There Is No Logic To This Stupid Disease

You are right.  There isn't logic to it, and it's unpredictable.  You're got a bad condition that nobody asks for.  I wish there was an easy fix, but there isn't.  Surgery worked great for me, but it doesn't mean I'll never have any symptoms again. 

It's important to come to a place of acceptance.  It is what it is.  You'll have good days and bad days.  You're not going to fix it and make it disappear with a diet, a wedge, or supplements.  Sometimes they will be effective, and sometimes they won't. You'll get yourself to a stretch of time when you're feeling better, and it will spring up again. 

I know it's hard, but if you can work on your attitude it will make it all more managable.  You may not want to accept it and are enjoying your fighting mode, but in the end, you can't become perfect again.  Even surgery will make big improvements, but you'll still have upper GI quirks. 

The sooner you can embrace your life...reflux issues and all...in all its imperfection, the happier you'll be. Do the best you can to eat right, follow anti-GERD/LPR guidelines, use whatever supplements that offer help to some degree, and look at the other good things in your life.

You are more than your GERD/LPR.  Embrace your whole self!

Good luck...hang in there!

Denise

So true...walking is great...just walk slowly, or you'll splash that darned reflux even more.  Sticking together is the reason I stuck around here to try to offer support to others, the way I was supported when I was a mess.

Hang in there!

Denise

Anything is worth a try.  What works for one, won't work for another.  I'm a big walker and before my surgery I could never walk after eating, because I'd always get reflux symptoms. I walk fast and hard, though, which is why I said to try it, but walk slowly. 

The thing is, what works for you might not work for thegspeak or Anne.  That's one of the maddening things.  There's no simple answer.  It's trial and error.  If something works for one, it could help another, or it could make them worse.

Nothing will close the LES except surgery to tighten it.  Some things can relax the LES and make it looser:

Foods that can relax the LES:

• Fried (greasy) foods
• High fat meats
• Butter and margarine
• Mayonnaise
• Creamy sauces
• Salad dressings
• Whole-milk dairy products
• Chocolate
• Peppermint
• Caffeinated beverages (e.g. soft drinks, coffee, tea, cocoa)

And some things create more acid and thus more reflux.

Foods that may stimulate acid production and increase heartburn:

• Caffeinated beverages
• Carbonated beverages
• Alcohol
• Spicy foods
• Black pepper
• Citrus fruit and juices (e.g. orange, grapefruit)
• Tomato juice

Even so, everyone is different.  One person's terrible trigger food might not bother another person at all.  That's what's so troubling to thegspeak.  It's frustrating and annoying.  All you can do is try things, and see what works.

If you want to email each other or even talk on the phone, put your email contact info in your profile and choose the "make it accessible" option.  Then you can click on the envelope to the left of the post to communicate privately via email, or even share phone numbers.

This forum is a godsend...enjoy the support and encouragement!

Take care,                                                                                                   Denise

The tricky part is that what works for one doesn't work for another...a trigger food for one person may not bother another person. There are certain foods that bother most people, hence the lists of GERD Triggers seem pretty consistent. 

Don't we wish there was a simple answer...

Denise

PS--the Gi doc takes biopsies to look for inflammation.  Sometimes it's there, under the surface and doesn't show up visually.  I never had any inflammation when I was tested (although I had times of painful esophagitis periodically before my surgery) during an endosopy.  You can have lots of LPR problems while the PPIs keep the esophagus safe.  Annoying.  It's tough to get an accurate diagnosis.

Surgery does help with LPR.  I'm a perfect example of that.  It's not that surgery doesn't work for LPR...it's just that there haven't been enough studies to prove it.  Here's one that supposes it works for the simple reason (as you've pointed out) both GERD and LPR arise from the same problem: acid reflux.

http://www.hindawi.com/journals/ijol/2012/291472/

Here's another summary of studies:

(http://connection.ebscohost.com/c/articles/62393318/impact-nissen-fundoplication-laryngopharyngeal-reflux-symptoms)

A retrospective review of all antireflux surgeries between 1998 and 2008 provided a patient base for a survey in which patients ranked pre- and postoperative LPR symptoms in addition to patient satisfaction with the outcome. Of the 611 patients identified and sent the evaluation forms, 244 responses (40%) were obtained. The percentage of patients with symptom improvement after surgery were: heartburn (90.1%), regurgitation (92.6%), voice fatigue (75.2%), chronic cough (76.3%), choking episodes (83.1%), sore throat (82.9%), lump in throat (77.4%), repetitive throat clearing (72.8%), and adult-onset asthma (59.6%). Twenty per cent with repetitive throat clearing and 30 per cent with adult-onset asthma had no improvement in symptoms. Eighty-one per cent considered surgery to be a success.

In my view, these percentages point to a lot of improvement...for me it's enough to get the surgery and take my chances.  That's what I did, and I got great improvement with my asthma symptoms, in contrast to the study.  However, it was not adult-onset asthma.

From what I've read and learned in my search for answers, the reason that GI docs aren't more positive about the surgical option is:

1.  They are concerned that reflux is not what is causing the symptoms.

2.  Since surgery doesn't stop all reflux, but rather brings it back to normal, GI docs fear that the reflux that may continue could be enough to cause the same problems post-Nissen as they did pre-Nissen.

3.  Some LPR symptoms can be caused by other non-GERD related issues like allergy/sinus related postnasal drip, sore throat, asthma, etc.

4. GI docs prefer to use medication rather than surgery.  They are most concerned with the physical condition and safety of the esophagus and stomach.  They really aren't all that concerned about symptoms that don't harm the esophagus.

That list, I'm sure, is not complete, but there are a few of the issues that keep us from being recommended for surgery.

At times LPR sufferers find relief from the majority of their symptoms, but a few may remain.  Even those people prefer their post-op quality of life to their pre-op suffering.

You've got some work on ruling out other options, since this a relatively new situation for you.  That's an unfortunate reality.  Nobody is going to send you to surgery without trying to help you in some other way.

If the level 10 reflux reading you received in testing is a DeMeester score, then it's within the "normal range" which is less than 14.  I never tested higher than 14.8 or so, but still suffered lots of problems.  One time, during which I'd even been hospitalized for reflux-induced asthma, my DeMeester score was 4.  When my GI doc finally gave in and gave me the option of seeing a surgeon, he said that "probably a couple good reflux episodes in a day could be enough to get your lungs going".  Really?  Finally...I had surgery within 3 weeks of seeing the surgeon, after suffering for 6 years. 

If you can choose surgery with an understanding that it's not a perfect fix, but rather a huge improvement, it can be a great option for you.  I can eat pretty much anything I want...I have a sensitive stomach, and my wrap has been created out of that sensitive tissue, so it limits me a little.  I'm very happy that I had the surgery.  I had to take the chance that it would help...I didn't know if it would work, but I had to rule it out and go from there.  Thankfully, it was the right thing to do.

There is definitely a very good chance that the surgery would help you.  Keep it in the back of your mind.  It can be a great option for those with LPR.

Hang in there,

Denise