GERD? Laryngopharyngeal reflux?

[TrustGod]

My symptoms may have started in Feb 05, with a bad taste in mouth that lasted about a week following a round of zithromax.  That was it. Then at the end of April, the bad taste returned, along with a choking feeling during the night. I visited my PCP, she prescribed Protonix. I took it for 2 weeks - no change.  She told me to try Prilosec. I took the over-the-counter for 2 days, had a slice of pizza, and had the WORST heartburn. I stopped the Prilosec, and took Zantac for a couple days - nothing. Then I stopped taking everything and for the next few days felt pretty good.  I saw a naturopath, changed my diet completely, elevated my bed, lost weight, etc. About a week later, the sore throat started, along with a cough, and the choking sensation again.  I saw an ENT, and he looked through my nose and down my throat. Said it was the worst case of acid reflux he'd ever seen - my throat was "fiery red"  He put me back on Protonix. Took it for 1 week, no change, had a small salad with a little bit of tomatoes and onions, and heartburn again. I stopped again - the heartburn stopped.  But the sore throat and cough continued.  I returned to the ENT - he wanted to do a 24 hour probe and said he would schedule one, but he never called me.  A week later I started on Prevacid - and felt GREAT for 3 days. The 4th day, heartburn pain right in the middle of my chest all day long.   Called my PCP, she said she'd get me in to see a gastroenterologist ASAP.  Saw him 2 days later, and stopped all meds.  He said that he wanted to do an endoscopy and said I probably wasn't taking ENOUGH medication.  This made no sense to me as the ONLY time I had heartburn was when I was on the PPI's.  We scheduled the endoscopy for yesterday. Last weekend, my sis in law convinces me to take her Zantac - 150 mgs. I take it for two days - I feel awesome again.  I tell the doctor I think this is it and want to postpone the endoscopy. He feels I should still have it done, but I'm questioning why? I haven't had acid reflux that long, although off and on over the past years, I've had minor sore throats that would last a few hours - maybe about 2x a month.  And now, after 4 days on 300 mgs of Zantac, the sore throat and cough are starting up again.  

Can you help advise me? Why do I only get heartburn when on the PPI's? Should I have the scope? I'm TERRIFIED of having it - scared of something going wrong.  Sorry this was so long, I hope you can help me understand why the symptoms are happening the way they are. One last thing - when all this started in April I weighed 158 (I'm 5'8") My weight is now 145. I'm not overweight and I don't wear tight clothes. I've given up all spicy and fried food, chocolate, soda, don't drink coffee or alcohol or smoke, I've cut out dairy and wheat - and increased my daily intake of fruit and veggies. The only meds I take is 5 mgs of Paxil a day for anxiety. Oh - my gallbladder was removed 10 years ago and I'm 43, female.

[Kevin Pho, MD]

I would go ahead with the endoscopy.  The symptoms sound like refractory reflux and this can lead to inflammation of the upper digestive tract, and what's called Barrett's esophagus.

If the symptoms continue despite medication (which sounds like the case), you can go forward with the 24-hr pH study to confirm the presence of disease.

If there continues to be GERD, then there are various surgical or endoscopic treatments that can be considered.

These options can be discussed with your GI physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

[TrustGod]

I forgot to add that my symptoms usually get worse as the day progresses. Generally I start off feeling pretty good but by day's end, I'm coughing and my throat is raw.  Right now my stomach feels all bloated.  Anyone got any suggestions for me?  Thanks

[Julie1111]

Hi TrustGod, I have just been through a very similar experience! Although I didn't have the heartburn, the waking up at night choking and general shortness of breath have taken me to my family MD, an allergist and finally a gastroenterologist. I too have been diagnosed with GERD and was prescribed various meds: Aciphex (did not work for me); Pepcid Complete (good-but not strong enough) and now Zegerid (has helped a lot!!) Granted, my life has changed as well: no more caffine, no alcohol, no "trigger foods" (onions, garlic, tomatoes, spicy things, chocolate, etc.) I no longer eat dinner late-by 7 PM at the latest, no snacks after dinner. Bed is elevated, drink enormous amounts of water (no juice). All this has helped.

I had the upper endoscopy today. They found major irritation in my esophagus, and confirmed the GERD diagnosis. I have never had these problems before and LOVE the foods I've had to cut out. But my doc claims with another 3 weeks of the med I should be back to normal and need it only for flair-ups. I would suggest the endoscopy-it was not bad and I am a real baby about things!! I was sedated, so felt nothing (only the IV pinched a little, like giving blood) and woke up after the whole thing! I had this procedure 4 hours ago, sedation has worn off and I have no soreness or anything.

Also, judging by your screen name, you might understand this: I of course was terrified by what I've been through in the past 3 weeks (suddenly began 3 weeks ago). But in retrospect, God sometimes uses situations to get our attention and draw us closer to Him. I know that is the case for me-I've found reading Psalms to be very helpful and have really focused on the trust issue that we all struggle with. Good luck and don't be afraid of the endoscopy-it will help you know what this is and move on. It will also tell you if you have ulcers, for which you'll need special meds beyond the PPIs.

[wassupwassabi]

It's interesting that you only have heartburn when you're on the medication.  Kevin Trudeau says that in most people heartburn is caused by not enough acid as opposed to too much acid.

Have you had a barium swallow?  It can show you the extent of your reflux.  But don't be afraid of the endoscopy, I've had it done...it's pretty safe.  They knocked me out and I don't remember a thing about it.  

[TrustGod]

Thanks for both your comments. I thought it odd that the only time I have heartburn is when I'm taking the PPI's.  I tried drinking a teaspoon of vinegar with a glass of water, but that didn't seem to work either.  I keep telling the doctors that the medication brings on heartburn pain, but they don't seem to listen, or just want to increase the medication.  That makes no sense to me.

And thanks Julie.  I have made all those diet changes. It's funny - I can eat pizza or tomatoes when I'm NOT on the PPI's - and don't have heartburn. Still, the sore throat continues regardless of what I do. Two great days on Zantac - now two "so-so" days with the sore throat returning. ARGH - the frustration of it all!

[astros18]

I wonder if you have read The Makers Diet or any of Dr. Jordan Rubin's books.If not I encourage you to do so.Your story is very much like mine. I had my gallbladder out 12 years ago and have had digestive problems pretty much ever since.If you try the apple cider vinegar, do not dilute it with a glass of water. Also, try not to drink with your meal, it dilutes stomach acid and slows digestion.Zirthromax is a strong antibiotic which probably caused an unhealthy balance of yeast in your digestive tract.Most people who suffer from acid reflux are very yeasty. Acidophilos is not strong enough to make much difference, you need a biphidophilos probiotic.You should also be taking a digestive food enzyme, especially a hi lipase enzyme to help you digest fats since you do not have a gallbladder.You shouldn't take the reflux meds for longer than 8 weeks. They are not good for you, in my opinion.I cannot stress enough how important it is you drink Lots of distilled pure water and make sure your bowels move daily if not more.I wish you good luck and good health.

[TrustGod]

Thanks Astros. I took a month's course of saccromythes boulardii and then acidophilos for a month.  I spent all afternoon yesterday in the ER with severe stomach cramps. These medications aren't treating what I have - they just cause further problems two-three days after starting on them. I'm at wits end, cause they work the first two days - then, not only stop working, but make me feel worse. But doing nothing doesn't fix the cough and sore throat either...

[astros18]

I'm sorry you had such a terrible day yesterday. What exactly did they do for you in the ER? Are you cramping like you need to have a bowel movement? Have you had a bowel movement lately? A backed up colon causes a backed up digestive system causing severe reflux. I would still continue taking a probiotic and I take an Intestinal Soothe and Build by Nature's Sunshine. Digestive enzymes should start helping within a day or two. Acid will literally burn the back of your throat and the pain sometimes takes days to go away. You might try a liquid antacid for about a week. Take a tablespoon after every meal and before you go to bed. That will soothe your esophagus. You might suck on a Riccola Throat lozenge to soothe your throat. Again, try not to drink more than 4 ounces of liquid with your meals and wait at least an hour after eating to drink anything substantial. Other than that, I don't know what to recommend. I know how bad you feel, I've been there before. Don't give up hope, you will find the answers.

[Supragirl]

Hi There,

   I had an upper Endoscopy last Friday, I promise you, it's no big deal. You can be sedated, but why blow hours waiting for the sedation to wear off for a three minute procedure. I refused the sedation, and it was just wierd feeling, no pain at all.

Here's a tip:  breath out of your mouth during the procedure. I was breathing out of my nose because I didn't want to fog the camera with my breath !!!!! DERRR!!!!! When I realized, DUH, how stupid that was, I took breaths out of my mouth, but then it was over. My test wasn't even 2 minutes long !! You only feel like you are gagging when the air they put in comes back out, but you really aren't gagging.

   All my symptoms are gone. For about 3 weeks I drank: aloe Vera Juice about 2 oz. 4 times a day, ate baby food, and drank Camomile Tea. Now I'm eating and taking digestive enzymes with meals.

   I had been on a Coffee, and chocolate binge for about 6 weeks. That is what I believe caused my reflux, because other than that, I eat a pretty healthy whole foods diet.


   Get the scope, it will set your mind at ease.  

[TrustGod]

Thanks to all who responded.  I was at the point where I was coughing all day long, my throat felt raw. I've lost nearly 20 pounds by now and was ready to drive off a bridge, I felt so bad. I saw my PCP again on Monday, and she believed that anxiety over my symptoms was making it just so much worse. She put me on Xanax, I finally slept more than five hours a night, and for the last two days, I've hardly coughed at all.  My throat still feels a little sore, but I feel like a human being again. I guess anxiety really can increase the severity of the symptoms. Now, I'm back on Prevacid and just waiting for it to hopefully start kicking in. I'm due to go in for my endoscopy at the end of this month.

[babbles]

Hi Julie I am going through the gerd thing too, I was having shortness of breath, feeling of a lump in my throat/ something sitting in the back of my throat, also reflux of fluids and food back up the esophagus. I had the Scope done and biopsies done and everything came back good. The doctor did say I had acid irritation and signs of sluggish emptying. So he put me on Cimedine and Relgan(methoclopramide). I was on protonix and he had me finish that out before starting the cimedine so I did that but the protonix was more problems for me then it was worth. So now I am taking cimedine and the methoclopramide 2 times a day, I have seen some improvements but not alot yet. It has been three weeks today that I started on both of these medicines together before that I was on the protonix. Do you have the feeling of being full, or bloated? What medicines did they prescribe you? Just wondering because as you have probably discovered the docs are of no help. My doctor finally answered the question I have been asking him for 5 weeks this last Monday, I asked him what was the cause of all this and he told me the acid irritation, which to me is odd because I had no acid reflux until a couple days after it all started. I had acid reflux previously but a year and a half ago after I had my son it had gone away completely. I guess it is possible when this all started at the end of June it could of been from acid but I don't see how. Anyway any input would be great. Also on Monday my doctor tells me to go ahead and take the medicine when I feel I need it, just because I told him I had seen a little improvement he acts like I am healed. I am far from healed, I have lost 30lbs in 5 weeks and it sure wasn't from eating. But that doesn't seem to concern him.

[babbles]

Good luck with your endoscopy, they really are nothing to worry about. I have had 2 now, one about 4 years ago and one last month. The first time they put me under and the last time they mildy sedated me, and all went good both times. Your name says it all, trust god and all will be good. I don't blame you for not wanting to do it, I was the same way the first time I cried and cried and refused and refused to do it. Then once I went through it I couldn't even believe I was worried about it. I am glad to of found this forum. I have been through so much over the last 5 weeks, I too am tired of it and pray and ask god to help me through this and when I have good days I make sure I thank him for helping me get through the day. I have 6 kids that are depending on me to get well and without gods help, I couldn't do it. The doctor I have really hasn't been any help, all he wants to do is up my medicine every time I talk to him he has me call in and give him a progress report every week and when things aren't improving he tells me to take more. This week things have improved some but I know I still have a long way to go. But at least I am functional now and not as worried, having problems like this cause anxiety which in turns makes it all worse. Also trying to self diagnose yourself, doesn't help at all. I learned to stay away from the internet because everytime I looked something up, it sounded like it was what I had and had diagnosed myself as having many things which only added to the anxiety. Good luck with your health.

[astros18]

I hate to say this, but your doctor has no idea what is causing your problems. He merely wants to treat the symptoms as he has been trained to do. If you have been reading the posts in this forum, then I think you will find that the majority of people never find a resolution of their medical ailment. One must think outside the box to get to the root of their problem. What have you done differently lately? Did you take an antibiotic recently, or go out of the country? Digestive problems, in my opinion start in the colon. If you have a toxic liver or colon, you are going to have digestive problems. Acid reflux doesn't necessarily mean you have too much acid, it means it is not staying in your stomach,it is traveling to your throat via your esophagus. Taking a drug doesn't stop reflux. Most people who suffer from acid reflux have a systemic yeast problem caused by overuse of antibiotics, a diet filled with sugars and red meat, using the birth control pill, the list goes on and on. Yeast can cause a host of symptoms and problems. I recommend to anyone I know with digestive problems to work on their colon first, replenish the good flora using a strong probiotic. Taking digestive food enzymes usually helps as well. It is imperative that your digestive system work as efficintly as possible, for obvious reasons. I'll get off my soapbox now and wish you good health!

[babbles]

Thank you I finally was able to get your post, I really didn't do anything or have anything different then I normally would. I have never really been a meat eater. It had been over 2 years since I was on any kind of antibiotic,after all this started into the 2nd week I did get a urinary tract infection but I think that was from not being able to eat or drink etc. And I was on cipro for that but after 2 weeks of having this. How do you know if you have a systemic yeast infection? Would the scope show this or blood work. I had blood work done three different times between all my doctor visits and also had an ultra sound of the abdomen and ct scan as well. You are correct these doctors don't know anything, I have seen so many of them over this and get no where I use to think my primary care doctor was great until this came about, I quit going to him because he acted like he wasn't believing me he would say well you seem to be having all these problems but we can't find anything wrong with you. At that point I had enough I had lost 22lbs and I hadn't lost it by staying nourished. I couldn't sleep for weeks worried about what was going on have ran up over 10000 in medical bills and have no insurance and to top it all off I know nothing more today then when I went in there 5 weeks ago. If you can help me on which probiotics to get and enzymes that would be great. I agree with you totally after having been through all this it is a problem with the way my body is digesting the food, I don't agree with the acid reflux because I didn't even have any reflux problems for almost 2 years, and then he tells me it is from acid irritation. It all started with alot of the stuff I had eaten 17 hours before coming back up and it wasn't everything from those 17 hours only certain things that didn't digest. The other night I ate a half of hamburger pattie that was grilled and then some maccaroni and some green beans and the only thing that came back up was the hamburger, which  tells me my body won't digest the meat but did everything else and this is after I have taken both medicines a half hour before eating. He said I had signs of sluggish emptying and I do get full fast and on only a small amount and I never get hungry. But this could also just be that I am not digesting everything. The other thing after having my gall bladder removed everytime for 2 years I ate it would send me within a half hour to the bathroom it would go right thru me now it is like I have a bowel movement every morning not like before everytime I ate. It could be I am not eating enough or could be the colon like you mentioned. Where do you get the colon cleansing stuff? I am willing to try everything at this point, I am not one for taking any kind of medication, one reason I didn't start the methoclopramide right off.Please help with what you can.Thanks again

[j yanni]

I personally believe it comes from stress. I was doing great until my son and his  girl friend and her three children moved in and my gerd started up again and it worst never than ever. Please help me to deal with it . I can not sleep at night anymore.

[astros18]

Wow that's enough stress to make me start having reflux! I feel your pain. Digestive food enzymes may help. Try taking a tsp. of apple cider vinegar and see if that helps. You may need to supplement with PDA, an enzyme that helps digest protein. And you must try to relax until your relationship issues are resolved, hopefully soon.

[TrustGod]

Thanks to all who have responded to my original post.  My doctor put me on Xanax at the beginning of August, and the coughing stopped immediately.  When it came back several days later, I then started on Prevacid, which I've been on since mid-August. It is now working great - no cough, no sore throat, and I feel great.  I do believe that stress and anxiety played a huge role in my acid reflux becoming so bad.  Best of all, I finally garnered up the nerve to do the endoscopy. Thanks to all who encouraged me on this. I did it yesterday, and it was a BREEZE! I was terrified of somethig going wrong, my heart rate was at 130 when they took me in, but my doctor was awesome and assured me I'd be fine. And he was right. And the best news?  Some slight inflammation near the lower sphincter and some redness in the laryngeal region - and that was it.  The dr. did a biopsy for Barrett's, I'll get the results in 2 weeks. But THANK GOD it's over with and I can set my mind at ease.

He told me to stay on the Prevacid for at least six months, and then I can start to wean myself off. But in the meantime, he said I could eat whatever I want. YAY!  It pays off in the end -don't give up!

[queen audia]

hello. I have been reading all your comments and suggestions and I know you have a lot of great ideas, I hope you can help me. I am 34 yrs old w/ 3 children and already ligated. I had several attacks 2 yrs ago but I thought it is all because I am acidic. Last July 2005, I had a severe attack and the next day, symptoms of Gerd started, no burning sensation but I felt a bad taste in my mouth , and felt a lump in my throat. To make story short, I had  gallbladder operation last July 27 and expect that all those symptoms of Gerd might stop. But it did not and I started coughing after operation. Now, I eat 1 raw potato in my every meal. Don't eat meat. I eat grilled chicken and fish. Is my diet okey. I have my bed elevated , stop Nexium, stop also liquid antacid. I don't consult Gastro, is there a chance for my Gerd to get healed w/o taking any medications. I am afraid of Cancer, how long for a gerd to become a cancer. Hope you understand, I am not very fluent in English. Thanks

[joebizz]

Hey, that is my concern too.  How long till it turns to Cancer.  What I've been reading is that it takes years for it to turn to Barrett's and then it's only a small percentage of cases that turn to cancer from there.   I have had heartburn after every meal for the past 6 months now.  And I saw the Dr and she told me to take antacids but I don't want to.  So I'm doing DGL tablets and eating soft foods for a week now and NO RELIEF!  The only thing I find works is:  CHEWING GUM.  But is there another way to heal my heartburn w/o DRUGS???  The soft foods don't work or do I need to give it more time?  Also should I do the apple vinegar while healing with soft foods? Or does that burn the esophagus while healing?   She wants to do an endoscopy in October if I can't get rid of this myself.  thanks.

[queen audia]

I tried to eat only rice and potatoes, apple, bananas,cucumber for a week and avoid fried or food w/ oil.I didn't  experienced the symptoms . but when I started to eat fish and chicken again, symptoms are all there again. I am so tired of it , why I have this sickness. I rather have TB, since it  easily can be cured if you just get the right medication. But this Gerd, I tried anything. I really don't want to hear from doctors that I need operation again, I just had a gallbladder operation. I really don't want my husband worried so much especially w/ financial aspect. To joebizz, how MANY years will a gerd to turn to barrets, I hope giving that time, I really pray healing for us. Actually, I really didn't have burning pain, and I don't cough so often. I am just tired of this lump in my throat and sometimes lump in my chest. I really still work even all I want is to lie and just get rest. My husband didn't know of what I'm going through. I have 3 children , I still want to see my children get old.

[fruitaholic]

Did you try taking digestive enzymes with your meals?  Since it seems digesting fat is a problem for you (which makes sense since you had a gall bladder operation) digestive enzymes might do the trick.

[chattykathy]

Hello everyone; let me tell you what has been going on with me and see if anyone else has had this problem.  I am so frustrated wtih this and we have no insurance till oct 15th, because of my husbands new job.  It started 3-4 months ago with me just haveing trouble swallowing, or getting choaked.  I recently started coughing at night and early morning.  I get so choaked that I can't get any air and then I do get alittle freaked out.  I do have a inhaler but does'nt seem to help that much.  My family has had to call 911 a couple of times. went to er and then a pulmanory dr and then to an emt and he said it was gurd (gerd) put me on Protonix have been on that for 3 days and tonight I had a really bad attack and I felt real sick like I needed to throw up but if I did I would choak to death.  It is the scariest feeling I have ever had in my life. I am trying to watch what I eat and drink, and I know it has just been 3 days.  He also put me on a steriod to reduce the swelling in my voice box and throat.  he did the scope where he went through my noise and in to my voice box.  I have also lost some of my voice.  I am raspy and sometimes cant talk at all.  Very hard for me.  If anyone has anything that can help please send me an
post.  Sorry this is so long.  kathy

[queen audia]

thanks. i have read that digestive enzymes is not advisable if you have an ulcer. Can you give me one example of digestive enzymes that you are taking. Do you also have gerd ....before?

[queen audia]

How's the result of your endoscopy. I hope you are okey now.

[Kidd1]

Dear Dr.Pho,

My husband has an acid reflux (GERD).  Is GERD the same as pylori? He had an endoscopy procedure done. During the procedure he was sedated.  After the procedure, he is so forgetful.  Even months after month, he is still forgetful.  Could the endoscopy procedure has an effect on his memory?  It has been a year and it is time for him to re-visit with the gastroenterologist.  I am afraid that the Dr. will recommend to perform the endoscopy again.  Should my husband perform it again?  If he does it again, I'm afraid that he will have a greater memory lost (forget where he put his key, wallet,...).

Thanks!
Kidd1

[wassupwassabi]

My grandma has suffered some loss of awareness/memory since she had a barrett's treatment procedure done.  It's the anesthesia that has the effect on your brain and makes you disoriented and they say sometimes especially in older people it can take months to get it out of your system :(

[shan74]

I really hope that someone can help.  Let me just give you a quick overview (i'm so sick of telling it!)  Well, since August 23, I have had a lump in my throat.  It started at the adam's apple then gradually went down to the biginning of my breast bone.  I went to the doctor and she ran the light down my throat and said it was gerd.  I've put my bed up the 6 inches, I was on acephex but that didn't work so I went on Prilosec and to tell you the truth I've not seen any change, although when I went on the achephex the day after I had the light ran down my throat for one whole week I felt great but then all of sudden it came back and it's stayed.  It's absolutely driving me nuts.  Sometimes it feels like someone has their hands around my throat trying to choke me to death.  The only thing that I've found that helps is peppermints.  I'm sucking on about 15 a day!  HELP before I go crazy.  I have no health insurance now and can't afford to have more tests ran.  What does someone suggest.

[JackieG]

First of all, if its GERD, you need to stop with the peppermints.  Peppermint actually stimulates the production of excess gastric acid, which exacerbates the GERD.  Search the web for a full range of GERD lifestyle changes, but limit your search to reputable sites like major medical centers.  You don't want to get hooked up with some of the kooks out there that push alternative therapies for every ailment known to mankind.  A reputable site will give you detailed dietary guidance for GERD, as well as practical pointers like not eating within 3 hours of going to bed, elevating your bed (which you are already doing), losing weight if you are obese, eating smaller portions, stopping the use of alcohol and tobacco (if you use them now), wearing looser fitting clothing, etc....

Putting your full effort into all of these lifestyle changes can make a real difference, and beats having to live with the unpleasant effects of GERD, or, having surgical intervention.

Good luck.
Chicken Soup

[shan74]

What gets me is like it came on all of a sudden.  I never really thought that I had trouble with acid reflux before.  Is that how GERD starts?  What I mean is, does it just come on all of a sudden with that terrible lump in the throat feeling?  I had read that peppermints were bad for some but helped others.  So, that's why I tried the mints and found a little relief, by this point and time I'm willing to try anything!  Also, I've lost 40 pounds in the last 4 months (dieting) and exercizing.  I don't know, what I do know is that right before all this happed with my throat I had a real bad thing happen with a family member and sometimes I think maybe that brought it on.  I just wish I knew why it happened so quickly and won't go away with meds!  thanks again chicken soup!

[reo]

hello! I'm a 37 year old male with a problem consisting of major gaging. It feels like a lump hanging onto my gag-reflex, I start gaging like i was throwing up then it turns into a cough. It will get to the point of vomiting up a small mouthful of froth with a bit of acid. this will be most severe in the morning lasting for a few hours with intervals of a few seconds to a few minutes.It will go away for awhile then return at any given moment,full or empty stomach. At times I would be hang out with friends and just throw up with no ill-feeling. Today it has lasted for over 7 hours with excessive gas. I have bad insurance and would like to start here for any cures or remedies.