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High Dose PPI for LPR

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Posted 8/6/2011 1:06 PM (GMT 0)
Finally got to the Ear, Nose and Throat Dr.  As many others on here have experienced, I have acid damage to my vocal chords :o(

I also have acid damage to my lower esophagus. Knew that already from an endoscopy in early July.

The new regimen is 40 mg protonix twice daily and 1 Zantac 150 at night.  (Plus all of the lifestyle recommendations that we all know).

Sigh, it seems like a lot of medicine but I have to protect my vocal chords.  Anyone else on a high dose PPI regimen for LPR?  And, if so, were you eventually able to lower it?

Posted 8/7/2011 10:34 AM (GMT 0)
Im currently taking 2 PPIs a day, 3 when I know its going to be a long day.
Posted 8/7/2011 12:16 PM (GMT 0)
I am currently taking 30 mg Prevacid 2 times daily. My 1st GI also had me on 300 mg of zantac nightly, but it didn't seem to help so we stopped that. What really seems to help the night time flow is the Reglan I take. The more empty my stomach the less acid flow I can feel. Well, at least I don't feel or hear anything as much. Sometimes not at all. Nor is my throat and upper chest sore anymore. I haven't actually been diagnosed with LPR, but I do feel that I have silent reflux. Not sure how that is diagnosed. When I told my current GI that I could feel and hear things gurgling in my throat night and day, he just looked perplexed. rolleyes
Posted 8/7/2011 12:54 PM (GMT 0)
Hi Katherine,


The purpose of hi dose PPI in LPR is minimize the damage of reflux When it happens. Your gonna have reflux no stopping that, but you want to minimize the occurrence and minimize the damage when it happens.

Its a vicious cycle every time you get a "BURN" or more symptoms, chances are your causing more damage to your LES, leading to more reflux. If you can break the cycle and give your LES chance to i figure 4-6 months then you fix your LPR, that's my 2 cents anyways.



I am currently on 40mg nexium 2x day, and 20mg prilosec at lunch.

My observations of my symptoms the past month:

I feel my throat symptoms gradually lessening, the esophageal soreness disappearing.... sometimes i do feel something but its really minor...

I think i got to this point 50% with the PPI, 50% with super strict diet and life style changes... I think i have turned the corner with this new approach.



-Jesse
Posted 8/7/2011 1:01 PM (GMT 0)
Hi Sewfun,


The trick with LPR is to goto an ENT to diagnose it and properly treat it. Gastro are pretty clueless about it. You go see a gastro to treat the reflux. You go to see ENT to diagnose the LPR, they can scope your throat or Strobe it and can usually tell in 10 min.


LPR sufferers usually have more mucous near the vocal chords, just goto youtube and search for LPR reflux, they have a bunch of clips of Videostroboscopy.

besides once you get acid in your throat, you can get cancer there, so its a good idea to get the ENT to check it out. Procedure takes 5-10min.



Hope that helps.


Jesse
Posted 8/8/2011 11:26 AM (GMT 0)
Sewfun, Jesse is right if you have concerns about LPR, you need to see an EN&T Dr. Basically, you'll need both GI and EN&T Drs. I'm going in for a stroboscopy in 2 months.

Jesse, how long have you been on the meds?  I am relatively newly diagnosed, on PPIs since early June but just recently started the really high dose.

I'm also being very carefull about diet/lifestyle.  That does help.  Although the weird thing is something that does not bother me one day, might bother me another day.  Thanks for your reply!

Posted 8/8/2011 12:34 PM (GMT 0)
Yeah, it doesnt really seem to matter what I eat. I try and stay healthy, but really, unless I eat a giant cheeseburger and drink a few beers, it doesnt really matter. I think the hard part for LPR sufferers is getting the medicine dosing right. I know the standard is "double dose ppis," but I think its very individual. Im currently experimenting with the timing of taking my pills. Had great success with Dexilant (totally resolved the throat issues), but it was blowing out my GI system. Currently experimenting with lower doses, timed differently. I am a firm believer that LPR sufferers have to take matters into thier own hands when it comes to finding a solution. The docs just want to throw something at you, and see you again in 3 months.
Posted 8/8/2011 12:38 PM (GMT 0)
ChuckT,

How long have you had LPR?

So far, I am finding it quite tricky. 

KatherineG

Posted 8/8/2011 4:24 PM (GMT 0)
Thanks Katherine and Jess. I didn't know the GI doc wouldn't be able to spot LPR on an endoscopy. Good to know I may need an ENT!
Posted 8/8/2011 5:08 PM (GMT 0)
Katherine,

Ive had symptoms since January. Im just trying to manage it for another year or two until the Linx surgery is approved. It seems to be effective for throat reflux according to those on this board who have had the procedure.
Posted 8/8/2011 9:34 PM (GMT 0)
Hi Katherine,

i prob been on this high dose for 2-3 months...


Jesse
Posted 8/8/2011 10:44 PM (GMT 0)
Thanks, Chuck and Jesse.

This LPR thing is tricky, I agree with you Chuck.  I've been trying different things, it's a chore for sure. Oh well.  Linx, huh, I'm not familiar with that but I'm going to google it now, curiosity :o)

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