A question to Concerned Lady or anyone else who can answer

[Abbey]

How prevalant are breathing problems in reference to Gastric Reflux? I heard only 5% of breathing problems are due to reflux. Any opinion on this?

Thanks,
Abbey

[Concerned lady]

Breathing problems are VERY COMMONLY CAUSED BY (or MADE WORSE by) GASTRIC REFLUX!

This includes many different types of breathing problems!

I've had over 180 people contact me about one type of breathing problem called Vocal Cord Dysfunction (VCD). Some of these people also had asthma. Some also had bronchitis.

MOST of these people ALSO had GERD!

The people who tried the GASTRIC REFLUX TIPS told me that their breathing problems were improved, as soon as they got their GERD under control!

What kind of breathing problem(s) are you referring to?

A GOOD lung doc (pulmonologist), and a GOOD ENT (ear, nose & throat doc) should be aware of the BIG connection between GERD and BREATHING PROBLEMS!

Please read my website, for more food for thought. It's called, "Can't Breathe? Suspect Vocal Cord Dysfunction!" Here's a link:

http://cantbreathesuspectvcd.com

In my website, there are references to doctors, etc. who DO recognize the CONNECTIONS between GERD and BREATHING PROBLEMS!

I hope this helps.

Sincerely, Concerned lady

[Concerned lady]

Some GASTRIC REFLUX TIPS (without acid blockers):

GER=Gastro-Esophageal Reflux. (Gastro=stomach. Esophagus=food tube.)

LPR= Laryngeal-Pharyngeal Reflux. (Larynx=voice box, containing the 2 vocal cords. Pharynx=throat, above the larynx. The larynx is above the trachea/windpipe.)

Reflux=acidic or alkaline stomach material that backs up into the esophagus (food tube), causing any of these problems: VCD/Vocal Cord Dysfunction/Laryngospasm attacks, cough, voice problems, asthma, globus (feeling of lump in throat), constant need to clear throat, worsening of sinus condition, sore throat, pre-cancerous conditions of throat &/or esophagus, etc.

SOME GER/LPR CONTROL THINGS WE DO, that we learned from the excellent book: STOMACH AILMENTS AND DIGESTIVE DISTURBANCES, by Michael T. Murray, N.D. See page 9, References, in my website: http://cantbreathesuspectvcd.com   and, also see GER/LPR info on page 5, and on LINKS page.

PLEASE READ THIS GREAT BOOK. It may possibly be bought on-line, from Michael T. Murray’s website.

Some of the following we learned from people &/or other books, &/or other good websites about voice, GER, etc.

(1) DGL (De-Glycyrrhizinated Licorice) is one of our main methods of controlling the GER/LPR. We use Enzymatic Therapy brand DGL, shortly before ALL meals (breakfast, lunch, supper). The DGL does NOT cause high blood pressure, and does NOT cause fluid retention/edema, because the bad (steroidal) part of whole/crude licorice has been removed, leaving the DGL. DGL is available at most health food stores, and at good pharmacies.
  
The DGL tablet(s) must be chewed, to mix with saliva, to be effective. If it is too dry, one could mash/crush it and mix with a little water, and then chew it up. Chew tablet(s) for about 10 seconds (at least), to thoroughly mix with saliva, shortly before EVERY meal, and if necessary, between meals (Read label directions).
  
The DGL seems to not only promote healing of throat, esophagus and stomach, but also seems to help prevent OUR reflux.(resulting in no more globus/lump in throat sensation, no more constant throat clearing, excess mucous, excess phlegm, no more NIGHT-TIME VCD/Vocal Cord Dysfunction/Laryngospams attacks, no more laryngitis, etc. for us)

We like the taste of the plain, fructose-free, DGL CHEWABLE tablets, but for those who hate the taste, try mixing the crushed tablet with a tiny bit of mashed organic banana, and then chew thoroughly, to mix with saliva. Avoid any DGL that contains mint. (Mint—in all forms, can cause gastric reflux episodes. AVOID MINT!!).

(2) We use Thayers brand of SLIPPERY ELM Throat Lozenges when we feel the need. (Soothing, coating, healing, nourishing). Slippery Elm (inner bark from a tree) also comes in teabag form, or in bulk, etc. as an herbal supplement.

(3) We drink the occasional small glass of CARROT JUICE (organic, fresh) which soothes, coats, heals the digestive tract, is nourishing, and stimulates the immune system, with beta-carotene, soothing and coating PECTIN (a type of fiber), and other good nutrients. (Carrot soup, cooked carrots are also good. Beta-carotene is heat resistant.) (Beta-carotene later is turned into Vitamin A inside us). Do not overdo. If your skin turns orange, cut back on the carrot juice. Avoid beta-carotene pills -- too potent.

(4) We tried elevating the head of the bed a few inches, by putting 6 inch to 8 inch BLOCKS, ON THE FLOOR, under the head end of the bed. This creates a slant (tilt), where the head is 6 to 8 inches higher than the feet. This helps some people, but not all people. (Check with a pediatric Gastro-enterologist, about raising the head end of a bed of a child, or a crib of an infant). Also, see (16) about a special GERD PILLOW, for adults.

(5) We try NOT TO BEND OVER too often, and we try to AVOID STRAINING (Valsalva maneuver). We AVOID LIFTING HEAVY objects. (No weight lifting!) (at least until after no more reflux symptoms for 3 months).

(a) If CONSTIPATION is causing any straining, see Ref.15,18,23,24,25 on page 9 for ideas about gently treating constipation, including eating whole grains, not white (de-natured ones), etc.  For us, exercise, increased water intake, acidophilus/bifidus, digestive enzymes, avoiding junk food, improved diet, chewing slowly (takes will power!), eating when not under stress or angry, etc., all are helpful.

(6) NO MORE TIGHT pants, belt, corset,--AVOID TIGHT CLOTHING etc.

(7) We try to not eat too much junk food. Some people avoid acidic  food, while others need to eat acidic food, if their stomach is not producing any (or enough) acid. (It is good to avoid acid, if one has an ulcer.) These gastric reflux tips methods often can help to heal ulcers. Some people need betaine hydrochloride supplements, which becomes HCl/hydrochloric acid, or, some use vinegar (acetic acid) in salads, or mixed with water, while others need to avoid eating excess acid. Each person is unique. We avoid all artificial sweeteners. Anyone with diabetes might want to look at the excellent book Reversing Diabetes, by Dr. Julian Whittaker, M.D..

Diet soda pop contains the harmful artificial sweetener Aspartame (Equal/Nutrasweet), which can cause WEIGHT GAIN, HEADACHES, UPSET STOMACH, BLURRED VISION, BLINDNESS, TWITCHING, SEIZURES, BRAIN TUMORS, HYPERACTIVITY, MOOD SWINGS, ETC., and soda pop often has strong acids, plus other harmful artificial ingredients. Plain water, gentle herb teas, certain fruit juices, brown rice-milk, etc. are healthier substitutes for soda pops.

We try to avoid all artificial ingredients, including fake fats (like Olean, Olestra, etc.), because these can destroy the digestive system, and prevent absorption of vital nutrients, such as fat-soluble vitamins (A, D, E, K) from foods. These fake fats also prevent digestion and absorption of needed fats & oils, used to repair myelin nerve cell sheaths (made of fatty material, mostly cholesterol). Hormones are also made of mostly cholesterol.

(8)  We try to drink more water, to prevent chronic dehydration. We like hard (nicely mineralized) well or spring water.
We do not drink distilled water (soft water, no minerals), because it can leach minerals out of our bones, possibly contributing  to osteoporosis. (See Ref.18,23, on page 9.) We avoid water softeners (chemicals) because they can be toxic, and because good minerals help keep us healthy. People with KIDNEY PROBLEMS &/or GLAUCOMA, etc. should ask their docs how much water is safe to drink, since too much water can be dangerous for them! (But, dehydration can cause problems also.)

(9) We use ACIDOPHILUS/BIFIDUS ( edible beneficial bacteria which keep bad YEASTS away, such as Candida Albicans, formerly called Monilia). ACIDOPHILUS/BIFIDUS also can eat or control some bad bacteria, and some viruses. The acidophilus/bifidus are also called PRO-BIOTICS and are beneficial intestinal flora (mainly for the large intestine). We keep the jars refrigerated, but not too cold. These are available at health food stores & pharmacies. (See Ref.14,15,23,24,25, on page 9).

Acidophilus/bifidus can re-populate the large intestine, with good bacteria, after antibiotics &/or steroids, etc. have killed off these good bacteria! Some of us have to continue eating the acidophilus/bifidus (daily, or from time to time), but the results seem worth the effort to us.

Yogurt and buttermilk contain similar beneficial bacteria, but are milk products, so see (11) below about milk products.

(10) We use DIGESTIVE ENZYMES. My husband likes Acid-Ease by Prevail, which contains Slippery Elm (inner bark), Marshmallow Root, Gamma-Oryzanol (from Rice Bran Oil), and the plant enzymes Amylase (digests starch), Lipase II (digests fat), and Cellulase I (digests cellulose from plant cell walls). The Acid-Ease does not contain Protease, which can be very irritating to ulcer/GER folks.

The Acid-Ease is NOT an acid blocker. It is not an antacid. It soothes, coats, nourishes, and promotes healing. Its enzymes help with leaky gut syndrome.

   I use Total Enzymes (which does have Protease, a protein digesting enzyme) by Nutri-West, a company that sells only to health practitioners (Chiropracters, Physicians, and others). One could ask their physician to order, at cost, for them, by having physician call 1-307-358-5066.

   Digestive enzymes are NOT FOR EVERYBODY.

(11)  My husband has found that AVOIDING MILK PRODUCTS helps him feel less congested, with less mucous in throat. Milk and milk products can cause gastric reflux episodes. Brown-Rice Milk (look for gluten-free) can substitute for milk (but not for babies!).

Gluten is in wheat (includes spelt & kamut), rye, oats, barley, & buckwheat. Read labels to avoid hidden gluten, in some soy sauces, gravies, grain alcohols, beer (barley malt), etc. People with Celiac Disease need to avoid all foods containing gluten. BROWN RICE (organic) is gluten-free. Corn is gluten free, but is very allergenic (allergy causing), so avoid corn. Avoid millet, at first, because there is disagreement about whether millet is safe or not, for Celiac patients.

MILK MAY CAUSE MORE ACID to be produced, IN THE STOMACH.

I occasionally eat milk products, like yogurt, cheese, whipped cream, or my ACIDOPHILUS/BIFIDUS, which is mixed with goat milk powder. So, at these times, I take LACTASE ENZYMES, to digest (break down into easily absorbed small molecules) the milk-sugar called LACTOSE. Many people (due to heredity &/or disease) have Lactose intolerance, where the small intestine does not secrete the lactase enzyme. Result is that the milk-sugar (lactose) travels further down the small intestine than it should. Then, bad bacteria eat the lactose, giving off lots of gas (a by-product of the digestion of bad bacteria), and this causes folks to get bloated, gassy, have diarrhea, and cramping. I use Lactaid brand lactase enzymes, and it works for me. Ordering direct from them can save money.

(12) Using the above methods has almost completely freed my husband of needing to use Tums, and seems to be nicely controlling his and my GER/LPR. We have never used acid blockers.

ACID BLOCKERS CAN HAVE DANGEROUS SIDE EFFECTS: Some examples are:

Acid must be present in the stomach, in order for the stomach to make a substance called Intrinsic Factor. Intrinsic factor must be present with Vitamin B 12, in the stomach, for absorption of Vitamin B 12 to happen, in the ileum (last part of the small intestine), I believe.

Acid blockers therefore prevent absorption of Vitamin B 12. Malabsorption (lack of absorption) of Vitamin B 12, causes NERVE DAMAGE (pain, numbness, pins & needles sensation, etc.) in the peripheral nerves (outside the brain & spinal cord). This is called PERIPHERAL NEUROPATHY. For details about this problem, see the Peripheral Neuropathy forum at http://www.braintalk.org

If Vitamin B 12 continues to NOT be absorbed, eventually there can be NERVE DAMAGE to the Central nervous system (brain & spinal cord).

ALSO, the minerals calcium, iron, zinc, other minerals, and important trace minerals, etc. cannot be properly absorbed, when there is no acid in the stomach (due to acid blockers, etc.).

AND, protein does not get properly digested (broken down--eventually into amino acids), in the stomach, when there is no acid in the stomach.

Doctors and pharmacists can advise about gradual(slow) tapering down (weaning) schedules (when and if safe) for the acid blockers. Some acid blockers, when stopped too quickly, can cause rebound acid secretion in the stomach, resulting in excess hydrochloric acid secretion.

ALSO, SOME FORMS OF REFLUX ARE NOT ACID REFLUX, but are ALKALINE REFLUX, (bile is alkaline). Besides refluxed stomach acid (HCl/hydrochloric acid), Pepsin (an acidic proteolytic/protein digesting, enzyme) & bile (alkaline) can irritate & damage: the esophagus, throat, vocal cords, & lungs.

(13) Do not drink ICY COLD DRINKS, and AVOID VERY HOT DRINKS. Use room temperature drinks, or slightly cool, or warm, but not ultra-hot. Extremely cold or hot liquids can irritate the stomach, which is bad for ulcers &/or gastric reflux.

(14) Ask physical therapists, chiropractors, osteopaths, etc. if they know any safe adjustments that might lessen GER/LPR, if you wish.

(15) Read (by Dr. James A. Koufman) PATIENT INFORMATION SHEET ON REFLUX by Center for Voice Disorders of Wake Forest University. Here’s a link:  http://www.bgsm.edu/voice/pt_info.html  Dr. Koufman was a pioneer in showing the connection between stomach reflux (can be acid reflux OR alkaline reflux) and breathing problems!

(16) Some have found a special (large) GERD pillow helpful for preventing GERD episodes while sleeping and while lying down. Here is a link to the Prop up pillow website:  http://www.propuppillow.com

(17) Avoid harmful chemical air pollution, which can aggravate gastric reflux. See page 5 of VCD website for more about this.

(18) Using the above methods, in addition to the SINUS SURVIVAL tips, has helped us to prevent VCD attacks, in us.

(19) Please check with your doctor, in advance, to be sure that it is OK for you to try these tips, in your particular case. Also, please get monitored by your doctor, to be sure that no more damage to the throat, esophagus, stomach, vocal cords, lungs, etc. is happening, from possible SILENT gastric reflux.

Pregnant or nursing ladies should check with their doctors, before trying any of these tips.

Avoid any herbs, foods, etc. that you may be allergic to.

Check with your doctor and pharmacist, to be sure that there would be no harmful interactions between any of your medications, diet that you may be on, and any herbs, foods, etc. mentioned in these tips.

Check with your doctor, to be sure that these tips would not interact badly with any medical condition you may have.

These tips help my husband and me (adults). Some of these tips may be OK for children, and others may not be OK for children. Check with your doctor! Babies with gastric reflux need DIFFERENT treatments, not these tips (except for raising the head end of the crib, if your doctor says it is OK to do this, etc.). Check with your doctor!

Hope this helps!

Sincerely, Concerned lady

[Addie]

Again and again you take the time to e-mail all this information on Gerd/reflux and Vocal Chord Disfunction to all of us. Thank You.

Wouldn't it be wonderful if some doctors would read/learn all about this condition.  Is there a seminar/convention coming up on this disorder and is it open to patients?

I have a question:  You mentioned that asthma/bronchitis can also come into play with VCD.  VCD, then is a seconday problem to another problem?  Must one get the asthma/bronchitis under control first to help with the VCD.  

Just like gerd/reflux backing up into the lungs/vocal chords, I am curious as how asthma can affect the vocal chords and cause  breathing problems.

Thanks so much, again.

[Concerned lady]

Dear Addie,

I'll try to answer your questions, the best I can! :-)

The VCD (Vocal Cord Dysfunction) Conference that I attended, was open only to medical professionals (I used to be a nurse), and to health-related professionals. This included interested EMT's (Emergency Medical Technicians), physicians' assistants, doctors, nurses, respiratory therapists, physical therapists, occupational therapists, etc.

Since I used to be a nurse, I was able to attend the conference. I used to be a VCD patient, but it was the nursing background that allowed me to go to the conference. Are you in the medical professions, at all? If VCD might relate to you, ask your doctors to go to the next VCD Conference. See page 8 of my website, about future VCD Conferences. Here's a link:

http://cantbreathesuspectvcd.com

From researching VCD, and from my husband's and my own experiences with VCD, and from speaking with other VCD patients, it seems to me that you are correct. VCD is a problem that is "secondary" to (caused by) another problem, or, usually caused by SEVERAL PROBLEMS.

In ancient days, people probably got VCD from inhaling volcanic ash & dust, &/or from breathing in smoke from forest fires. They probably also got VCD from bronchitis, etc.

For example, take bronchitis. The coughing and phlegm can cause VCD. Also, if there was a virus involved, the virus can sometimes spread to nerves (the vagus nerve, or branches of the vagus nerve), causing a new case of GASTRIC REFLUX, plus other problems.

And some types of gastric reflux "episodes" (due to viruses, or due to stomach irritation, etc.) can cause VCD attacks!

To get VCD under full control (a "cure" or close to a "cure"), it is important to try to remove all the underlying CAUSES of VCD, and remove all VCD "triggers", and remove all VCD "aggravators", and treat or control all associated/pre-disposing conditions.

If removing the causes is not possible, try to at least lessen all the VCD causes, &/or treat all the causes.

So, you are right. If a person has asthma &/or bronchitis, and these have caused VCD, then it is helpful to get rid of the bronchitis and try to control the asthma.

At the VCD Conference, they said asthma itself can cause VCD, but I don't remember if they explained exactly how this happens. That's a very good question, though! Also, some asthma medications (like Albuterol) can directly irritate the vocal cords, causing VCD attacks.

And, some of the inhaled Albuterol gets swallowed, and ends up in the stomach, where it may irritate the stomach, causing a gastric reflux "episode".

Then, the reflux material (or the fumes evaporating off the stomach liquid) gets inhaled. When this irritating material (gastric reflux material) comes in contact with the vocal cords, the vocal cords get burned (damaged). After enough irritation & burning, the vocal cords become "twitchy", are very likely to go into a closing-up spasm, called a Vocal Cord Dysfunction attack, from the next little bit of stomach material hitting the vocal cords. This is also sometimes called Laryngo-spasm.

I hope this helps some!

Sincerely, Concerned lady

[Concerned lady]

Dear Abbey,

Thank you for your nice comments about the "tips".

Regarding the "thread" of 6/18, about Bloating & Gas on Proton Pump Inhibitor meds (sometimes called "acid-blockers"):

Pharmaceutical reps probably don't emphasize medication side effects, when they are promoting their products to doctors, because that might negatively impact "sales"...

I'm so glad you are going to very slowly taper down the acid blocker medication doses, over a couple of weeks.

I urge you to simulataneously start using the DGL (De-glycyrrhizinated licorice) chewable tablet, shortly before every meal, to help heal your stomach & lessen or stop the gastric reflux. DGL also helps promote ulcer healing.

Try many of the Gastric Reflux tips, not just the DGL! I think you may be pleasantly surprised by the results. Let us know.

And yes, you are right. It is sad, that you can't just blindly believe everything that all doctors tell you. You do have to ask questions, and expect accurate answers. You need to be an active part of the medical team, and not just a passive patient.

Now that your eyes are open, and you see the good AND bad, that exists in the medical profession, you are more likely to get good help, and to help yourself!

Don't blindly believe all that you see on the internet either, but do keep asking questions! :-)

Sincerely, Concerned lady
<http://cantbreathesuspectvcd.com>