I know that some doctors put a lot of emphasis on the term LPR and often use it as an excuse not to do the Nissen surgery, since the results are less clear cut than the patient with straightforward food and acid reflux into the mouth, or esophagitis and Barretts.
I was never diagnosed as an LPR patient, however I fit the LPR standard. I had real asthma before my GERD started getting worse, and that asthma got uncontrollable because of the refluxing that was occuring. I never had a large amount of acid refluxing, but because it was hitting my lungs, that small amount of acid was doing a tremendous amount of damage.
I also think that those of us who have a lot of "silent reflux" are in the LPR category. Straight GERD seems to be just those people with many, many reflux episodes, and acid and food regurge into the mouth. Or, those people who have obvious damage to the esophagus.
Those of us who have endoscopies only to find healthy esophageal tissue (even when we're on PPIs, which one would think GIs would take into account) are often relegated to a status that seems to carry the label "unimportant".
GI docs are really mostly focused on those patients with large amounts of acid that has the potential of creating pre-cancerous and cancerous conditions. The rest of us have to stand in the background, seeing our ENTs and our asthma doctors, and arguing that our seemingly non-existant (in the eyes of GI docs) reflux is affecting our quality of life. Unfortunately we are often speaking to deaf ears.
It's a lot more difficult to get noticed, so we have to be a lot more persistent. My GI docs dragged his feet and kept me from pursuing a surgical cure for probably 5 or 6 years, with the last 4 years being unbearable. My PCP and asthma docs were very frustrated, as they couldn't get my lungs cleared up due to the reflux. On one occasion I was in the hospital for a week because of a gastritis induced reflux episode that required high doses of IV steroids to keep me breathing. I'm not sure that most GI docs (at least the ones I've come in contact with) truly understand the impact of LPR style GERD.
I know you face frustration constantly.
I wish you luck in your quest for answers!
Post Edited (dencha) : 12/3/2011 6:45:27 PM (GMT-7)