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kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/25/2011 6:10 PM (GMT -6)   
I have been having issues with constant throat clearing, globus sensation, coughing and it is driving me insane. Been to the ENT 4 times - 2 months of double Prilosec and 3 weeks of Dexiland and NOTHING....then took a course of Prednisone and NOTHING. I've changed my diet - juicing, probiotics, enzymes, ACV etc but it continues. I am so fed up with this. Is anyone out there who has found a cure for the throat clearing - I can't even go to a movie? I have not been definitely diagnosed w/LPR (my insurance will NOT cover this) - could it be anything else. I have had a barium swallow test which shows a slight narrowing of the esophagus and the muscles aren't working properly. The ENT wants me to have a endoscopy which I cannot afford and I don't even know if that would do any good. I am getting really discouraged over this - it's been going on pretty much non stop since August. My throat is so sore and scratchy - if I don't get some relief soon I will go nuts. Any suggestions will be appreciated.

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 11/25/2011 6:47 PM (GMT -6)   
I totally empathize with you and your LPR symptoms.  I was a professional singer, but lost my voice over a year ago.  At its worst, I could hardly speak, but now have managed the symptoms so I can speak normally for short periods of time.
 
Your insurance won't cover GERD/LPR?  Are you sure?  Sounds like you're good with your prescriptions?
 
Unfortunately, you're going to need the EGD (endoscopy) to definitively diagnose your problems.  During the procedure, you should also have a Bravo pH probe implanted in your esophagus to record reflux episodes over a 48-hour period.  On top of that, I would also recommend upper, mid, and lower biopsies to test for eosinophilic esophagitis.  Eosinophilic esophagitis commonly occurs alongside reflux, and the symptoms are similar.  EE can be treated effectively, however.
 
Are you sleeping on an incline?  That will help a little, but won't completely eliminate the symptoms.  Six inches is recommended, but in my experience, twelve to sixteen inches is better.  Don't mess with elevating the bed frame...just get those foam wedges from Bed, Bath, and Beyond.  (Keeps the bed friendly for your partner, too!)
 
The reason the prescriptions aren't helping much is because they only reduce the stomach acid, but do nothing to stop the non-acid components of reflux, such as bile, etc.  These can almost be as irritating/corrosive as acid. 
 
LPR is a special complication of GERD.  Not only is the LES weakened, but the pharyngeal sphincter too.  The esophagus is tough enough to handle a small amount of reflux episodes, but not the delicate tissues of the throat, bronchial tubes, lungs, etc.
 
Some folks respond better to different PPIs, so it's worth a try to experiment with different ones.  Be sure to check the manufacturer's website for coupons before going to the pharmacy -- it can save you a lot.  I can't take PPIs because they cause massive headaches, but I experienced the most relief from Nexium.  I tried omeprazole, Dexilant, and Aciphex too, but none of those worked as well for me.
 
Best wishes.
 
-Bruce

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/25/2011 7:03 PM (GMT -6)   
Thanks for your answer Bruce - my insurance won't cover anything to do w/reflux because it's a pre-existing condition.
I do sleep elevated but I'm not sure how much good it does. I have been diagnosed with EE from an endoscopy several years ago - it was where the esophagus enters the stomach and I have was having horrible bouts w/nausea. I took Endocort a steroid and after just a few days I got some relief. It's the throat clearing that is driving me crazy - it keeps my throat so sore. It goes on for hours and hours and hours. The only relief I get many days is when I'm sleeping. Then I get up in the morning and as soon as I eat something everything goes haywire. It feels like my throat is full of mucous and the whole cycle starts up again. Now my left ear is hurting probably from all the throat clearing.

The endoscopy will cost several thousand dollars and I just can't handle that right now. Even if my insurance did cover it I have a $5,000 deductible. So basically it's going to come out of pocket one way or the other. I keep hoping for a miracle but it hasn't happened. I'm not taking the PPI's - I just couldn't see that they were doing any good at all and I know they aren't all good for you.

I haven't been keeping the diet as well as I should - this week has been super busy but next week I hope to get back to juicing again on a regular basis, do the enzymes, probiotic and lots of fresh vegetables, fruits and salads. Most raw foods are not acidic and enzymes allow the stomach to work on the food in the order it is supposed to be digested - enzymes in the top stomach area and then acid in the lower chamber. But right now I can feel the burning in my throat like something is backing up into it. It is soooooo frustrating.

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 417
   Posted 11/25/2011 7:48 PM (GMT -6)   
I use a Pulmicort inhaler for my eosinophilic esophagitis.  I'm currently at two puffs, twice per week.  It helps keep the eosinophil count down, but I'm fairly certain it's a reaction to the reflux, and until I eliminate the reflux...
 
I think it might be worth talking to your doctor about the cost, or perhaps getting in touch with a University hospital.  It's possible that a run-of-the-mill procedure like an EGD could be part of a teaching curriculum, and maybe you could be offered some sort of deal.  Worth a shot.
 
A couple of suggestions that I learned as a singer for throat ills, and it helps with the reflux some as well.  Slippery elm lozenges are OK for a portable relief when needed, and DGL licorice will help the throat a little, and also if your stomach is a bit upset.  The best thing for throat and vocal cords, though, is to put a quarter teaspoon of Manuka honey in your mouth before bed, and don't swallow.  Again, none of these are going to eliminate the problem, but they do help soothe a bit.
 
There aren't good standards for Manuka yet, and quality control can vary.  The best is Wedderspoon, available on Amazon among other places.  The Vitamin Shoppe carries Y.F. Bee Farms, but I've found that this one varies in quality.
 
I know it's hard, but you have to break the subconscious urge to clear your throat constantly.  That compounds the damage.  Try the lozenges.
 
Best wishes.
 
-Bruce

sunbeam48
Veteran Member


Date Joined Jun 2011
Total Posts : 795
   Posted 11/26/2011 9:47 AM (GMT -6)   
You might do better on a diet specifically designed for GERD/LPR. You can scroll back not too far, and find the thread I started about the Kouffman diet. It has helped me a great deal: no more coughing, only occasional throat clearing. I am back to singing in the church choir. The wedge I had been using I felt wasn't getting me high enough, so I bought an electric bed. I eat nothing after 6:00 pm, but not all food gets digested in 3-4 hours, I think it takes six or so. I go to sleep nearly upright, then lower the bed somewhat later in the night, when my stomach is actually empty.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 11/26/2011 8:34 PM (GMT -6)   
Hi Kaylajane,
I believe this is your missing post. turn
Sorry to hear you're having such trouble.  Without health insurance that covers your problems, its difficult for you, I'm sure.   You've had some great responses to your post so far. 
 
Since you can't go the medical route, the interventions that are mentioned here are probably your best bet.  You'll have to be super careful with your diet, eating small meals, and never eating 3-4 hours before going to bed.   Sunbeam's reference to the Kouffman Diet would certainly be worth looking into. 
 
Good luck with your search for answers!
Denise

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/26/2011 8:38 PM (GMT -6)   
Sunbeam - I was reading the about the Kouffman diet before I FINALLY found my post had reappeared. I had downloaded another paper done by someone with LPR and he says that most fruits are no acidic if they are raw - I juice carrot/apple in the morning sometimes with a 1/2 lemon and some ginger - It's so hard to know what to believe - one person says one thing and someone says another. I've seen in two different sources that lemon is acidic until it hits your stomach and then becomes alkaline. I know enzymes work in the top part of the stomach and acid works in the lower chamber so uncooked foods that all the enzymes are perfect for the digestive process. Raw tomatoes are even supposed to OK - the cooked are high in acid. I have cut a lot of stuff out of my diet but not to the extent I need to. Fish and chicken, lots of salad and I've started using ACV/olive oil dressing, juicing etc. However it doesn't seem to matter what I eat - the mucous starts in as soon as I've eaten most anything. It is so frustrating.
Bruce - I will get the lozenges you mentioned - I've seen slippery elm mentioned on several sites. If this is still going on the first of the year I may have to break down and go see the gastro doctor. I hate the thought of what this is going to cost. I am sorry you can't sing anymore - that must be so heartbreaking.

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/26/2011 8:41 PM (GMT -6)   
Thanks Denise - I don't know why this showed up all of sudden - this morning I checked and it wasn't there and it wasn't there an hour or so ago - It showed up after I asked about it. Weird. I am trying the diet thing but I'm a weakling lol. I definitely eat better than I used to but apparently it still isn't good enough. I may have to invest in a book about this and try to do better.

Jesper A
Regular Member


Date Joined Nov 2011
Total Posts : 131
   Posted 11/27/2011 8:53 AM (GMT -6)   
Hi Kaylajane!
Your symptoms sounds exactly like mine. For almost a year my life just got more and more difficult, with panic attacks several times a week due to the mucous building up and the feeling of choking. Just like you describe it I woke up in the morning feeling good and happy and from breakfast to bedtime it just got worse and worse.

The first life changer for me was when my doctor doubled my dose of PPI’s. I went from 30 mg Lansoprazole once a day to 30 mg twice a day. From that moment my life got so much better. No more panic attacks, less mucous and less hoarseness.

However it never went away totally and 20 days ago I got a Nissen Fundoplication. I am still recovering from this procedure but aleady at this early stage I feel small improvements. I am not sure if you can get a Fundoplication due to the results of your barium swallow but I would suggest you to try the different PPI’s before thinking of the operation.

I have myself tried different PPI’s and it is very individual which ones help. I know a lot of people here prefer Nexium but to me Lansoprazol worked much better. Actually I have also experienced different brands of Lansoprazole is better that others, so I really recommend you to test them all for yourself!

You can find a lot of material on the web warning you against PPI’s and of course it would be better not to take them. But compared to other medicine you could be forced to take due to a chronic disease the side effects are very minor and you can take them for many years without any problems. For me it was a simple question of being able to live a happy life and a have job and as such a really easy choice!

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/27/2011 10:15 AM (GMT -6)   
Thanks Jesper A - I realize I may have to get back on them if the diet doesn't work. It is just so irritating - this constant throat clearing. I hate to think of that surgery because I understand it isn't reversable if it doesn't work. I certainly hope you have good results. Thankfully I haven't had the panic attacks but I have had the choking feeling and sometimes I go to swallow and it's like the muscles don't work anymore. I just sit there and tell myself to stay calm and finally I can start swallowing again. Did they ever find out just what your problem was?

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 11/27/2011 10:34 AM (GMT -6)   
Hello KJ and welcome to HealingWell.  You have had great responses from our members and I am glad you have joined us.
 
This appears to be your original post as it corresponds to the date and time you joined the forum. Occasional there is a fluke when posting but I am glad to see your thread is right here where it belongs.
 
Also anytime you have a problem with posting or the forum feel comfortable in sending me an email and I will try to figure out where the problem is.  I look forward to getting to know you and again, a warm welcome.
 
Kindly,
Kitt
~~Kitt~~
Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.

www.healingwell.com

"only as high as I reach can I grow, only as far as I seek can I go, only as deep as I look can I see, only as much as I dream can I be"

Jesper A
Regular Member


Date Joined Nov 2011
Total Posts : 131
   Posted 11/27/2011 11:45 AM (GMT -6)   
When I had my 24 hour PH test I came out with Demeester score of 25 and I had a gastroscopy which showed a small hernia. Those facts plus the positive effect of PPI’s made my doctor conclude that I was a candidate for the surgery, if I was not fully relieved by the medicine.

No, the surgery is not reversible however it can be tighten more or less if you have trouble after the procedure, iut helps more than 90% of people having the surgery. After having taken the PPI’s for about a year, and having no chance of full recovery by diet and medicine, it becomes a much easier decision. If you ever get there you can get a lot of info about the surgery and recovery on this site.

sunbeam48
Veteran Member


Date Joined Jun 2011
Total Posts : 795
   Posted 11/28/2011 5:29 PM (GMT -6)   
Kayla,
I don't know what paper you read, but the sources you talk about are not discussing the actual pH of food, but rather a digestive product. Those of us with GERD/LPR need to worry about actual pH, which is acidic for most fruits according to Dr. Kouffman's testing. It is easy to adjust for a lower pH with calcium carbonate, so acid foods are not a problem if you reduce their acidity. Fats, on the other hand, should mostly be avoided.

kaylajane
Regular Member


Date Joined Nov 2011
Total Posts : 61
   Posted 11/28/2011 6:40 PM (GMT -6)   
The paper was from an on-line search that pulled up a research paper from an lpr sufferer. It made a lot of sense - he talked about the way the digestive systems works etc. The upper chamber of the stomach works w/enzymes which is why we need a lot of raw foods (cooked and processed food have destroyed enzymes) the lower chamber works w/acid - at that point the enzymes are destroyed but have started the digestive process and you need less acid to finish the job. Anyway - I ordered the book today from Amazon and will definitely give it a try. I would still like to know why ginger ale would be all that bad for you. I noticed that ginger is on the list. And I will definitely buy some calcium carbonate - sounds like something that would help.
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