Doubting an LPR diagnosis: Creative DR needed!

[Geodude]

I am in need of a Dr. who thinks outside the box.  I was diagnosed with laryngo-pharyngeal reflux (LPR) about a year ago.   Various tests, including a 24 hr impedance, show that I had (on test day) 22 reflux events reaching up near the larynx, most were alkaline.  However, I never regurgitate anything, and don't seem to get much benefit from any treatment meant to help with LPR, including 2x daily PPIs, gaviscon (UK version),elevating the bed, etc..  I also recently had a Stretta procedure, which seems to have had no effect.   I am now confused and questioning the LPR diagnosis.    My gut (no pun intended) feeling is that some other problem is mimicking LPR, perhaps a tonsil problem.   I say this because:  

1.) My laryngoscopy showed that my lingual tonsils were literally covered with tonsil stones (but not really swollen)  
2.) I notice that when my throat periodically "heals", I usually get some tonsil stones coming out, as if the tonsils have been fighting something, producing stones, then shedding them.  This goes in cycles.
3.) When my tonsil stones come out, they invariably have thick clear mucus associated with them, which also can be seen in-situ, from the laryngoscopy.  I wonder if this mucus causes the "throat clearing", and not LPR?
4.)  My throat-clearing is noticeably improved by an Ipatropium Bromide inhaler, suggesting my throat-clearing may not be related to incoming refluxate, but to the production of mucus.

My ENT doctor never mentioned all the tonsil stones, or checked for any other potential cause of my throat problem, such as tonsilitis, a bacterial infection, sinus drainage, etc.     After going a year with no improvement from LPR treatment, can someone (esp. a doctor) please recommend other causes that should be looked into?   I'd really appreciate some advice, I am starting a new job soon, and sometimes it hurts to use my voice.

[Ratnakar Kini, MD]

Hi Geodude,
Throat clearing may be due to sinus problems also.

You have mentioned that your reflux is alkaline. Treatment for alkaline reflux is different from acid reflux. Discuss with your doctor regrading this.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.