Not sure I can take much more of this...

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/17/2012 7:34 PM (GMT -6)   
I haven't been here in a while, as most of my symptoms have been and remain under control (as long as I take Dexilant). 
 
However, I can't get rid of this lump in my throat. It drives me crazy every single day. I've had it for almost a year now and I feel like I'm at the end of my rope.
 
Right now I don't have health insurance (just switched jobs). My ENT wants me to undergo an esophageal functioning test and a 24-hour pH test. These tests are being done in the beginning of February, since my insurance will pick up then. Depending on the results of the tests, the ENT may end up injecting botox into my cricopharyngeal muscle to force it to relax. But he'll only do it if I have acid reflux. If I have non-acid reflux, he won't do it (at which point I may start begging him to go through with it anyway.) I'm not sure why he won't use the botox if I have non-acid reflux. He believes the only cure for non-acid reflux is nissen fundoplication surgery. I know I have acid reflux, but the ENT says it is possible to have both non-acid and acid reflux at the same time.
 
Is there anyone out there who has had the botox injection? If so, does it work?
 
Has anyone suffered from the lump in throat sensation and had it go away after nissen fundoplication surgery?
 
I've been on all sorts of meds (flexeril, klonopin, various anti-depressants) and nothing helps.
 
Any feedback is greatly appreciated.

Nal
Regular Member


Date Joined Jan 2006
Total Posts : 410
   Posted 12/17/2012 9:02 PM (GMT -6)   
Hello.  I know that lump feeling too well.  Have they looked into your stomach? What is the medicine for that you are taking?  I have had 2 botox injections into my esophageal sphincter muscle.  I had a fundoplication procedure last year and have a ton of problems since.  Anyway, I cant say that the botox has helped in my situation.  However just having that muscle dialated has helped me out but its temporary.  There is medication they can give you that is supposed to help relax that muscle (its used for heart problems too).  Maybe that will help?

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 12/17/2012 10:55 PM (GMT -6)   
Does the PPI help your throat?

I had throat symptoms (tightness, like needing to swallow constantly) that improved a bunch when I started a PPI, but continue somewhat now that I'm on PPI.

I'm having fundo in a few weeks from now. My 24 hour test showed excessive amounts of "weakly acidic" reflux (same as nonacid) and also, that a higher percentage (60%) of my reflux episodes made it to the proximal sensor on the probe. I think that explained my throat symptoms. I did have a "normal" DeMeester score, but that does not take into account nonacid reflux nor proximal extent of reflux.

It is a good thing that your doctor is already thinking about fundoplication. Since I had a negative DeMeester score, a few of my docs initially thought against it and instead tried some "hypersensitivity" medications such as anti depressants and even anti psychotic, no help. Weakly acidic reflux, of bile, pepsin etc. can definitely do a number on the throat. Some advice, when you get your test, ask to get the full results (sometimes called a tracing). They might just give you a summary, but there is more important data they may be leaving out which is why you should get as much as you can.

Anyways I have a long journal thread here which I'll update after the surgery. I can't wait :)

Post Edited (drtinsac) : 12/17/2012 8:58:52 PM (GMT-7)


KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/18/2012 10:24 AM (GMT -6)   
The PPI does not help my throat at all. I'm hoping that I only have acid reflux and not non-acid reflux as well. If my doctor proceeds with the botox and it doesn't work, I guess then next step would be cricopharyngeal myotomy.

I'm absolutely terrified of having to undergo fundoplication surgery, but this lump in my throat needs to go! Not sure if the surgery will help with that or not.

Right now I survive by popping peppermint candy all day long (for some reason it causes the muscle in my throat to relax). I am so sick of them! Unfortunately, eating also helps, so I keep gaining weight.

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/18/2012 10:26 AM (GMT -6)   
drtinsac- I'm assuming you've met with your surgeon at this point. Has he indicated that the surgery will help with throat symptoms?

drtinsac
Regular Member


Date Joined Apr 2012
Total Posts : 458
   Posted 12/18/2012 11:30 AM (GMT -6)   
He said it might. With any "atypical" case, they will not come out and say that the chances of fundoplication helping are as high as they are with heartburn. They are going off of either personal experience or publications, and since most people studied who get fundoplications have heartburn, that is where most of the proof is.
 
I do not expect, and one shouldn't expect, that surgeons (who treat many other diseases besides heartburn), or even gastros or ENTs will be familiar with all the research out there on treatment for the various symptoms of reflux. For that reason, I have done my own research, and I have concluded that there is a very high chance that my symptoms will be helped. After all, fundo is known to decrease all types of reflux, and some of my reflux #s are very high even with a normal DeMeester score. PPI-responsive symptoms are another indication that fundoplication will help, and PPI definitely helped my throat. I do not know why in your case, a PPI does nothing for your throat, but to me that would make me wonder whether reflux was causing it.
 
True PPIs only decrease acidity and reflux still occurs. If there is reflux reaching your throat either way, and it doesn't matter how acidic it is, I'd do more investigation.
 
 
Here is a paper on fundo fixing globus.

ericapeace2000
Veteran Member


Date Joined Mar 2012
Total Posts : 1110
   Posted 12/18/2012 12:44 PM (GMT -6)   
Have you tried chewing gum in between meals? That has got rid of the lump feeling for me
GERD Moderator; Diagnosed GERD, no other medical conditions (this one is enough)

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/18/2012 1:56 PM (GMT -6)   
Erica- If I chew peppermint gum, it does help, but I'm not supposed to be chewing gum. I have invisalign braces and it sometimes sticks to them and makes a huge mess. The weird part about the peppermint is that it is supposed to be bad for reflux but for some reason makes my throat feel a lot better.

I wish that I could just go to my doctor and demand a cricopharyngeal myotomy to fix this! I think it might eventually get to that point.

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1604
   Posted 12/18/2012 3:05 PM (GMT -6)   
I haven't had LPR, just regular GERD but with constant awful sensation of whatever I drink(even water) crawling up my throat all the time. After 2 years of trying everything in the health food store, I've found milk thistle really helpful for the sensation of reflux. Acupuncture is also helping me now - though it took 3 months to kick in.

MMM
New stuff: GERD, Recurrent cystitis/Overactive bladder
Lifelong stuff: Food allergies/intolerance, eczema, asthma

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/18/2012 7:06 PM (GMT -6)   
MMM- Do you mean that you feel the regurgitation? I have that sometimes, usually if I eat too much or drink water too fast. It comes all the way up to my throat and I can feel my UES trying to stop it. The pressure is uncomfortable and usually causes me to burp. Fortunately I've never had reflux come all the way up to my mouth.

I do wonder if the occasional regurgitation has caused my UES to tense up as a compensatory response. If that is the case, I would think that fundoplication would help if it was able to stop the reflux.

I have a question about PPIs. My GI and ENT seem to think that PPIs should stop regurgitation. Oddly, I never experience regurgitation until I started taking PPIs. My GI doctor was very confused by this. He said that the PPI should stop regurgitation. I think the reason why the ENT won't do the botox injection if I have non-acid reflux is because he is concerned that the reflux will go up to my mouth. He told me that PPIs work for acid reflux, but not non-acid reflux. Based on this information, it would seem that he is not worried about regurgitation if I only have acid reflux because the PPIs should stop the regurgitation. However, a lot of reading I have done indicates that PPIs do not stop reflux; they only remove the acid. Is this the case? Or are the PPIs supposed to stop reflux from happening in the first place? If PPIs don't stop reflux, doesn't that mean that everyone successfully treated for acid reflux with PPIs then has non-acid reflux?

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 12/18/2012 8:15 PM (GMT -6)   
PPIs just reduce the level of the acid. If you have a malfunctioning LES and a hiatal hernia then you need the surgery to repair it.

I took PPIs for almost 10 years and the acid was still strong enough to damage my epiglotis.
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, Degenerative Disk and Facet Disease, and Allergies

When life throws you lemons....
Pick them up and throw them right back at them! :))

KitKat880
Regular Member


Date Joined Apr 2012
Total Posts : 132
   Posted 12/19/2012 12:54 PM (GMT -6)   
Joy- That's what I thought, but I don't understand why both of my doctors seem to think that PPIs stop reflux! I guess there is no convincing them.

I'm hoping my pH test shows acid reflux so I can get this botox injection. I'm thinking it's likely that the test will show that, since I will have been off of Dexilant for 7 days beforehand, which I have been taking for over 6 months now. Guess I better prepare myself for the rebound. I don't get heartburn, even without the PPIs, so maybe it won't be so bad.

Even if my doctors are hesitant about surgery, can I insist on a referral to a surgeon? I really don't want to go doctor shopping just to get the referral. (This is if the botox fails or I have non-acid reflux.)

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 12/19/2012 3:21 PM (GMT -6)   
I went on and found my own surgeon since my GI was doubtful the surgery would help me. I had my file sent to him and he did his own tests. I had my surgery 3 months after meeting him.
Joy
Lupus, Fibromyalgia, Glaucoma, Asthma, Hypothyriodism, Sleep Apnea, Degenerative Disk and Facet Disease, and Allergies

When life throws you lemons....
Pick them up and throw them right back at them! :))
New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, September 18, 2018 8:28 AM (GMT -6)
There are a total of 3,004,239 posts in 329,124 threads.
View Active Threads


Who's Online
This forum has 161731 registered members. Please welcome our newest member, gfdag8966988888@outlook.c.
231 Guest(s), 10 Registered Member(s) are currently online.  Details
Psilociraptor, Froggy88, BossJ, Woogy, 142, searchinginla, Lynnwood, Mamatomypeas, straydog, halbert