My pulmonologist sent me to an ENT. I was diagnosed with Asthma earlier this year, and my pulmonologist is still trying to figure out my triggers.
ENT identified that I have LPR Reflux (silent reflux) which is causing me to feel like there is a constant build up of mucus in my throat... I am always clearing my throat, coughing, etc...
ENT believes resolving LPR may help my Asthma...
Anyone else have this experience?
acid reflux can mimic asthma and the drugs that you take for asthma can cause acid reflux - I’ve been referred to speech therapy to help and ENT to check out for polyps in my nose or larynx
yep- my asthma became severe and uncontrolled 5 years ago. Investigations showed that I also had LPR. I am unable to distinguish any symptoms that are attributable to LPR rather than asthma.
However, I follow all the advice strictly so that they can’t blame my constant tight chest on LPR.
I read around LPR a lot. There are books by Dr Jonathan Aviv - the Acid Watcher diet and The Acid Watcher cookbook- Apparently acidic food and drink can activate tissue bound pepsin. I totally changed my diet and eating habits- no food after 4pm, smaller portions, lots of foods to avoid. I was also prescribed Gaviscon Advance for after each meal and at bedtime.
I have noticed no change in my symptoms, but I did lose 2 stone quite quickly !
Good luck and I hope you feel better soon.
I consider acid reflux to be a major trigger for asthmatic symptoms. I take a 10 mg dose of Omeprazole first thing in the morning and take Rennies at other times if I feel I have acid symptoms. If you can control your silent reflux with diet, smaller portions, not eating after 6 pm etc do it but ant-acids would help. Acid pump inhibitors such as Omeprazole are very effective but only use them long term if all else fails.
I have never heard of LPR Reflux. Just reading about it, is making me think about some symptoms I have in my throat/voice. I have a GORD/GERD diagnosis, but didn't realise there is an upper sphincter in your oesophagus as well. I had blamed my symptoms on Symbicort, but knew I didn't have such bad symptoms in the past with it. I can see that a medication for my mental health can cause it. I'm glad you have asked the question as I will be reading everyone's replies. I had heard of Silent Reflux, but didn't think it applied to me
Hi I've had LPR for over 30 years. I saw Professor Alyn Maurice in Hull several times. He was the head of respiratory medicine at the Castle Hill Hospital. I think he has now retired from clinical practice but still teaches.
He was the expert on cough and reflux disease. He explained that gaseous mist triggers the vagus nerve and causes bronchospasm. In the paper he wrote about this he said that it is still asthma. That explains why salbutamol helps improve symptoms. He did a Methocholine challenge test which showed a positive reaction again an indication of asthma.
I had 2 Nissan Fundoplication operations which improved the sudden choking and voice hoarseness and to a degree the asthma symptoms.
I always have reacted to things like fat droplets in the air when cooking a roast, cooking with vinegar to deglaze a pan. Smoke, humid weather (probably am triggered by the particles caught in the air).
It has recently been found that I get mucous plugging, so I do mucous clearing morning and night, also when I'm having an asthma attack. I've always had times when I feel like I'm drowning and now I know why. My PF goes up usually by 20 or 30 in the PF reading after clearing mucous.
A note of caution (the following might be a difficult read).
About 20 years ago I was told by a severe asthma team that because I didn't have eosinophils that I didn't have asthma. Thinking has now changed thankfully. I was diagnosed with LPR. I was taken off all my inhalers, after several asthma attacks I ended up having a life threatening asthma attack that landed me up in EAU. My 4 hourly neb was delayed and I deteriorated, I had called the nurse who was busy. Next thing I know the crash team had been called and apparently they were working on me for 2 1/2 hours to stabilise me. Fortunately I managed to improve enough to not need the ITU bed they had available for me. I never managed to thank the ITU doctor as despite trying to thank him what came out of my mouth didn't make sense.
Differential diagnosis are all well and good but if they lead to dismissing a patients underlying asthma that could be very dangerous.
I have had a number of years avoiding A&E. Unfortunately this year my symptoms have got worse, mainly due to the humidity this summer. I still have post nasal drip, I'm waiting for a referral to gastroenterology which apparently could take a year. I'm also waiting to see the speech and language therapist at the tertiary severe asthma clinic.
I have been taught huffing and swallowing to suppress cough by a respiratory physiotherapist. That has been very useful.
You have been through so much! And sound lucky to have survived it.
I react to many triggers, humidity and particles are some of my main ones.
I don't have severe asthma, but I get the drowning feeling, during some of my attacks. I was diagnosed with a dysfunctional breathing pattern after 30+ years of 'difficult to control asthma' and I have noticed when I correct my breathing , when my symptoms are not asthma, it shifts the 'liquidly gunk' in my lower lungs, for me to be able to cough and clear it, just like my inhalers do. (It doesn't work when it is asthma causing my symptoms until my inhalers work.) The consultant could not explain what was going on, he explained that they still don't know everything that is going on in the lungs.
I have had a more difficult year also, due to the continuous high humidity alongside my pollen allergies. Nothing like yours of course. I hope you find some more solutions.
I have also been diagnosed with 'an element of breathing pattern disorder' but I had respiratory physio which helped with this. Sitting in a car with the aircon on for a few hours dried out my nasal passages and triggered it off again but I'm learning how to control it.
You have been through a lot as well. Having symptoms that aren't fully understood and negotiating the system with different Dr's is hard. For me I find that different Consultants have differing opinions which I find very confusing and frustrating. It's good to hear that inhalers work for you as well.
I am on the maximum level of medication and have had more than 2 courses of prednisolone in the last year hence why I am under the severe asthma team.
In really humid weather I can start wheezing etc within a couple of minutes.
Let's hope the air quality improves.
Yes, I did a lot of sofa surfing every year for 4 to 5 months. Any symptoms I have now don't last for months so, they don't turn my life upside down. The respiratory physio, educated me on what I was doing wrong with my breathing and the correct way to breathe. It was life changing for me.
I found Consultants very contradictory and confusing also.
I almost needed a 2nd course of prednisolone this summer, but fortunately, with the Mart regime, the higher dose of inhaled steroids kicked in, just in time.
I am so looking forward to some fresher air with lower humidity!
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