Can GERD progress to LPR?

I did have LPR from GERD, and like it was because of careless lifestyle choices. And I started to control myself, it receded to GERD then to none. I was lucky to have taken action when it was at mild stage.

Mr Mustard said...


Hi WJF,

It's great to hear you got GERD under control...I also had long periods of remission during my 5 year battle with GERD...I guess people sometimes become complacent about the lifestyle choices once they've improved for long periods of time...well I surely learned my lesson not to again!

How long did your LPR last and what helped it to recede back into GERD? Did PPIs help you?

It lasted for a few weeks. I didn't take any PPI. I was careful with what I ate and did, then it got better.

ericapeace2000 said...
I seem to be experiencing this right now as well. I did not have LPR symptoms usually (there have periods of short time of having a few LPR symptoms in the past 10 years with this horrible illness)....

Thanks Erica for sharing your experience with this awful illness. Indeed I know my wife had gerd during her pregnancy and it was difficult. Lucky for her that she recovered immediately after labor.

I still cannot find anything in the medical literature about the progression of gerd to lpr. Some researchers believe lpr is just a continuum of gerd but don't go into detail about if and when gerd progresses to lpr or whether it is a progression at all. Again I used to have classic GERD symptoms until a few weeks ago they suddenly changed to mainly upper esophageal and throat symptoms.

You seriously might want to talk to a knowledgeable doctor on the GERD/LPR subject if you can to see ahead of time how to be able to manage the conditions during pregnancy....as I can imagine the added pressure on the LES during pregnancy could make it worse.

I wish you all the best with your conception and hopefully a good management and resolution of your symptoms.

Yours,
Fellow sufferer ; )

I am not sure what else I can do to treat myself in pregnancy. Other than go on a PPI ( which I will in the third trimester if I am dying). I already take pepcid, gaviscon and carafate as needed. Thankfully all catagory B. I dont really understand the change from GERD to LPR. A lot of GI doctors don't recognize LPR. I haven't been to my GI in a while as I feel I know more about my condition than the GIs I have been to in the past. My primary oversees me as he is more available and receptive. My symptoms as of now are mild and I can manage on a daily basis. They are annoying as I am not used to them. I started breathing exercises maybe they will help.

I dobt take a PPI I'm on an h2 blocker. I also take digestive enzymes which I would suggest to help with digestion.

Hi Ericapeace 2000
Sorry for the confusion. I was applying to Mr Mustard's original post. I should have listed his name

Hi Mr Mustard,
Yes, my situation has seriously improved. There is no comparison to where I was a year ago. But I had to wean off all PPIs & H2-blockers including antacids. I went through 3 months of horrible acid rebound to do this. But Once I was off all these medications my situation slowly improved. Every three months I would notice an improvement. But it does take a long time to completely reverse. I have been off all PPIs & H2-blockers for 16 months now and my symptoms are almost completely gone. This is without taking any supplements.

Basically the PPIs and h2-blockers can cause the acid in the stomach to become so low where you cannot break down the food in the stomach... which is causing delayed gastric emptying. The remaining acid in the stomach along with the food will be pushed back up the esophagus over & over again until the stomach empties out. This is why low stomach acid can actually cause GERD/LPR. Google: Low stomach acid PPIs.

I already had globus sensation before I went through acid rebound. But acid rebound was extremely painful, and yes I did go through the pain. All I knew was I was a perfectly healthy 46 year old before taking omeprazole 20mg, and eleven days after taking it I was not. They gastroenterologist did not realize the PPI caused the problem to begin with. So the idea of increasing the dosage and switching PPIs never worked for me. Their idea of staying on it for another three more months and give it more time, only made the delayed gastric emptying symptoms like GERD/LPR much worse.

You asked if I was worried about esophageal damage with acid rebound. I was more worried if I did not get better, I was at risk for esophageal damage in the future. I've read this can happen over many years if GERD/LPR is not kept under control. When trying to wean off the PPI, I constantly reminded myself that acid rebound is only a temporary phase.

hello everyone,

I had a bad spell of waking up to choking on acid after a careless late night dinner of salmon drenched in lemon juice and a big bowl of mint chocolate chip ice cream.
I went to the ER and was immediately given Nexium 20mg twice a day.
I later was scoped by a GI and upped to Nexium 40mg twice a day with a Zantac 150 right before bed.
I went from having one bad spell....to being entirely miserable 24 hours a day.
I was bloated, dropped an insane amount of weight, so dehydrated and malnourished because I couldn't eat or drink, had horrible anxiety, couldn't sleep.
I did a lot of late night internet reading on the effects of PPI's.
I decided that I wanted to try changing my lifestyle/diet first.
Once I brought this to the attention of my GI...he scoffed at me..and said I'll be back on the PPI's within 2 weeks.
While I'm still using the h2 blocker Zantac....I did wean myself off the ppi's.
While I'm not feeling as bloated or the burning that I did on the PPI...
I am having a lot of nausea.
Any suggestions on to what I could be doing to help with that?
I eat extremely bland, drink only water, and take Gastromend HP, digestive enzymes, a probiotic, and Pepzin GI.

Hi Holding on to Hope

All the symptoms you describe are symptoms of delayed gastric emptying (slow digestion issues). PPIs can cause delayed gastric emptying in some people. They change what is needed in your stomach to digest your food properly. In order for it to reverse, you have to wean off all PPIs, H2-blockers, and antacids. But if you continue to stay on any gastric suppressants of any kind, it will not reverse.

CAGU said...
Hi SsjGogo
The last GI doctor I visited finally admitted they do not know everything that causes GERD. Since they don't know what is causing the GERD, the focus always becomes more on treating symptoms by throwing PPIs at the problem and less on finding what caused the problem. If the medication does not fix the problem than they look at surgery. But surgery is usually not fixing what caused the problem either. It's again just treating symptoms and surgery does not always seem to work for some.

The LES (lower esphageal sphincter) excuse has been around forever. There are millions of people with reflux, and we are all NOT waking up one morning and are LES (lower esophageal sphincter) is now broken as many doctors would like us to believe. However,the LES does relax to allow acid to come back up the esophagus. The question should be what is causing the LES to relax..? instead of saying your LES is broken. LES relaxing is just a small part of the big picture.

Exactly it seems odd that normal doctors have very little interest in curing the cause of GERD, almost every hospital website says try these lifestyle changes but btw they usually don't fix the problem so take PPIs. Only doctors who practice integrative medicine or naturopaths are interested in actually trying to cure the problem, even if their methods aren't proven.

It's really hard not to be cynical about it. PPIs are one of the 3 biggest selling drugs, and they generate billions of dollars. Pharmaceutical companies give doctors VIP treatment and release studies only showing that they are very effective with few side effects SHORT TERM, with zero interest in long term use. PPIs can often cause hyperacidity when trying to quit so it's hard to quit as well, a vicious and profitable cycle.

CAGU said...

...
You can have delayed gastric emptying without vomiting but then you are dealing with severe GERD/LPR issues.

Nausea
Abdominal distension
Bloating
....

I actually have a degree of all of these symptoms (they call them extra heartburn symptoms). I never paid attention to them thinking they were side effects of PPIs ( well they are in a way!).

In your case, when you had the LPR, did you feel a bitter taste in your mouth as if you had soap coming up in your throat? In my case I think I have bad bile reflux when I'm on full dose PPI. This is what is killing me at the moment. If I skip the night time dose of the PPI (I take 2x per day) I feel instant relief of the stomach symptoms you mentioned! I will now try to wean off to give it a try.

I, too, am very frustrated with how this disease is treated. I got off PPIs because I believe ( and my GI also) the PPIs gave me IBS which I now have under control ( that took a while). I had a gastric emptying test when I was on a PPI and that did not seem to be an issue. But who knows. I would love to know how all these people's LES stopped closing. Is it the food we eat, another root cause? The only really treatment for this disease is restrictive eating and a scary stomach operation. Most Insurance won't cover the Linx which again does not really fix the issue either. I'm currently on an otc pepcid ( h2 blocker) and carafate plus gaviscon if needed. I consider that a better treatment option than a PPI. I am not perfect, and eating/ meal planning is exhausting. The only drug that tightens this LES can give your permanent nervous system damage. This is just crazy. All of us are just suffering while the GIs and pharmaceutical companies fly by the seem if their pants with this epidemic.