LPR - anyone managed to tame or cure this condition?

[Inominate]

After a year of LPR, I'm still struggling and symptoms are almost as bad as they have ever been, despite heavy medication and lifestyle changes. Recent bronchoscopy has confirmed that it is LPR. I am maxed out on esomeprazole and from 3 weeks ago swapped from peptac to Gaviscon Advance. Also, have domperidone with main meal of the day. The other adaptions I do are wedge pillow, not eating 3 hours before bed, no acidic foods or foods which relax the LES, alkaline water after meal, chewing whitening gum (for carbonate) etc. I am recently using meditation and relaxation techniques. I have had good spells but am currently not controlling the symptoms well. Not sure what to do next. I appreciate that I may never be cured but wish to reduced the severity or frequency of my symptoms if possible. Any advice or stories will be gratefully received.

[hjskev]

Sorry you feel rubbish. I have silent reflux too. I think we all have to find our own way with this. But this is what I do.

I have stopped omeprazole. I had to do that gradually. While it helped initially I think it had stopped being effective. I also heard that it is detrimental to bones which is another of my issues. So I changed my diet and take Gaviscon Advance last thing at night. I eat a high fibre diet now, which in the first instance made me very bloated but after a while it calmed down a lot. I had noticed when I had a bad bout of reflux I was also constipated so at least that has been improved. I have had to cut out wine because its too acidy. I also find that strong tasting toothpaste irritates my mouth so I use a mild toothpaste with no parabans. When it all feels really bad I chew mild chewing gum.

For me its just about managing the reflux. I can go for long periods when I'm ok and then it starts up and its not clear why. Hope you can find some solutions.

[Inominate in reply to hjskev]

with many thanks for your reply. I also seemed to feel better initially with each new medication they have put me on but again it doesn’t seem to last. Interesting what you said about constipation, because that could be true for me too exacerbating the reflux. My otolaryngologist said no chewing gum, but there is scientific evidence that this helps increase the pH in oesophagus, so I do use it occasionally. He was bothered that it increased acid production. Thanks for your help - I hopefully will be off the PPIs sometime…

[hjskev in reply to Inominate]

I have read mixed thinking on chewing gum, but it is the only thing that gives me any relief, so I'm going with my gut. Pun intended.

[Jumpey]

You could ask for a manmometry to assess your oesophagal functionality. You may be a good candidate for fundlopication surgery.Good luck.

[Inominate in reply to Jumpey]

Thank you. Yes, I was referred to ent recently and had a course of treatment recommended. I will have to try that for a while before my nhs gp will refer on the gastro route, even though routine referrals are taking about 6 months. But I agree with you, a gastro referral should be next. Everything seems to take so long with the nhs. Thanks for your thoughts.

[Ascb]

I followed Dr Aziz Acid watchers diet a few years ago. I think it helped but it is obviously restrictive and I stopped. But others who continued onto the maintenance plan report it helped. There's a Facebook group which is good for tips etc.

[Inominate in reply to Ascb]

Thank you, I will look it up. The restrictive diet is not easy when cooking with other household members, but I will have a look and get some tips.

[Ascb in reply to Inominate]

Yes it's difficult, my partner had different foods to me, and trying to find new ways of cooking old favourites (which I wouldn't ask him to eat!) was time consuming. But I did it for 4 weeks.

[Opelcorsa]

Look up exercises to strengthen your oesophagus muscles on utube. Hope you get relief

[Inominate in reply to Opelcorsa]

Thank you. I did see a research paper about this, but annoyingly the exercises weren’t detailed, but I will research this again. Thanks

[Hidden in reply to Inominate]

I was referred to a Speech and Language Therapist who has been very helpful and supportive. I was doing a doing a lot of coughing and choking. She advised on eating etc for LPR. I have now had a Barium swallow, and another barium test involving eating barium mixed with different thicknesses of food, discovering I have weak swallow reflexes so residue of food stays around my epiglottis and some going into the windpipe, but not too far luckily. She is now giving me exercises to improve swallowing. I wasn't aware that they did this kind of work, but apparently a good part of their work helps people who have had strokes, and swallowing issues.

[Inominate in reply to Hidden]

Thank you for your reply and sorry to hear about your throat. It’s not nice is it. I am hoping at some point to see a gastrologist who could arrange a barium meal to see if the oesophagus and sphincter are working properly. But I have to wait to see if my current treatment works. Some physio from a speech therapist might strengthen the muscles though. Thank you for sharing this idea, I hadn’t thought about that.

[Hidden in reply to Inominate]

One of the things I found out, which may not apply to you is that chocolate and peppermint aren't triggers, but relax the sphincter making it easier for acid to come back, I have found details of a youtube video of the exercise the therapist has started me on.

The Christie NHS Foundation Trust - Masako technique

[Inominate in reply to Hidden]

Thank you. I shall look that technique up. It always surprises me that many reflux treatments, like Gaviscon, are mint based, when this causes reflux. I try to use aniseed flavour when I can.

[Canta]

Some people have found that taking vitamin D has helped their LPR. It may have been coincidental but it's worth a try I think.

Also, I saw a video on Facebook just the other day where a doctor demonstrated an exercise for strengthening the sphincter. He said to breath in expanding the stomach, hold your breath for four seconds and then breath out through your nose. I can't remember how many times to do this nor the frequency. It's simple enough and again may not work but is worth a try. LPR is horrible, I hope you can get relief.

[Inominate in reply to Canta]

Many thanks. I had not heard about the Vit D link. I was taking a multivitamin with iron but then found that iron relaxes the sphincter. Yes, I think I must try these physiotherapy exercises. Thanks for taking the time to reply.

[mjames1]

I have it. First, are you taking your PPI on an empty stomach an hour before meals? That can make a big difference. If that doesn't work, you may have to go to a stronger PPI like high dose Dexilant, the King of PPIs. Also, if you need to lose weight, that might help even more than medications. And speaking of medications, sometimes certain meds can trigger GERD. About the wedge pillow -- unless you sleep on it just right, better is to put some blocks under the head of the bed, so you're on a real incline as opposed to just crunching up the upper body. I tried the alginates like Gaviscon advanced, but didn't work, but if you get results, great.

Jim

[Inominate in reply to mjames1]

Thank you for your reply and sorry for the delay in replying…busy times. I am taking the ppis on an empty stomach. The bed is on blocks as well as the wedge pillow. I’ll look up dexilent to see if it is available in the uk. Weight is not an issue. Good idea…I’ll check out my other meds. Thanks

[Pte82]

Inominate, my reflux was so bad I was spitting it out. I used Tums and omeprazole with limited success. My search illuminated thiamine as a possible long term answer for my reflux. I learned thiamine (vitamin B1) requires magnesium to become activated. Magnesium threonate and two forms of thiamine, benfotiamine and TTFD, have an easier time passing through the blood brain barrier than other forms. The brain and the vagus nerve need activated thiamine to control the function of the sphincter valve in addition to other digestive functions. In addition to the thiamine supplement I use a B-complex, B vitamins wotk better together. Be aware of ant-thiamine factors that diminish or destroy thiamine. Search for a list of them. I have not used Tums or omeprazole since I started thiamine with magnesium threonate I have had no further reflux episodes. Always consult your health care professional before using any supplement.

[Inominate in reply to Pte82]

interesting. I was taking a multivitamin with iron, but read that iron relaxes the sphincter so stopped taking them. I have bought some B complex vitamins as I read that ppis are not good for vit b in the body. I haven’t started taking them yet. I will look up about the thiamine link and the anti thiamine factors. Thank you

[Eton in reply to Pte82]

Hi Pte82 can I ask what thiamine and magnesium threonate supplements you use please as I have terrible LPR. As I have osteoporosis I do not wish to take pis. Many thanks

[Pte82 in reply to Eton]

Eton, the supplemental thiamine tetrahydrofurfuryl disulfide (TTFD) I'm using one capsule a day is Thiamax because it uses no fillers. Magtein is a trademark of Magceutics so all magnesium threonate supplements will contain the same active ingrediants allowing you to shop by price or preference. Iodine is lacking in most foods and is needed in the converson of T4 to T3 and a deficiency may be a secondary cause of osteoporosis. Lugol's is an iodine supplement worth checking out.

[Eton in reply to Pte82]

Many thanks for the reply. I will follow up on these supplements. Are they still proving effective for you when managing reflux?

[Pte82 in reply to Eton]

Yes they are Eton. In addition, I now avoid processed foods and seed oils to cut down on inflammatories in addition to added sugars.

[Eton in reply to Pte82]

Thank you. I will definitely give them a try.

[Nova04 in reply to Pte82]

Has this actually helped then Thiamax? I've just started vitamin b complex

[Pte82 in reply to Nova04]

I have not had a recurrence. The B1 in your b complex and Thiamax needs magnesium for activation.