Silent Reflux

[collipeg]

I,'ve been diagnosed with LPR silent reflux.Could this have been caused by eating too many extra strong mints, or could these be making it worse I await your answers.Many Thanks

[Hidden]

Laryngo-pharyngeal reflux is called 'silent' because people do not necessarily feel heartburn with it, despite the acid rising from the stomach. It is basically the effect of stomach contents / acid, coming up past the lower oesophageal sphincter valve at the junction of the oesophagus and stomach, and then progressing higher past a second valve at the top of the oesophagus, where it then affects the larynx / pharynx and, sometimes, the lungs. People feel heartburn because the lining of the oesophagus cannot cope with the strong acid because it is constructed differently than the lining of the stomach. Over some years, however, the cells can change and create a protective effect against the pain. By this stage you would probably have developed Barrett's Oesophagus. So a question you might be asked is whether you have ever suffered in the past with persistent heartburn.

Sometimes diet can contribute a certain amount to this (as can a high body mass index, or a problem such as hiatus hernia). Barretts Wessex produce a book called Down with Acid, by Chris Robinson, that describes this condition

sites.google.com/site/downw...

Peppermint is medium alkali, so if anything it would counteract acid, but it might depend on how many you have been taking as to whether this affects you. If you were suffering from bile reflux (which is very much less likely to be silent) then lots of peppermint could conceivably make it worse.

Your stomach acid is very strong acid, and I suspect that it is very unlikely that peppermint would make a difference either way. It is much more likely to be some aspect of your physiology that causes acid to rise, and it is your doctor who would give you the best advice about that.

I presume that you have had an endoscopy to check on Barrett's Oesophagus? This could be important, as if dysplasia develops with Barrett's Oesophagus there is an increased cancer risk. Dysplasia can sometimes be treated with radio frequency ablation. These diagnoses tend to be made by gastroenterologists rather than ear nose and throat specialists, but this aspect may have been taken care of already.

It would be easy for the doctors if these conditions could be pinned down to something as simple as eating too many peppermints; unfortunately the causes are not that easy!

In the absence of any complications, taking medication like Omeprazole for a couple of months will reduce the amount of acid generated by your stomach. The doctor might then review your situation to see whether the reduced acidity in your system has resolved the underlying cause (eg gastritis)

[collipeg in reply to Hidden]

Thank you Alan for your very helpful advice.I visited my GP because the symptoms I had were, the constant need to clear my throat of mucus, sometimes with a streak of blood.Recently I wake with a chesty cough (no blood) the cough eases off after being up and about.My GP organised me seeing an ent consultant who diagnosed lpr but I wasn't told about any medication needed.I have been taking 1 Lansaprazole a day for years for a burning feeling in my stomach, now my GP has increased it to 2 a day for 2 weeks, done 1 week not noticed any difference yet.I also had a chest X-Ray 4 days ago, no results yet, do you think that was necessary?

Kind Regards,

Chris.

[collipeg in reply to Hidden]

Hi Alan, I forgot to say I had an endoscopy some years ago which found I had ulcer scaring. This time the ent consultant used the camera probe up my nose and into my throat to get the LPR diagnosis.

Kind Regards,

Chris.

[Hidden]

Sometimes it takes a couple of weeks or more to feel the benefit. If you do not notice any improvement, or if it has not resolved it, go back to the GP.

[chris_usa]

The acid / base balance of mint is not the most important issue. Mint does in fact cause reflux, and is as potent at relaxing the upper esophageal sphincter as chocolate or nicotine. Eating a lot of mint can certainly worsen reflux. As you have a history of ulcer scarring, dietary management is an important tool in combination with the acid reducing medications.

The chest X-ray is an important tool to ensure there has been no aspiration, no underlying lung problems (blood-streaked mucus can be a warning sign for some lung disorders), and no other hidden problems.

All of your issues are likely due to reflux, but your doctors want to make sure they are not missing anything while focusing in on the reflux.

[collipeg in reply to chris_usa]

Thank you very much for your very useful information. I am just waiting for my chest X-Ray results.

Chris.