Do any of you good people recognise my symptoms and if you do, I'd be really grateful if you could offer any advice.
My symptoms are that I feel as if something is coating or lining my throat and I want to clear it, quite often. It's not like a lump but having said that I do get a sensation of a slight obstruction that is uncomfortable. My breathing isn't affected. I don't have any cough at all.
I have had these symptoms in varying severity over the last 1 year.
The condition started after I had been diagnosed with Polymyalgia rheumatica. I was on 10mg prednisone (steroid) for 2 years with a PPI lansoprozil for stomach protection. When I eventually recovered from the PMR, I tapered off the steroids and (on the GP's advice came off the lansoprozil) ever since then I have had the above symptoms. I have had 3 visits to an ear nose and throat clinic and had the camera up my nose and into my throat plus an endoscopy to look further down all the tests showed nothing remarkable. so, the doctors diagnosed me with Silent reflux and told me to take 15 mg lansoprozil and gaviscon advanced as and when needed. My problem at the moment is that I am having the symptoms even though I have been sticking to the 15mg lansoprozil. I've just had a telephone consultation with a GP and she has recommended that I increase the dose to 30mg. She say's that this is a very common condition. I have an upcoming appointment with the ENT clinic in 3 weeks, so will see what happens from the increased dose and that appointment . In the meantime any comments or advice would be very welcome. Thankyou.
RJ
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birdwatcher
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I have had silent reflux for several years, this is what has caused ,in part, my bronchiectasis. I had a barrage of tests, which led doctors to the diagnosis.
As this type of reflux is caused by pepsin as opposed to acid, antacid medication isn’t very successful. Gaviscon Advance has been the most useful, especially before bed. I follow an alkaline diet, which you can find information on online. An American specialist Dr Koufman. constructed the diet. Book is called Dropping Acid.
Basically foods with a ph above 5 is recommended to start. Things like fish, light chicken, lean meat.
Most vegetables apart from tomato or onions.
Fruits like melon and banana are fine.
Carbs. beans, oatmeal, bread are okay.
But little dairy, low fat milk, low fat yogurt. No fatty cheese etc
Nuts can effect some people, soy and eggs too are individual irritants.
No fatty, spicy, rich foods or fried, roasted etc for a few weeks until the pepsin is under control.
I find a wedge in bed helps prop me up so both reflux and breathing is a little better.
No food or drink 3 or 4 hours before bed.
After coughing,choking, heavy stomach, lump feeling in throat, constant mucus, sore right side of throat, ear pain, sinus and sneezing . I finally managed to get it to a controllable level. Unfortunately the antibiotics can tend to set it off, so I go back to sweet potatoes, porridge and bananas which helps. Almond milk too is alkaline and may help.
Thankyou astragal, It’s very interesting what you say about the pepsin as opposed to acid. Could it be that the PPI might not be being effective,( my GP has just recommended doubling the dose from 15 mg to 30mg) if it’s the pepsin causing the problem?
Do you think the Alkaline diet has been effective in reducing the symptoms? can I ask, how strict are you on avoiding these foods and drinks like half fat milk on your porridge, and would you completely avoid tomatoes and a coffee (I only have 1 cup a day.) and any alcohol drinks, ie if you went out for dinner what would you order to drink? I tend to start off cutting things out, then slip back. My number one best food in the world is potato’s of any description. (Not much though) Are they not good for this condition? I don’t seem to have a particular trigger, as far as I know. I never eat after 6:30PM (Unless we have gone out for dinner)
Regarding the wedge. Strangely, my symptoms seem to ease off through the evening. Also I don’t have any problems sleeping and get through the night without any problems, when I awake I am fine, my symptoms seem to return from mid morning. Perhaps I should cut the mid morning coffee out.
When it comes to PPI and other medications such as Ranitidine, success probably varies from person to person. MoyB mentioned Metoclopramide was effective for him. That med. apparently improves muscle tone in stomach, aids gastric emptying and reduces nausea also.
It may depend on the reason for the reflux. Because I had nighttime reflux also, Gaviscon advance was more effective.
I had side effects from other meds, also as I had pneumonia previously I was concerned about any increased risk.
The alkaline diet had the biggest impact. It reduced my symptoms a lot over time. I think some people are less strict and introduce more foods, but as I have other health conditions a bland vegetable based diet works for me.
I stay away from foods I did very much enjoy, tomato, orange juice, dairy, dark chocolate
. I have found that strawberries and blueberries can set it off, shame as I love them.
Potatoes are fine as is oatmeal, if you like porridge. Oatcakes too.
Instead of chocolate I have carob.
I tend to drink water as I do find coffee can react unfortunately, I do like a nice latte. Instead I have almond milk which is alkaline and honey. Also camomile tea is quite gentle.
After an initial 2 to 4 weeks on a strict regime, add foods gradually to see if they cause problems.
Also probiotics might help. There are various supplements also low fat live yogurt. Good if you take antibiotics anyway.
Dr Jonathan Aviv another specialist has a book too, Acid Watcher.
Information is available on the internet.
His diet is similar alkaline based, but slightly more liberal.
I’m glad you are free from symptoms overnight, so maybe the morning coffee may start it off, it might be worth experimenting without it and see if it helps.
Oh a surprising culprit for some is mint. Traditionally it’s supposed to help stomach issues, but it can relax the lower sphincter causing more reflux..
I found chewing gum after meals helped a lot, the saliva kept the reflux down and ph in throat up. There are natural brands that do flavours other than mint, but some may be an acquired taste.
Mainly it’s trial and error, hopefully reaching a level where you only need to follow a strict regime when symptoms flair.
If you have a knowledgeable GP or gastroenterologist, that’s one less battle.
There are a couple of websites that give you information on the diets and food lists. Or Amazon has the books, ebook version also.
Thankyou very much for sharing all that information, I think it’s going to take a while to get to the bottom of what is going on with me and what the solution might be. But I will let you know if any lights go on.
My bronchiectasis is believed to have come about from silent reflux. I've been on 30mg Lansoprasol for years but it was only when I saw the chest consultant that I got put on Metaclopromide which has made a huge difference - no obvious reflux since on it and my chest has improved dramatically. Something you could try is to put a bed wedge under your mattress (Amazon sell them) as this might help. I had to stop using mine as kept getting cramp in my hip, but they were a good help when I had them. xx Moy
Are you still using Metoclopramide because it says to be used short term ? would love to stop my acid i know that's what caused my reflux and it's still really bad.
Hi Birdwatcher. Interested to read your post and replies.
I have similar symptoms: an almost constant feeling of mucus at the back of the throat, sometimes problems in swallowing and slight obstruction feeling, I do also cough a bit. Whilst these symptoms are annoying, I also have lung/chest problems which affect quality of life a lot. I read that acid/pepsin can get into the airways and assume this is what is happening. This comes and goes. Typically I get a particularly bad period of mucus in the throat and this is followed by chest problems. After a few days, this subsides but returns again on a roughly weekly cycle. When these symptoms are present, it feels like a typical chest infection: tightness and discomfort in lungs and, worst of all, feeling very tired and generally awful.
My problems started following a lengthy throat and chest bug in March of this year. 2 lots of antibiotics, X-ray and scan showed nothing out of the ordinary. Omeprazole tried and didn’t have any effect. Asthma inhalers no use. Now seeing ENT and been told this could be silent reflux. On Gaviscon Advance + life style changes. Been taking this 4 times a day for 3 weeks now, no improvements as yet. Must admit was guilty of late eating, too much coffee and wine. To be reviewed in 3 months. Mention of possible hiatus hernia and procedure needed.
Like Astragal, I have found Dr Koufman’s Dropping Acid book and am following the low acid induction diet. The idea is that the pepsin in the throat etc gives up when it doesn’t have the acid stimulus to reactivate it. Seem to make sense. Diet’s a bit tough but prepared to try anything to beat this.
ENT doc did not seem that interested in the lung symptoms – I see some mention of these in the literature but not the pretty disabling effects they are have on me. The chest infection-like symptoms have meant the ruin of most of this summer’s activities. I realise it could be a lot worse, but is getting me down.
Would be interested to know if anyone else has similar chest symptoms and had medical opinion on this??
Hi Somerset99, I’m so sorry you are having such a hard time with your symptoms, and really feel what a miserable time you have had with this over the summer. I recognise that everybody’s symptoms vary, but I think it’s useful to share our experiences and symptoms, in the hope that somebody may recognise, then possibly be able to suggest an effective way forward. As you have probably gathered from my post my symptoms are very similar to yours apart from the cheast/lung issues. I also don’t have a cough, at the moment. Nor was there any sign of a hyatus hernia with me at gastroscope investigation. I walk run and play sports and don’t have any issues with respiration, “thank God”
Mine is all to do with the back of my throat and clearing and feeling of something lining throat, pharynx & voice box area.
The really interesting thing for me at the moment is that as the evening wears on and I go to bed, the symptoms ease off to nothing, I also have no problem through the night and early morning until about 10:30 am, when symptoms build through the day. I am very strict with myself about not eating and drinking anything after our evening meal usually 6:30 pm (even a cup of tea),I only have water, except on the odd occasions we go out for a meal. I’m just experimenting with replacing the half fat milk I have on my porridge and serial with soya and almond milk. I have another appointment on the 14 Oct to see an ENT person, so I’ll ask more questions then.
One GP I have spoken to recently just advised me to double the dose of the 15mg lansoprosil I’m taking. I’m really reluctant to do that as I fear that the body just adjust to the dose and we have to keep taking more to achieve the same level of relief. I may be wrong, but I’m not happy about that at the moment. I really hope you get some answers and that you get some relief for your chest problem. Keep us informed. Good luck.
I'm wondering if the timing of your problems fits with refluxing acid and pepsin from your breakfast and calming down when you effectively fast after an early meal. Could be interesting to skip breakfast, if you can face it, and see if you don't get the 10.30 reflux.
You may be interested in reading the Koufman book, Dropping Acid.
Hi, Thanks, yes that might be a good idea, although tough, so used to my porridge and cup of tea at half past eight. I’ll have a look on amazon at the book you mention, thanks. R.
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