Thread: LPR as something else, falsely being treated as acid reflux? Probably...

It may be that your throat problems aren't related to reflux.

Personally, when I have a sore throat that doesn't come from a cold or something, I also have a nasty taste in the back of my mouth, which makes me believe it is reflux.

However, PPI therapy often doesn't help, especially in folks without heartburn.

I'll be looking into LSN. I also have sinus drip especially in the morning and mucous. eating seems to make it worse too. Especially cottage cheese, soda, etc. Hard to know what I can eat that won't aggravate it.

Thanks for all that wonderful info...Paula

any update on how your feeling on the meRAB?

Thank you, Sunrise Seeking, for drawing attention to the possibility that many people diagnosed with LPR are actually suffering from LSN.

After reading your references I believe that I am far more likely to be suffering from LSN than LPR.

Like you, my chronic cough and post-nasal drip began with a cold and cough. The cough was one of the worst I have ever had, and it was followed by a repeated buildup of mucus in my bronchia which had to be coughed out every few minutes. I believe that the mucus originated in my nose, because it was white & frothy with a nasal smell. And it subsided into a post-nasal drip, which is still with me.

My ENT suggested that I might have LPR. I was doubtful. I have heartburn only a few times each year, and I sense stomach acid rising into my throat (typically as a result of a burp gone wrong) only about once a year. Still, he asked me to take a PPI for 6 months, and he gave me a free sample to start with, and two repeat-subscriptions.

I asked if my throat should be examined first, but he advised that it was less invasive to just take the drug. I asked how the PPI worked, and he said that it reduced stomach acid. But, I asked, wouldn't that affect digestion? No, he said, it had no effect on digestion. Did it work, I asked, by reducing the strength of stomach acid or by reducing its quantity? Both, he replied testily.

I don't think that he was lying deliberately. He just didn't want to appear ignorant. But his advice to take a PPI for 6 months, without inquiring about my clinical history, was irresponsible bordering on criminal, since I had been diagnosed with B12-deficiency 6 months earlier and PPIs are known to reduce B12 absorption.

In the event, after researching the side-effects of PPIs, I did not take it. Instead, I took B12-supplements, and this has steadily reduced the intensity of my post-nasal drip, to the point that it is little more than an annoying "frog" in the throat.

I now blame low B12 (167 pg/ml) for the whole succession of effects. First, I was somewhat anemic from lack of B12, which weakened my immune-system and caused my cough to last weeks rather than days. Second, low B12 is known to inflict neuropathic damage. I suspect that my laryngeal nerves, damaged by the flu, were inadequately repaired due to lack of B12. The nose produces several pints of mucus per day, which is normally swallowed unconsciously, but with nerve damage can pool in the throat or be misdirected to the bronchia.

The suggestion here that LPR-like symptoms might actually be due to neuropathy therefore stikes a chord with me. And I suggest that people who suspect they might have LSN have their B12-levels checked, and perhaps try harmless B12-supplements before resorting to Lyrica. One problem is that the "normal" B12-level in the US is set too low, and is less than half of what would be regarded as low in Japan.

Wow!

Sheepdog, I'm glad you took up the challenge! Your much more detailed record of how it has benefited you, and what remains, matches me eiriely closely!

Exactly that. Globus and sore throat gone, but I still have a "pinch in the corner" exactly!!! I can't believe how well that describes what I'm still sensing. But the fact that it goes from globus to a pinch in the corner only further supports the notion that this really is nerve damage in cases where it starts with a severe URI.

I have to reiterate that my symptoms also started with the worst cold I've ever had in my life. It lasted for weeks. But anyway, I think you can agree with me that a pinch in the corner is much better than globus.

I wonder if the addition of 10 mg of klonopin or elavil before bed would do the trick in completely alleviating all the symptoms. I still do some throat clearing too, but it's mild, and actually, that symptom is do-able, and doesn't crush my will to live at all. It's almost sort of fun in a weird way... (an exaggeration, I know)

This goes out to ANYONE whose globus and other symptoms began with a cold/URI. Take the Lyrica/neurontin/elavil/klonopin challenge and post your results!

Good to hear Sheepdog!

This is very interesting. I have been seeing a naturopath for 7 months now, off ppi's for 4 months. I have had "gerd/lpr" diagnosed with both by my gastroenterologist and throat dr in 2009...everyday for 1 1/2 years. Its nutty to comprehend. Everyday i wake up with a pink/red throat, my digestion is improving since going off ppis but still struggling big time. I was in the middle of a psychiatric drug withdrawl (slow and planned from a previous anxiety and depression) when one day it literally came on that quick on June 22, 2009. I was taking out recycling and felt something off and it has never, ever gone back. I also developed a bad cold/chest bug that same week, it was awful in my throat, i had never had a cough that bad in my life. I was diagnosed with mild esophagitis and gastritis a month later and ppi's worked for like 2 weeks, then i stopped them (retried many and stayed on them for a long time) and i've never been the same. The ppi's really helped mess my digestion up to the point of being 90 some lbs and my family (and i) thought i was dying...lost FORTY lbs....i had no digestion problems till i began the ppis. My ND has said although he sees some inflammation upon looking in my throat, its mainly neurological/nerves.

I can't go in and get a scope constantly or do those awful tests b/c for one i am very sensitive to the meRAB they use to put you under and two i've been ON ALL THE MERAB...they didn't work...not even close. I don't want to live my life in constant fear that i am getting ready to die of esophageal cancer after 1 1/2 years of this every single day. They have tried ppi's and other stomach meRAB galore...but nada, nothing....things only got worse.

I have always been sensitive. My ND brought it to my attention that although i am now dealing with digestion issues, it is most definitely made worse by the ppis due to my sensitivity and my throat/esophagus are extremely sensitive. I am currently working on lots of qi gong, lifestyle changes, meditation, etc....b/c psychiatric drugs was i thought my biggest nightmare until this came on. So, i won't be doing lyrica.....but i really find this intriguing and something i have pondered and always knew that there is some kind of fibromyalgia situation going on in my esophagus since that day. I do hope researchers find more and soon, soon, soon. There are alot of us, thank goodness for this board. I have never physically met someone with this strange situation i find myself in.

I came to this thread just yesterday.
I was diagnosed with Gerd about 5 years ago. And handed a rx for Nexium. I went off it because I didn't feel good on it. Can't remeraber now what it was. Maybe I didn't stay on it long enough.
Previously to this diagnosis, however, I always have had copious amounts of mucous in the back of my throat for years. A globus feeling of a lump in my throat. (One doctor said I had globus hystericus - I thought that was hysterical if I hadn't felt so miserable.) A cough. But little else.
Over last 5 years developed other various symptoms. (Went to doctors about Lyme since I had so many symptoms I couldn't keep up with) For the last few months have had increasing severity related to burning tongue, mouth, back of throat and in the last 2 weeks I can barely eat anything. This has been so long in the making I fear I have done more damage then I care to think about. Oh yes, about 2 months ago I took LOSEC but I felt very short of breath with it and "buzzed."

I saw your mention of Dr. Jamie Kaufman she seems to make a compelling case for LPR and treating it differently then GERD. It's so new I'm sure it would be impossible for you to know yet whether it all works.

So here I am, with all of you. If any of you have encouraging news on successful ways you have been coping or have been treating your LPR (GERD) I'd love to hear more.

I just wanted to say one more thing ... talk or visit as many as u can doctors ...
dont be satisfied with only one opinion ...and dont forget to describe everything u feel
(be persistent ) to your doctor even if u think it s not so important ...

I ll let u know how it went happy holidays

Hi Gpinzone,

I'm currently taking 75 mg of Lyrica twice a day. That's why I'm apprehensive to add a tricyclic antidepressant to my regimen. My throat already feels somewhat dry and I don't want to exacerbate it. I, too, sleep with a cool mist humidifier in my room and it seems to help (although it seems to damage my electrical equipment). Thank you for the suggestions. This medicine is very new to me; I've never been on antidepressants of any kind. But I know that the Lyrica is producing some positive benefits and, if I can make it through the next few months without catching another cold, I should be feeling better by this Spring.

The supplement called "Clear-Ease XL" is distributed by Hydromed and was created by an ENT named Dr. Murray Grossan. I found out about the product because I use the pulsating sinus irrigator that he created. It helps to prevent colRAB and sinus infections, but, unfortunately, it hasn't helped my throat at all. However, the Clear-Ease contains protease, papain, and bromelain, which supposedly break down thick phlegm and maintain one's voice. I used it for several weeks and it helped my voice, but it always left a mild stinging sensation in my throat. About three weeks after I was sick in October, I took my morning dose and two hours later, my throat was burning worse than ever. The pain lasted right through Thanksgiving and into Deceraber. I knew this pain was not due to reflux, as before I'd taken the supplement, I was starting to feel better and the pain I had prior to using it was only mild. The pain that I felt after using it was a corabination of intense, widespread burning in my larynx and a scratching, biting pain at various points in my throat.

I really don't know why I suddenly had this reaction to it. The most plausible explanation is that I suffered further nerve-damage while I was sick in October, and the papain and the protease in the Clear-Ease aggravated my nerve-endings even more. Thus, I used the supplement to solve a certain problem that it only made worse, a lot worse.

Not everyone has this reaction to the supplement, but I know I'll never use it again.

Again, thanks for the advice.

wicked lady about your sore throat, have you had a laryngoscopy done to see if there's redness or inflammation?