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Could this be GERD or LPR? Any comments REALLY appreciated!

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GERD & Acid Reflux
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Posted 6/1/2012 4:44 PM (GMT 0)
As per title, I would love any input anyone has on this! I'm at my wits end right now, but also hopeful that I could have found the cause of my problems.

For around 5 years now I have had problems swallowing solid foods. I struggle with large meals, bread, meat etc and get choking sensations etc. It's a daily battle.

As it started happening around a fairly stressful time, I've always put it down to anxiety. I've tried counselling and CBT but have had no improvements. As of now I have avoided anxiety meds. I don't generally have any anxiety symptoms and I'm very happy and relaxed in every day life.

Because of the problems eating, I have been pretty stupid and replaced too many meals with sugary rubbish foods including extremely excessive amounts of diet coke and chocolate. It was just a way to fill up an avoid meals.

Around 3 or 4 years ago I developed a chesty cough towards the top of my chest. Since then, I've never been able to shake this rasping cough which sounds truly awful and seems to shock people in the street. I had lots of blood tests etc and they all came back normal.

This week I stumbled on GERD and reflux as an illness which can present the two symptoms - the swallowing and the cough. Which is good...

However, I have never really had stomach problems and never had heartburn. Once or twice over the years I have woken up with burning sensation in my throat, and once a few months ago I went and was physically sick - it felt like I literally had acid in the back of my mouth - it was pretty traumatic for a few moments! Generally though, my stomach is 100% fine, no heartburn, no taste of acid etc. Literally 3 or 4 incidents in my life.

I've been to the GP today and as soon as I mentioned the swallowing problem and the coughing together, she mentioned Reflux before I even had a chance to say it.

I'm feeling quietly optimistic as my rubbish diet fits - coke & chocolate come up in every list I have found!. However, having had no heartburn and no stomach issues whatsoever, I also wonder whether this damage could have been happening so silently.

She has given me a PPI tablet (Omeprazole). How soon do you think this would start to have an impact considering this has potentially been doing damage for 5 years? Should I be pushing to have my throat checked?

ANY comments appreciated on all of this!

Post Edited (bswootton) : 6/1/2012 10:49:10 AM (GMT-6)

Posted 6/1/2012 5:16 PM (GMT 0)
You sound like you may have symptoms of LPR. Give the Prilosec a few weeks. I would eliminate all the trigger foods especially diet coke and chocolate as they are full of caffine which is a huge trigger for reflux. You may want to see an ENT so that he/she can check your throat. It also could be good for you to get an endoscopy to check your esophagus (talk to your doctor about being referred to a GI specialist as well.) You will have to change your diet. It will be hard but it may help you. LPR often has no heartburn or stomach issues. But that does not change that it is reflux related. If you smoke, stop. Cut down on alcohol and do not eat late at night. I mostly eat veggies, fruits, and protein that is not high in fat. Foods high in fat, fried foods, acidic foods, and in some theories, carbs, can all make symptoms worse. You should also eat small meals not huge ones (and don't skip them either!). You may feel some relief if you start mkaing changes to your diet and lifestyle.
Posted 6/25/2012 4:00 PM (GMT 0)
Just an update on the above. I'm actually seeing some huge improvements after starting the Omeprazole and implementing some lifestyle changes over the last 3-4 weeks.

I've struggled with the swallowing for over 5 years without any respite, but it's clearly and undisputedly better. I'm not there yet but I would say 60-70% recovered.

The cough has also improved. It is still there but does not sound anything like as aggressive as it did.

Side effects have been mild, a few crams and a little bloated, but I can handle that.

This is like a dream come true to me! I'm kicking myself for living with swallowing problems for so long when a few small pills & sensible lifestyle changes could have resolved it within a month or two.

If you have problems swallowing but no heartburn, I cant say enough GIVE OMEPRAZOLE A TRY!!!!
Posted 6/25/2012 5:48 PM (GMT 0)
Thank you for updating this thread. Considering I'm in the same situation, it was really worth reading!

I'm starting my third week of pantoprazole, after first few days I felt like it's working but now I'm no longer so sure. The cough came back and it's pretty bad actually. Maybe because it's very hard to give up on all those tasty things haha..

bswootton - would you tell a bit more about your dietary changes? What things do you eat nowadays? I quit all fizzy drinks and most fatty foods but it's really hard to say no to a cup of coffee once a day...

I would say, when you don't experience heartburn directly, you feel like everything is fine and it's more difficult to obey the diet plan wink

Post Edited (Incognito) : 6/25/2012 11:56:20 AM (GMT-6)

Posted 6/25/2012 6:26 PM (GMT 0)
bswootton- It's good to hear that the PPIs are working for you! I have swallowing issues as well, though I only have problems when swallowing saliva, so it's good to know that there is a reason to be hopefull that this will improve. I've been on Dexilant for 2 months and almost feel normal but am not quite there. I've never had heartburn in my life, so it took me a while to accept that this was reflux. I would definitely recommend having an endoscopy done. Your gastroenterologist can check the condition of your esophagus and may find that dilating it will help your swallowing if your esophagus has narrowed or you have a stricture, etc.

Incognito- I hear you about the diet! I tried to stick to it in the beginning and ended up just eating whatever I wanted because I don't have heartburn. I have started watching what I am eating again and it definitely makes a difference in terms of my swallowing issues.
Posted 6/26/2012 10:14 AM (GMT 0)
I know what you mean re the willpower required when the benefits are not immediately visible.

I didn't have heartburn or any classic symptoms so I was also very skeptical as my original post above shows.

However, I saw benefits after 9 or 10 days, so it's not too long to keep the faith and hold out for some hopefully positive signs.

My symptoms are still up and down too. Some meals great, some not so good. I keep getting downhearted but then I have a big meal which I manage better than I have done in years and I'm buzzing again.

I know I praised the PPI above, but I actually think diet is the key here. I view the tablets as just a little nudge towards recovery, but they are obviously not a long term solution. Diet and lifestyle need to be your primary focus I think.

In terms of what I have cut out, it is mainly coke, fizzy drinks and chocolate. I still eat very spicy foods a few times per week and have the occasional beer. I don't eat a lot of fatty foods.

For me, I think the reflux is very closely related to anxiety. Cutting out the caffeine and sugary foods is therefore giving benefits on multiple levels.

I would *definetly* try to cut out the coffee - it's much higher than the coke which has definitely been contributing to my problem:

Caffeine content....
One mug of instant coffee: 100mg
One mug of filter coffee: 140mg
One mug of tea: 75mg
One can of cola: 40mg
One can of energy drink: 80mg
One 50g bar of plain (dark) chocolate: around 50mg
One 50g bar of milk chocolate: around 25mg

KitKat880, if you have got to the stage of having difficulty swallowing saliva, have you considered whether this could be related to anxiety too? Cut out all caffeine, sugar, stimulants etc, and try to relax and get more and better sleep at the same time.

The other thing I am doing in parallel is exercise and a high dose of magnesium supplement. Anyone in a similar situation, consider doing the same.

Good luck to all of you.

Post Edited (bswootton) : 6/26/2012 4:17:17 AM (GMT-6)

Posted 6/26/2012 1:00 PM (GMT 0)
I just started a magnesium suppliment and I do see a difference. My esophageal spasms are less which I am thrilled for.
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