GERD and voice loss

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minnietoty
Veteran Member


Date Joined Dec 2010
Total Posts : 2805
   Posted 1/9/2014 6:27 PM (GMT -6)   
I'm a Crohn's patient and I posted earlier asking whether GERD can turn into LPR and a fellow GERDie answered that I can have both. Well, I have had GERD for 15 years and for the last 7 years I have been on Nexium 40 mg x 2. Things started to deteriorate lately. Since November I started to have recurrent colds though I took the flu vaccine. I saw my GI as I started to lose my voice. He recommended I see an ENT doctor. I also told him about the chocking episodes I get lately. He said the cause was GERD and upped Nexium to 120 mg/day and Gaviscon advance 4 times/day.
The ENT said tat he could see the GERD in my throat and mouth. For the last 3 days, I couldn't have proper sleep. I already raise the head of the bed, sleep on pillows and follow all the instructions given to a novice GERDie. Being a Crohn's patient in addition to GERD doesn't give me the luxury to eat and my diet is very restricted. I avoid anything that might irritate my stomach. Still, sleeping is a torture for me. I feel the acidity pouring in my throat when I'm sleeping at night. Normally, I wake up coz of coughing.
The ENT doctor had me have a throat culture to identify the appropriate antibiotic to treat the infection as all the options he mentioned would throw me into an intestinal flare up.
How would you normally deal w such a situation? I'm at my wits end.
Thank you.
GERD, gastroduodenitis, ileocolitis, chronic proctitis and persistent mouth ulcers and fissures
Current meds: Pentasa sachets 4g, Entocort 4.5 mg, Nexium 40 x2, Ensure, Calcium and magnesium supplements, Imuran 150mg, Zantac 300mg (not any more), Gaviscon 1x4
Pred 40 mg from Oct. 2010 till Jan.2012
Failed:Azathioprine, Methotrexate

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 1/9/2014 6:44 PM (GMT -6)   
Hi minnietoty,
Sorry to hear you're having so many problems! What testing have you had done? It sounds as if it's time for them. A barium swallow, manometry, and 24hr PH monitor would be in order.

From you description, a Nissen fundoplication surgery, might be the best option right now. Like you, I never do well on antibiotics, as they irritate my stomach and cause gastritis. Thankfully, since my Nissen, I no longer get esophagitis along with the gastritis.

I know surgery is not fun to consider, but if you're getting the amount of reflux you're describing, while making lifestyle changes, a Nissen might just be the answer. The testing I necessary to see if this is a viable option.

Good luck getting to the bottom of it all!
Best wishes,
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

minnietoty
Veteran Member


Date Joined Dec 2010
Total Posts : 2805
   Posted 1/9/2014 7:08 PM (GMT -6)   
Denise, thank you very much. My GI had performed 5 upper endoscopies so far. I had one barium swallow 14 years ago and an SBFT 3 years ago. He never mentioned any further tests. According to scopes, the LES is normal; however, I have GERD.
I still need to see my GI for the results of intestinal and colon inflammation markers. Would wait for him to suggest further tests as I dread any tests performed through the nasal route w/o sedation.
Take care :)
GERD, gastroduodenitis, ileocolitis, chronic proctitis and persistent mouth ulcers and fissures
Current meds: Pentasa sachets 4g, Entocort 4.5 mg, Nexium 40 x2, Ensure, Calcium and magnesium supplements, Imuran 150mg, Zantac 300mg (not any more), Gaviscon 1x4
Pred 40 mg from Oct. 2010 till Jan.2012
Failed:Azathioprine, Methotrexate

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 1/9/2014 7:39 PM (GMT -6)   
Hi Minnietoty
I don't understand how you can have GERD with a normally functioning LES. The most common cause of GERD is an poorly functioning LES.
www.practicalgastro.com/pdf/May04/MitreArticle.pdf

Hiatus hernias are also a cause, and often people have both. It seems to me, though, if you're suffering with extreme reflux that is painful and keeping you from sleeping, it's time to look into your options.

If you've made lifestyle changes, are taking meds, and still are having significant reflux, it's time for your doctors to look at other options.
Best wishes,
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

minnietoty
Veteran Member


Date Joined Dec 2010
Total Posts : 2805
   Posted 1/9/2014 7:51 PM (GMT -6)   
Denise, thank you for this interesting article. What do you think of Baclofen? My GI keeps insisting on my taking it but it causes drowsiness and I didn't find it that effective throughout the years.
GERD, gastroduodenitis, ileocolitis, chronic proctitis and persistent mouth ulcers and fissures
Current meds: Pentasa sachets 4g, Entocort 4.5 mg, Nexium 40 x2, Ensure, Calcium and magnesium supplements, Imuran 150mg, Zantac 300mg (not any more), Gaviscon 1x4
Pred 40 mg from Oct. 2010 till Jan.2012
Failed:Azathioprine, Methotrexate

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 1/9/2014 8:40 PM (GMT -6)   
Hi Minnietoty,

Actually, I've never heard of Baclofen for GERD. I looked around for information, and found this study:
www.medscape.com/viewarticle/761973

In the conclusion, it says that Baclofen is more effective with upright reflux. Since your problem seems to be a nighttime reflux, it doesn't really seem to be the best choice. That said, I'm no doctor!

Good luck!
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"Whatever you fight, you strengthen, and what you resist, persists.”

“Worry pretends to be necessary but serves no useful purpose”

“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”
Eckhart Tolle

NGonzales
Regular Member


Date Joined Dec 2013
Total Posts : 21
   Posted 1/10/2014 3:19 PM (GMT -6)   
Hi Minnietoty,

I have had Gerd for 2 years now. My Integrative GI doctor initially wanted me on PPI's but I refused, so we started off with Zantac which proved only moderately effective at 150mg X 3 per day. It wasn't until he included the Baclofen that I noticed better control of my severe GERD, which included at the time esophagitis, LPR, and aspiration of acid in the lungs, particularly at night. My GERD was constant, and could not be appeased with dietary modifications. I also have UC, so like you, I have to be VERY conscious that my foods do not cause or exacerbate a flare.

I have not had any testing done to show a poor functioning LES, but my chiropractor believes that I do have a sliding hernia. I delayed testing after being diagnosed last year with severe Hashimoto's. My GP thought that the LES may be weak due to years of extremely low T3 and T4. But, unfortunately, after taking Levothyroxine for 8 months, instead of improving the reflux, my symptoms worsened, and I had to put myself on OTC Prilosec. I still take Baclofen 10mg X 2 per day; I take it in the morning with 20mg Prilosec and in the evening with 150mg Zantac. I am fairly stable, although I can not tolerate vegetables :(

I do not feel any muscle weakness from the Baclofen, nor any other side effects such as drowsiness. I do believe that if I were to remove this from my regimen I would not be able maintain my current stability. I think it is the Baclofen that allows me to sleep through the night without reflux.

I just thought that I would mention the benefit of Baclofen for my personal GERD symptoms. You said you didn't find it effective for you over the years, but I wanted to share that Baclofen has been very beneficial to me.

I'm sorry to see that your GERD is getting worse. That is indeed a most scary place to be, and I know that you want some relief. Maybe you could give the Baclofen a go again, at least until you can figure out your next move? I do hope that your issues resolve soon.

Nina

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 1/11/2014 12:10 PM (GMT -6)   
Minnietoty-

It might be time to have a manometry done to see if you do have a weak LES or any other swallowing issues.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

minnietoty
Veteran Member


Date Joined Dec 2010
Total Posts : 2805
   Posted 1/11/2014 2:11 PM (GMT -6)   
Denise, Nina and Bill, thank you very much.
@ Denise. I think I have upright reflux, too. I think I have to exhaust all options before I talk to my GI.
@ Nina. I think I'll give Baclofen another chance.
@ Bill. Waiting for the results of inflammation markers in order to see my GI. I'll raise this issue w him next time though I'm dreading it and say that as long as he did not suggest it, why would I volunteer?
Take care all of you :)
GERD, gastroduodenitis, ileocolitis, chronic proctitis and persistent mouth ulcers and fissures
Current meds: Pentasa sachets 4g, Entocort 4.5 mg, Nexium 40 x2, Ensure, Calcium and magnesium supplements, Imuran 150mg, Zantac 300mg (not any more), Gaviscon 1x4
Pred 40 mg from Oct. 2010 till Jan.2012
Failed:Azathioprine, Methotrexate
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