NOTE: If you experience frequent heartburn then the following post will most likely be irrelevant to you.
Hey there guys...
For those of you who aren't familiar with me, I have had LPR for 3 years and was strongly considering getting the Nissen done. Well now, thanks to a visit to the doctor's office.......I don't have LPR anymore. You read that correctly. I went to a GI Doctor at a university who my ENT referred me to to get the Nissen. I walked in and he asked me my symptoms and what drugs I had been on. He then proceeded to tell me that it was basically impossible for a fit, healthy 20 year old male to still have significant reflux after I had tried all 4 PPI's and made lifestyle changes. I got so angry I almost walked out of the room but my father calmed me down a bit.
He then went on to say that the GI community is in a kind of tussle with the ENT community in that whenever people come in to ENT appointments with Globus, Burning, and Post-Nasal Drip they automatically diagnose them with LPR and send them on their way. He said that he has seen hundreds of LPR patients go through with the Nissen and for a significant portion of those patients the surgery helps only about 20%. He said that the GI community believes there is a disorder with a large percentage of LPR patients of some nerves that have been damaged from some event (virus, particularly sudden onset cases) in which they become "hypersensitized." He went on to say that he has seen great success with about 50% of LPR patients who take an anti-depressant called Elavil that "balances" out the nerve.
I am going to interrupt my story to add some information I have garnered in the past week on my research from this "hypersensitivity." :
When damage happens to your throat, or anywhere on the body, your nerves become hypersensitized so it becomes painful. For example, your knee would hurt unbelievably if you tore your ACL, so you wouldn't attempt to run (common sense). 99.99% of the time, the nerves heal from this "hypersensitized" state once the physical damage
is fully healed. In a large amount of these LPR patients, the physical damage (from a virus, infection, screaming like hell etc) heals normally but the nerve does NOT. It stays in this hypersensitized state, thus being irritated horribly by normal, incredibly tiny amounts of acid. An ENT research paper I came across compared it to getting a 3rd degree burn on your arm, healing perfectly, but still having incredible pain to the touch after it heals.
This research made immediate sense to me because I only really had super-intense burning and a lump on ONE side of my throat. Now if abnormal and damaging amounts of acid were actually coming up, wouldn't you think it would irritate both sides? Also, if any damage was actually happening to my larynx, then why was I able to sing and use my voice perfectly on stage.....but be hoarse off of it? Because NO ACTUAL DAMAGE had happened from LPR, but my nerve cells put me in so much pain all of the time that I thought I was hoarse unless I absolutely had
to use my voice......are you following me?So anyways, I have been on Elavil (25 mg) for 6 days and 90% of my burping and reflux is gone and my throat is healing at an amazing rate and I am probably a couple of months from being 100% normal again.
I know this post is all over the place and disorganized so let me get some quick thoughts in I missed:
1. If you have never had an incident of throat reflux while asleep, and always had your throat feel good after awaking, this post is probably particularly important to you. Because if your sphincters were actually bad, then you would most likely have frequent horrible nighttime reflux.
2. To Clarify: I was experiencing Acid Reflux and that IS what was doing the damage. But I do not believe I have abnormal amounts of acid, it just felt like I did. The PPIs DID help, they just only helped 60%.
3. If you want to research this yourself, search "Laryngeal Sensory Neuropathy" or "irritable Larynx syndrome" or "laryngeal hypersensitivity"
4. LPR specialist Jamie Koufman is reportedly increasingly treating SOME of her patients with Elavil and other nervous system drugs.
TO CLARIFY: LPR is a legitimate diagnosis for a good amount of patients, but some have this "hypersensitivity" and do not have abnormal LPR.
5. If someone wants to sticky this after a while if this ends up helping people, then please feel free to do so.
Post Edited (Jacket923) : 10/6/2011 7:53:39 PM (GMT-6)