LPR - long term damage?

Hi all,

I've had episodes of reflux for over a decade, always presenting as a barking cough, and it has always responded to a 3 month course of losec whenever it crops up. The last few years it has gotten debilitating because it has struck my respiratory tract pretty hard. I have a continuous barking, usually very mucousy, cough - but I have some things I can use to manage that, but my sinuses have been getting worse quite rapidly, mostly it has been increased incidences of post-nasal drip and runny noses but now my nasal passages, and sinuses in particular, feel like they have been scraped raw making every breath incredibly painful, they are also getting inflamed fairly regularly, maybe every two or so days. At times they also feel like they are filled with so much watery mucous it feels like I'm drowning, and when they aren't, its mucous thick enough that it regularly makes me choke.

I'm seeing a gastroenterologist, but his input ends at the shoulders. His opinion is that nothing needs to be done about these upper respiratory problems because it is all being caused by my reflux and once that is sorted everything will clear up.... The only problem is that its not even close to clearing up and I can't help but think surely there must be something I can do to try limit the damage to my sinuses. My GP suggested antihistamines which has helped thinned out the thick mucous a bit, but thats it.

Does anyone have any suggestions for how I could limit the damage, or know what the long term effects of LPR on these areas is? I have made the necessary lifestyle changes and, with the exception of raising my sleeping position, have been living with these changes for over a year now, so I don't need the standard suggestions for managing reflux.

My gastroenterologist has already diagnosed LPR. This all first started when I was 16 and had what seemed to be an unending chest infection and I went through the ringer trying to get treated and by sheer chance stumbled upon an ENT who had knowledge about reflux and the effects it can have on the lungs. He gave me a 3 month course of PPI's and it was like magic, the cough was gone within a week and my lungs healed up nicely. That was 12 years ago and maybe once a year since then I've needed another round to nip it in the bud. But a few years ago I was misdiagnosed with partial seizures, and some of the antiseizure medications I had to take were horrific and did horrible things to me. Then once the correct diagnosis was found (atypical migraines) I was weaned off the anti seizure meds over 6 months, and it was ugly. Among everything else going on I got horrific heartburn and of course up came the cough, so we hit it with PPI's, the heartburn and cough subsided and I kind of forgot about it while dealing with the rest of the withdrawl.

Then round the start of this year I was at the stage where I shouldn't have still been having effects from the seizure meds but I was having extreme abdominal pain, a lump in my throat and shortness of breath. One really lazy and awful dr diagnosed glandular fever (which I've already had) and wasn't even going to bother testing for it but I insisted, sure enough it was false.

Luckily I saw my usual GP when I came back for the results and he caught acute cholecystitis just in time, the surgeon who took my gallbladder out rescheduled another patient to get me in for a few days later because he said if we waited the month until he had a free spot it would have progressed to pancreatitis. All the testing for this surgery exposed that I had fatty liver disease as well, most likely from the antiseizure medications. So after the surgery the abdominal pain had subsided but the instances of this lump and the shortness of breath were happening more often. I was still experiencing withdrawl effects from the remaining antiseizure meds and this made things really difficult when it came to figuring out what was wrong, I was having attacks of tachychardia both during the surgery and at other times, which prompted investigations into cardiac problems, once that was ruled out they went through a range of different things and each test was coming back negative, then as a last ditch attempt the dr who had been doing this stage of the investigations sent me for a barium swallow, when that came back she said "Well it shows reflux, but its really uncommon to have respiratory effects from it" at that point everything clicked into place for me, and I realised she hadn't looked at any of my medical records including the most recent ones showing I was being treated for reflux and taking PPI's was such common place for me that I had never given it a second thought. Long story short I got sent to a gastroenterologist who did an endoscopy, manometry and ph test and confirmed that we had finally hit the nail on the head. Unfortunately over that period things have gotten progressively worse.

I wouldn't be at all surprised if the gallbladder removal exacerbated the problem because my problems with regurgitation started after the surgery, and it takes a while for your body to adjust to digesting stuff without it. That being said all of the other post-surgery digestive troubles, mainly dumping syndrome, have completely resolved but the regurgitation is getting worse, thus the problems with my airways are getting worse.

On the issue of surgery, I would jump at the opportunity, the problem is there is a mix of opinions at the moment as to whether its the right move. Everyone agrees that I have done the necessary lifestyle changes. One of my GP's thinks that it is ridiculous we are even pursuing medication because I am on a lot of it, and it doesn't seem to be doing any good. So he thinks they shouldn't have even tried different medication and gone straight to LNF. My other GP is a little more on the fence because he says there is an outside chance that medication would help and do I really want to have to go through having another major abdominal surgery so soon. Unfortunately its up to my gastroenterologist who has to make the call and he is incredibly reluctant to do the reccomendatoin so soon after my gallbladder surgery because it may make the recovery longer. Though it is clear that if this current course of medication doesn't help that is probably where things will end up anyway.

I understand completely why there is hesitation about doing another surgery this soon but the way I see it is its clear thats where this is heading eventually anyway, my life has been completely taken away from me thanks to not being able to breathe so chasing after ineffective treatments is just adding more time until I can get back to a normal life and be able to go out for more than 5 mins without having to recover for days, be able to go back to uni and finish my degree and go back to work. I know that there are definite risks with the surgery and it could make things worse, a thought which terrifies me because I don't know where that would leave me then, but I at this point I don't feel that I have any options left.