Please help!!--suffering and confused about some aspects of LPR

Hi all, and many thanks in advance for any help you can provide! It's deeply appreciated!

So, I have had regular "heartburn" (burning in chest) in the past, taken Prevacid for chunks of time, and had it go away for long periods of time (i.e., years).

For the past two months I have been dealing with chronic lump in throat, excessive burping, and a gradual sense my throat is easily irritated by acidic foods and alcohol (which I've now been avoiding for over a month, along with all the usual other things, coffee etc.). So: LPR, right? No "heartburn" sensations whatsoever. Why did this suddenly appear? A few things occurred that seem to have set it off: 1) To try to deal with menopause hot flashes, I stupidly drank two glasses of ice water one night after dinner, setting off a huge 12-hour esophageal spasming that sent me to Urgent Care. 2) I slept on my back for awhile, which I normally never do because it is a reflux trigger for me, for reasons not worth going into here. 3) We got a problematic new espresso maker, also not worth going into... Whatever.

I tried a whole bunch of natural remedies to try to avoid going on PPI again, and because some things I read suggest PPIs don't help LPR (though the "Dropping Acid" type books do recommend them, which is confusing). Tried D-Limonene, DGL (bad side effects), a tiny bit of ACV in lots of water (TERRIBLE idea), mastic gum... Finally last week broke down and tried first just Zantac at night, then added the darn Prevacid (30 mg which is what I've always taken) in AM a few days ago. Part of why I don't want to take these is the digestive issues they cause (along w. everything else), as I have ulcerative colitis. (Any suggestions on things OK to take with PPIs to regularize digestion? I'm already eating tons of fiber and take VSL3 probiotics.) I think the Prevacid IS helping a bit, however. Can finally get in to see dr. on Friday, and hope to get a referral to an ENT to look at throat.

But my question really is: What actually CAUSES LPR, as opposed to heartburn? This would seem important if one wants to get rid of it! The Dropping Acid books say the reason you feel it in your throat vs. your esophagus is your esophagus has been exposed to acid for so long it's desensitized. I think that is bunk. I tried tapering the Zantac last night and got regular old esophagus-area "heartburn" for first time in ages. I could feel it just fine. I do feel tightness in my back sometimes with the lump, but never the burning in front. But then how is acid making it to throat and somehow bypassing esophagus?

What really interests me is the relation between the throat symptoms and burping. Burping is always written about as if the burp brings the acid up to your throat. We've all had those (awful) burps, but most of mine are not like that. In fact, usually a burp feels relieving and makes the lump sensation go away. The worst is when I *can't* burp. That suggests the lump feeling is really caused by pressure from below (though this wouldn't explain why throat feels raw and acidic foods burn-- but maybe it gets sprayed by the burping somehow, and esophagus doesn't?). My one lower-down symptom is a pressure right below sternum. Maybe a hiatus hernia? I had a perfectly clean endoscopy about a year and a half ago after having some mild heartburn (dr. insisted). All that makes me think, though, that all this would best be treated, as some do suggest, by digestive enzymes or HCL or whatever. (My fellow menopausal friend swears by HCL for lump in throat, etc.) BUT... I've been terrified to try these things while having the throat burning, because I don't want to burp up scary acids or enzymes (some bad reports on web about this).

I guess I am tempted to say I would take the PPI for awhile if it does help, then maybe try using (perhaps non-HCL) enzymes to try to avoid this situation in future, as many menopausal women seem to do? Here's the thing: I guess I just find it hard to imagine I really have to not have any vinaigrette or a glass of wine once or twice a week etc. for the rest of my life, as the authors of these books blithely imply. I am a healthy eater, not a consumer of the "typical American diet." I look at how people eat in other countries around the world and it just seems crazy that here we are in the US obsessing over cutting out this and that when they just eat a range of decent healthy food (when not corrupted by American tastes). I feel like there is a piece missing with how all this is explained to us. Can anyone help out??

Hi Willie,

I appreciate very much you taking the time to write this lengthy reply. But unless I am misunderstanding you, your explanations for this condition (or perhaps your doctor's) still do not make sense. They don't explain why people would have LPR symptoms *without* heartburn symptoms. The question is, how is the acid getting to the throat and bypassing the esophagus altogether? The only mechanism I can think of for that would be burping. (I.e., when you burp you can sometimes taste the food, so it must rocket right up there.) And then the question becomes, is there a condition causing the burping, the alleviation of which would help the LPR? This leads me to think about the many people who feel that things like digestive enzymes help their LPR, even though they have no acid-lowering effect (if anything, more the opposite).

PPIs do not put a lid on anything (Gaviscon Advance, which forms a literal barrier, does that). What they do is decrease acid production so that when stomach contents are refluxed, they will be less acidic. They have no effect on the refluxing happening in the first place.

All the Dropping Acid/Acid Diet books suggest one is simply a "refluxer" and thus must avoid acids, caffeine, alcohol and so on FOREVER. Perhaps in a small number of cases this is true, but I feel doubtful it is for most people. Don't most of us (who are not driven to surgery) find that reflux waxes and wanes? And, if so, the question is, what causes this to happen (if one does not have a hernia, etc.)? As usual, our put-a-bandaid-on-it American medical system has very little interest in asking this question.

D-limonene (read my post on it) heals the LES valve, the lid your speaking about. Its $10 a bottle. Less than one Dr appointment. I would not post about this if it did not work. It works.