Worried about LPR ^^;

Hello, I thought I'd share what I'm experiencing atm because my doctors are a bit stumped and I can't find anything that would fit my bill. I've been suspected with IBS, GERD and most worryingly of all, LPR, but I don't match enough of the symptoms in either category to get a proper diagnosis, and most medication I've used - including Omeprazole and Lansoprazole (30mg) - has had little to no effect thus far. If anyone can help me figure out if this could all just be anxiety or something else entirely I'd be very thankful! :D

My symptoms include:

- Loads of mucus (?) in my throat, especially at night, with a constant need to swallow it.

- "Vurping" but no real burning pain. There is however an ulcer on my tongue and I do get sore throats sometimes.

- A tight throat which occasionally restricts my swallowing and deep breathing, resulting in lightheadedness

- Ear pain and a sore throat

- Loss of appetite due to nausea

- Tightness and mild burning in chest and abdomem, but mostly in the abs.

- A lot of gas

- Throat spasms

I'm quite concerned about throat cancers, so I really really really hope this isn't LPR. XD

5 Replies

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  • I doubt anybody will give you an answer as these symptoms could be anything including what you have suggested. I would suggest you pressurise your doctor for a referral to a hospital specialist if this has not happened at all and he can not give you an answer.

    Have you had an endoscopy? This would indicate anything serious.

    Mucus in the throat, deep breathing and tightness in the throat can be an indication of worry as most of us have probably had this. You should try to stop deep breathing.

    Dont worry yourself into giving yourself problems when they may not be there. De- stress first perhaps with lots of exercise and see if the symptoms disappear. Sitting around and worrying is the worst thing you can do.

  • Hi Daxter,

    Your symptoms do sound like LPR. I have experienced them myself.

    Refluxate passing up the oesophagus can enter the throat and be aspirated into the nasal cavities.

    Although PPIs such as omeprazole are provided to control acid reflux, they actually only control the acid, not the reflux itself. So your GORD becomes NERD (Non-Erosive Reflux Disorder).

    Although this is less harmful without the strong acid component, it can still cause breathing problems, sinus and ear problems and COPD.

    medscape.com/viewarticle/77...

    Chris

  • As discussed above, all of your symptoms are consistent with reflux of gastric contents into the esophagus and oral cavity, and also possible contact with your nasal passages and eustachian tube.

    In addition to PPIs, lifestyle changes can help greatly. Decreasing or eliminating caffeine and nicotine can greatly reduce reflux. Losing weight (if overweight) can give a huge benefit. Decreasing fatty foods (which stay in the stomach for a long time) and elevating the head of your bed will help lower the chances of nighttime reflux.

    Drugs help, but the acid is only part of the problem with refluxate. As a licensed pharmacist (and a post-esophagectomy patient), I know the benefit of drugs, but they are too often relied upon as an easy fix.

    A proper endoscopy by a board-certified gastroenterologist will make sure there is no malignancy, stricture, or structural problem. Some people cannot reduce the reflux enough with PPIs and lifestyle changes, and may require fundoplication or reduction of hiatal hernia. But surgery should be after all other less invasive treatments have been tried. As you have probably seen on this site, GI surgery is nothing to be entered into lightly. Even the newer transoral fundoplications.

    Hope this helps. I don't mean to preach, but I just feel that not enough emphasis is placed on fixes that can really help reflux that are not stressed enough.

  • The only way to find out is to have a proper examination, as the comments above have suggested. Do not be worried by the thought of seeing somebody else for a second opinion if things are not moving forward in a way that you trust.

    The other passing thought I have had is that reflux is not always acid. It can sometimes be bile reflux (which is alkali) and there are other stomach contents that are not acid. There is something called impedence monitoring that can be done to assess whether there is bile present.

    As a temporary relief you might try gaviscon, which acts as an alginate, creating a protective raft around the oesophagus lining, rather than switching off acid production in the stomach (proton pump inhibitors like omeprazole, lansoprazole) or counteracting the acid (antacid)

    I do think that you need to have a proper endoscopy, and that this (and/or a barium meal test) will help with a diagnosis. There are sometimes blockages in getting referred for these if you are under 55 years and have no 'alarm symptoms' that might suggest cancer.

    The alarm symptoms would be something like difficulty or pain in swallowing. I think that some GPs can be more creative in making the case to get an endoscopy referral than others, but, as always, if you can set out your symptoms in a very systematic way, it usually helps the GP to find the right way forward for a referral.

    Consulting a gastroenterologist and/or ear nose and throat specialist would be a good idea as well.

  • This has got to be the best answer I have ever seen on the internet. Thanks.

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