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Link between chronic throat clearing, non acidic reflux and/or allergie...
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Link between chronic throat clearing, non acidic reflux and/or allergies?

I have been living with (for about a year now) with something very much like (not to say exactly like) what many of you are describing. All this seem to have started after a series of sinusitis’s, bronchitis and allergy season last year!

My symptoms are

1) An annoying (chronic) throat clearing which seems to be related to ingestion of foods or beverages. It’s always present in the morning no matter if I’ve eaten or not (about ½ to an hour after I’ve gotten up). The symptoms oddly stop when I lie down completely. I’m thinking either non acidic reflux or some form of post nasal drip pr mucous thickening?

2) A whitish lump on my tongue which comes and goes depending on different food or beverage in ingest. My general doctor could really recognize this (she seemed a little confused when looking at it). Sometimes, after I drink pear juice (for example), the bump swells up to the point I feel I have something moving around in my mouth (due to the swallowing muscle movements). Gross, I know …

Oddly, so many people are going though this and so little of us seem to find the solution!

So here goes …

I met with my ORL subsequent to getting a 24 PH study results. The 24PH study results indicated that the tracing did not indicate significant gastro-esophageal acid reflux. Due to this and the multiple inconclusive tests I’ve had previous to that, my ORL concluded that this is probably all in my head now and that I should stop trying to figure out what the source of the problem is and either adapt to it or slowly learn to stop clearing my throat!

For the record, here is a list of what I’ve done so far to eliminate possible causes for my throat clearing:

• Chest scans: all good
• Lower abdominal echo: nothing abnormal
• A gastrocopy : all ok in there
• A 24hour PH study and a motility test: no significant gastro-esophageal acid reflux
• A sinus scan: revealed a slightly deviated septum
• Allergy tests: some grass, weed allergies (I have not had food allergy testing yet)
• Home based acidity test (saliva sticks): almost always normal levels

Here is a list of the medications I’ve tried:
• Benadryl: Helps a lot but puts me to sleep (drastically)
• Nexium: no significant effect
• Gaviscon: “seem” to help but not much
• Nasonex and sinux flushing: clears the sinuses well and I haven’t had a sinus infection since
• Magic Mouthwash: no effect whatsoever

I don’t smoke, I train regularly, I eat really well, and I’ve stopped drinking coffee and really cut out acidic foods like tomatoes and citrus fruits.

I’m the first to believe that the human brain can cause the illusion of symptoms but these symptoms are real; chronic throat clearing, occasional phlegm in my saliva (slightly acidic tasting), a white infection like bump on my tongue which comes and goes with the level of “reflux” I have (almost a weekly cycle).
After meeting this meeting with my ORL, I contemplated the fact that 1) he is a renowned ORL (he is chief of the ORL department) and 2) there was no significant gastro-esophageal acid reflux in my 24 PH study which itself was done by a chief GI. However, over the past two weeks, I’ve stopped all medications and returned to my normal diet (nothing bad, just not watching the acidity levels as much). I have noticed that the reflux (assuming that’s it) is more frequent and I can especially see my tongue grossness factor increasing. I tried to brush it off (as suggested by the ORL) but it hurts and it bleeds!  

It’s in my nature to resolve things and I just can’t accept that this is psychological until I’ve gone through all possible other scenarios first. It’s a process of elimination thing that I have. So by sheer curiosity, I looked up “non acidic reflux” which I fell on a few months ago and found some interesting claims. From what I’m reading now, this seems to be exactly what’s going on for me!

From the research I’ve done, the 24 PH study I’ve had doesn’t measure “non acidic reflux”. Apparently I need a Multichannel Intraluminal Impedance (MII) for this. For your convenience, I’ve indicated a few websites that contain what I think to have pertinent information about “non acidic reflux”:

• Source: MedScape (Year of publication: 2004), http://www.medscape.com/viewarticle/493040
• Source: EndoNurse (Year of publication: 2008), htttp://www.endonurse.com/articles/i_left_my_heartburn_in_san_francisco.html
• Source: ABC (Healthbeat) article about non acidic reflux (Year of publication: 2008), http://abclocal.go.com/wls/story?section=news/health&id=6442172

So, my questions are;
1) The 24 PH study shows average levels of 7 which from the bellow extract of the EndoNurse article seems to point toward Non Acid Reflux!

"The ACG practice guidelines define acid reflux and non-acid reflux as follows: Acid Reflux = reflux that reduces esophageal pH to below 4 or reflux that occurs when esophageal pH is already below 4. Non-Acid Reflux = esophageal reflux where the pH remains > 7 or increases to > 7.

Should I push to get the MII test?

2)  Could whatever is happening to me be related to some form of anxiety? I’ve read a lot about acid reflux (or non acid reflux) having a connection to this?  The fact that lying down (relaxing) stops the symptoms (pretty much) could be a hint of that? If so, what type of cure exists for that?

3) Is there any chance some type of food allergies could be causing an excess mucous build up in my throat (or Larynx area)?

I’m so desperate for answers …

Thanks
iDanny




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To add to this post:

I've just finished a 2 "Boost" diet (that's a meal replacement drink with no lactose or gluten). No change whatsoever ... I'm thinking this should eliminate any food allergy causes.

Now there is still a whole bunch of other things that can cause chronix throat clearing:

(1) LPR (laryngopharyngeal) reflux and/or Non acidic reflux (are they the same thing ?)

(2) Post nasal dripping and/or thickening of the throat mucus (read up on Librax for this - I'll ask my ORL this week)

Both seem to have links to anxiety ... mmm

I'm now considering myself the Indiana Jones of chronic throat clearing! I will find out what's causing this :-)


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