressed that at night time when I fully relaxed my reflux disappers.

What can I say? My ENT doctor was about to see me today but there is an emergency surgery so I have to wait till next Weds.
At 8 o'clock I was so symptom free but already in such pain in 10 o'clock. The burning throat really add stress to me on top of other worries. Do i have reflux esophugitis now? How my esophagus deal with the acid/bile? Will I be able to go back as a healthy mom as before? Will I see all my kids go to college and have weddings? I know I worry too much but at this point I am just to depressed.

Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 7/31/2009 4:41 PM (GMT -6)   
Have you had a motility study done? It's called a momoetry test? Or a BRAVO test for acid readings?


New Member

Date Joined Jul 2009
Total Posts : 3
   Posted 8/1/2009 6:17 PM (GMT -6)   
Its exactly what I have, LPR.
I have gone through the exact experience as you, except that I am struggling over a year now with this.
Nexium and all the similar derivatives don't make a difference. It could be that we are probably having another problem which these pills are pretty useless to control. How it works on so many people, is a mystery to me (unless its silently supressing the symptoms and they still are getting that liquid going up beyond the LES)
I am in NYC and no way going to pay $1000 to see  a doctor (who does not take insurance), to just say oops, your throat area is all red and you need surgery.
From consulting top doctors in the NY/NJ area, they are saying there are too many failures with the nissen, despite sending to top doctors in the NY/Philly area, and even from renowned Univ/Colleges where these surgeons are located.
All in all, the acid does come up, and it could be a misbehaving stomach, gas and other upward pressure exerted which breaks through the 2 sphincters.
I have done EVERY-SINGLE-THING (perfect diet, changed to a 9-5 job, no-stress, sleep at least 6 hours), and not found it makes much of a difference. Reducing stress, seems like the best option and of course try and get as much sleep. it helps..
Contacting top doctors (even from Ivy league schools) is useless, since they have nothing to offer, besides data which is already on the internet (i was even surprised, I knew more than them). And many of these gastros, are pretty-much static with information.
Overall, i blame myself for landing in this mess in the first place. My bad habits: working too hard so i could provide for my family with 2 kids, eating odd times, sleeping late, and not detecting the acid was creeping slowly inch by inch every year.
The muscle spasms could be the acid going in the lungs.. Although i hope its not in your case, but muscle/upper pain, could be related to it.  I wish the wind-pipe was not located next to the food pipe :(

Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 8/1/2009 7:22 PM (GMT -6)   
Have you enquired about the Esophyx procedure? It's new but you can find out who does it in your area. Most insurance approves it since you don't have a hospital stay in most cases. Check with the American Gastroenterologist listings to see who is quailfied to do it in your area and contact them by email asking about insurance. That's what I did. My procedure will be in a few months as soon as my HH size is determined okay.


New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/2/2009 5:48 PM (GMT -6)   
Thanks a lot for all the input. I am writing this post with tears...

My family doctor thinks my anxiety caused all the problems and suggests me to take zoloft again and again. She DOES believe I feel the pain but she thinks anxiety makes the pain so unbearable.

I now think my problem is about bile reflux and acid reflux because I do feel the bitter taste in my mouth. I am such a unlucky one with LPR and on top of that, bile reflux. I really lost my hope now. My hubby just tries to push my take zoloft. He doesn't understand how I suffer from that burning sensation every single second. gee.......... lord,how can I live like that?!!! I am losing my mind now. All the doctors I visited think I am just a over-stressed crazy woman.

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/3/2009 5:18 AM (GMT -6)   
nel_joseph and Joy,thanks a lot for the information.

Another question, what's the result of your 24 ph test? If the result is normal, have you ever thought about bile reflux?
If you have bitter taste in your month, the first thing any chinese doctor would mention is that you might suffer bile reflux which almost all the american doctors don't know much about it.

Here is the link for an article i found out yesterday.
(The symptoms are similar to heartburn, and many sufferers are told they have gastroesophageal reflux disease, known as acid reflux. Yet treatment with popular remedies for acid reflux, like the acid-suppressing proton-pump inhibitors Prilosec, Prevacid and Nexium, fails to work or gives only partial relief. )
That could explian why Nexium doesn't work for me at all. And might explain why some people here mentioned when you are in great refulx pain, when all the PPI lost their magic power, try some VINEGAR! If VINEGAR works for you and all your PH tests turn out normal, then you might be a bile reflux suffer instead of a GERD suffer.

Why american doctors do not know much about bile refulx? why they only think about acid all the time?

I am about to see an ENT and another GI this week. If I find out they knew nothing about bile reflux, I will buy ticket back to china and see some good doctors there.

Good thing is I do have support from my family back in China. They sent me some herb medicine recipe. I am taking it and will keep you guys updated. If it works for me I will post the recipe here. You can go to any chinatown pharmacy to get those traditional herbs and give it a try.

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/3/2009 5:20 AM (GMT -6)   
The Damage of Reflux (Bile, Not Acid)

Published: June 29, 2009

In describing an instance of intense anger, you might say, as a figure of speech, that bile rose in your throat. But for some people bile does indeed rise, perhaps not as far as the throat but far enough to cause digestive distress and serious damage to the lining of the stomach and esophagus.

The symptoms are similar to heartburn, and many sufferers are told they have gastroesophageal reflux disease, known as acid reflux. Yet treatment with popular remedies for acid reflux, like the acid-suppressing proton-pump inhibitors Prilosec, Prevacid and Nexium, fails to work or gives only partial relief.

That’s because acid reflux is, at most, only part of the problem. The main culprit is bile reflux, a back-up of digestive fluid that is supposed to remain in the small intestine, where it aids the digestion of fats.

Bile is not acid. It’s an alkaline fluid consisting of bile salts, bile pigments, cholesterol and lecithin. It is produced by the liver, stored in the gallbladder and released intermittently into the duodenum, the upper part of the small intestine, when needed to digest fat. (Bile continues to be produced as a digestive aid even after the gallbladder is removed.)

Misdiagnosis of bile reflux and failure to control it can result in serious, sometimes life-threatening problems — stomach ulcers that bleed and Barrett’s esophagus, a possible precursor to esophageal cancer. Yet misdiagnosis is common, and even when the condition is properly identified, doctors are often fatalistic about its management.

‘Shadow Land’

Raymond Kozma of Staten Island said his wife, Lynne, 52, developed bile reflux after surgery to remove her gallbladder and had been “in constant daily pain” for the last two years.

“We have had doctors say everything from ‘There’s no such thing as bile reflux’ to ‘There’s bile reflux but we can’t do anything about it’ to ‘You just have to learn to live with the pain,’ ” Mr. Kozma wrote in an e-mail message. He urged me to write about the condition, saying that “thousands of suffering people live in a ‘shadow land’ because of the denial and disinterest of the medical profession” in bile reflux.

Although the condition is certainly not unknown, there is a relative lack of information on it in major medical journals read by nonspecialists. Mr. Kozma said his wife had now developed Barrett’s esophagus and, instead of being offered treatment, was told to return in three years to have another endoscopic look at her damaged esophagus. “What are we supposed to do? Wait and see if this develops into cancer?”

No one with bile reflux needs to just wait for worse to come, although the remedies are not as simple and well known as they are for acid reflux. The condition usually can be managed with medications, but severe cases may require surgery.

Symptoms and Causes

Both acid reflux and bile reflux may afflict the same person, which can make diagnosis a challenge. But the stomach inflammation that results from bile reflux often causes a burning or gnawing pain in the upper abdomen that is not felt with acid reflux, according to experts at the Mayo Clinic. Other symptoms of bile reflux may include frequent heartburn (the main symptom of acid reflux), nausea, vomiting bile, sometimes a cough or hoarseness and unintended weight loss.

A brief anatomy lesson makes the problem easier to understand. The main organs of the digestive tract are separated by valvelike tissues that, when functioning properly, allow food and digestive fluids to pass in only one direction: down. Thus, as food and liquids pass through the digestive process, they normally travel from the mouth to the throat, then down the esophagus into the stomach, and finally into the small intestine. The opening between the esophagus and stomach, a muscular ring called the lower esophageal sphincter, is meant to keep stomach acid from backing up. When it malfunctions, acid reflux — chronic heartburn — is the usual result.

Likewise, the pyloric valve, the muscular ring between the stomach and small intestine, is supposed to open just enough to permit a fraction of an ounce of liquefied food to pass into the small intestine, but not enough to allow bile to back up into the stomach. When this valve fails to close properly, refluxed bile can cause gastritis, an irritation and inflammation of the stomach lining. Untreated, that can result in a bleeding ulcer or even stomach cancer.

If the esophageal sphincter malfunctions at the same time, or there is a build-up of pressure in the stomach, bile and acid can reach the lower portion of the esophagus, inflaming the delicate lining of this organ. If the problem persists, it can cause scarring that narrows the esophagus, which may result in choking, or the cellular abnormality called Barrett’s esophagus, which can become precancerous and eventually develop into cancer that is nearly always fatal.

Gastroenterologists have recently demonstrated that Barrett’s esophagus can often be effectively treated with radiofrequency therapy, which might help patients like Mrs. Kozma.

Bile reflux can occur as a complication of certain surgeries, like the gallbladder surgery Mrs. Kozma underwent. More often, though, damage to the pyloric valve results from gastric surgery — total removal of the stomach or the gastric bypass operation used to treat morbid obesity.

Occasionally, the pyloric valve is obstructed by a peptic ulcer, for example, or scar tissue, which prevents the valve from opening enough to permit quick transport of stomach contents into the intestine. That causes pressure to build up in the stomach, pushing both acid and bile into the esophagus.

Diagnosis and Treatment

The main diagnostic tests include an endoscopic examination of the esophagus and stomach to check for inflammation or ulceration; a test to check for acid in the esophagus (this would be negative if bile reflux is the only problem), and a test to determine if gas or liquids reflux into the esophagus.

A medication called ursodeoxycholic acid can be prescribed to promote the flow of bile and reduce the symptoms and pain of bile reflux. Other drugs might be used to speed the rate at which food leaves the stomach.

Surgery is a treatment of last resort, used if nothing else reduces severe symptoms of bile reflux or when the esophagus develops precancerous changes. The most common operation, called Roux-en-Y surgery, involves creation of a new connection to the small intestine to keep bile away from the stomach.

If acid reflux is also a problem, treatment with a proton-pump inhibitor should help, as should nonmedical remedies including weight loss; limiting high-fat foods and alcohol; avoiding carbonated and acidic beverages, spicy foods, onions, vinegar, chocolate and mint; eating small meals; practicing stress-reducing techniques like meditation or exercise; not eating within two to three hours of bedtime; and sleeping with the upper body and head elevated.

Regular Member

Date Joined Mar 2009
Total Posts : 171
   Posted 8/3/2009 10:18 PM (GMT -6)   
Hi QQ31,
I am Maria,
I saw your post regarding to Acid Reflux /Bile Reflux and LPR thing.
I also sufffer from Acid Reflux and Bile Reflux. While back in mid 2008, I was having this horrible burn throat. Actually, I was having both at the same time.
Burning throat plus, and a  strange electric shocking pain on top of my burn. It was really weird - paing - painful. So, I went to a few GI dr., none have any clue. One of the GI even yell at me and scold at me - stating that there is something in my head.
Anyhow, I do some research and find bile reflux on the internet.
Went back to another GI, and spoke to hime about bile reflux, and he gave me this med:  Cholestyramine  - I took that for a month and it did help me with the bile reflux.
QQ31, If you see your GI dr, ask your dr he/she to prescribe your this type of med for bile reflux. It is called:    Cholestyramine. This med did help me with my bile reflux!
I think we have bile and acid inside our stomach. Bile and acid work together. I think if our LES is not working, I believe we can experience acid reflux and bile...
Take care.

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/4/2009 10:39 AM (GMT -6)   

Thanks a lot for your information.

I am on the edge of losing control. Thanks a lot for your understanding. Only people who suffer from reflux can understand how I feel.

Have an appointment with an ENT doctor tomorrow. Hopefully he will understand bile reflux esphagitis and LPRD and have a solution for me.
Can't imagine how I can live like this for the rest of my life. Really want to cry.

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/4/2009 10:41 AM (GMT -6)   
QQ31, If you see your GI dr, ask your dr he/she to prescribe your this type of med for bile reflux. It is called: Cholestyramine. This med did help me with my bile reflux!

-----Got it! Definitely will ask my GI(a new one this Friday) about this!

Thank you Maria. I wish I could hug you. I am so glad that somebody on this planet knows that I am not insane and my pain is NOT caused by anxiety.

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/4/2009 11:05 AM (GMT -6)   
I am trying traditional chinese herbs to treat my bile reflux now. Have to say the taste is soooooooooooo nasty. Being on it for a week hasn't helped me at all but all the traditonal herbs heal root issues and it definitely takes time. If I see improvement, I will share.

Regular Member

Date Joined Mar 2009
Total Posts : 171
   Posted 8/4/2009 1:20 PM (GMT -6)   
Hi qq31,
How are you today?
qq31, do you have any test done prior to your bile reflux?
Do you have the manometry and 24PH study done?
I heard that mamometry is to test the strength of your les and esophagus and 24 PH study is to test how much acid in the esophagus. I also heard someone stated that 24PH study also can see bile reflux.
qq31, as for me, I had very bad reflux - as this state - my dr recommand me for surgery. I am still waiting for my insurance.
You know qq31, when I had my bile reflux - it hurt so bad. I spoke to everyone, but I didn't have a solution then. I went to one of my GI, he say there is nothing wrong with you. It is in your head.
I told him that I taking nexium 20/20 day and evening and it doesn't seem to help at all.
The burning was so bad!
He say I worry too much. He got so mad that he yell at me to come back in a month to see him. I never did come back to see him cause he neve listen to my problem.
I did some research on the internet and saw acid reflux, bile reflux, and lpr - which I wasn't quite sure. So I went to another GI, I spoke to him and he say ok - let try this and that.
Finally when he gave me the Cholestyramine for bile, as soon as I get that, I tried it, wow - it seem to calm the reflux. I went back a week and spoke to the GI. He told me to continue that for another month. If I get better, than he say stop taken it.
I learn to eat small portion many times a day. I think it help a little. I also do meditation - it help a little also.
qq31, you can email me - if you have any question. We all gonna get this problem solve one way or another. qq31 stay strong - we will be ok. We are learning this togetther as we go.  Take care for now :) I will talk to you more :)
Thank you.

Post Edited (mariex800) : 8/4/2009 1:37:23 PM (GMT-6)

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/4/2009 4:49 PM (GMT -6)   
Marie,I haven't been so touched for a long long time. You are such an angel to on earth. Your words give me more strength to deal with this ordeal. HUGS!!!

New Member

Date Joined Jul 2009
Total Posts : 12
   Posted 8/4/2009 5:07 PM (GMT -6)   
Marie, you can't imagine how ridiculous my GI is. She just simply told me that "I don't why you have bile reflux and since you don't respond to Nexium which is the best PPI on the market I don't have anything else for you."

For all the tests (24 ph test etc), she didn't mentioned that at all!

I have no idea why she doesn't give me an ultrosound about my gallbladder either. Last week I had 2 nights that I simply just couldn't bear the pain and I almost went to the ER. Called her office the next day and her suggestion to me is to see an ENT for the burnig throat or go to ER. But she did suggests me to take double dose of carafate(from 1 tsp to 2 tsp).
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