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Clarification on GERD, LPR, and Bile Reflux

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GERD & Acid Reflux
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Posted 3/4/2013 12:07 AM (GMT 0)
Recently I have been trying to read up on information pages for general Gastro Esophageal Reflux Disease (GERD), Laryngopharyngeal Reflux (LPR), and Bile Reflux. The GERD pages have a fair amount of information, but as most people that come to this forum can confirm, not every little bit of information applies to every person with GERD. Both the pages on LPR and the pages on Bile Reflux make a big point to stress that they are different from GERD and are often confused or not known about. I have also seen a couple posts on this forum stressing the importance of figuring out whether you have GERD or Bile Reflux, or GERD or LPR, or some combination between them.

Now, is there an actual difference between treatment methods for each one, or are they actually the same? Webpages on Bile Reflux seem relatively new (I think) and do not contain a lot of information about treatment. The same goes for LPR, not that information out there except for the few defining differences: Bile Reflux is bile from your liver backing up into your stomach and esophagus. LPR is the flow of gastric contents into the esophagus and other areas including the larynx, but often does not come with heartburn. I can see that there is a clear difference between them, but could someone try to clear up exactly how each one is separated or where to find treatment options for each one?
Posted 3/4/2013 10:17 PM (GMT 0)
DontStealMyBacon

It all depends on what the tests show. If there is a definite issue with the LES being open then some type of reflux surgery would most likely be offered for all. Not all people with LPR are issue free with reflux surgery, but some are. Some have to keep on some type of acid meds, but usually at a lower dose.
I would think that bile reflux due to an open LES wuld fall into the surgery route as well. I am not sure what else could cause bile reflux though.

Take care,
Bill
Posted 3/4/2013 10:30 PM (GMT 0)
Here's what I can't figure out....I have a hiatal hernia, manly open les, lpr (lump in throat), and I show reflux. Now my doctor says he would not recommend surgery based on my test show "normal or acceptable" reflux (acid & non acidic) for someone on acid supressers. By the way, my GI is one of the top at University of Wisconsin. He says I have a hypersensive esophagus. Ugh....What to do?
Posted 3/4/2013 11:18 PM (GMT 0)
I have only ever seen doctors that address GERD, and had not heard of LPR or Bile Reflux until I started looking online. I have the exact symptoms that LPR describes, mainly the constant cough/itch in my throat, but I also get terrible heartburn. I assume this means I have a combination of GERD and LPR, but figuring this out doesn't seem to change anything since they both involve the same treatment of PPIs.

I also get this terrible exercise induced reflux that no doctor or website will acknowledge, but my LES is so weak that the slightest amount of exercise sends acid straight up my throat. Its come to the point that even climbing a staircase gives me heartburn, and that is a giant problem that I cant seem to get treated. I've been on PPIs to treat GERD for five years now and it is quite clear that they simply aren't strong or helpful enough to help me. I am still annoyed that no doctor or website acknowledges exercise induced reflux as it is my number one symptom, and it doesnt quite fit into one of these three 'categories' but hopefully I can find a way to be able to run again.
Posted 3/5/2013 12:08 AM (GMT 0)
Hey DOGGBONES,

No news to you, but reading your account had me thinking it was my own post. We sound like we have the exact same diagnosis, except I also have hypotensive esophagus (in addition to hypotensive LES/open LES).
Posted 3/5/2013 2:33 AM (GMT 0)
ARM,

You complete me! lol. But lets not forget my haital hernia. Hey, hope you've been feeling better (I'm about the same), talk to ya later.

Posted 3/5/2013 2:33 AM (GMT 0)
http://www.webmd.com/heartburn-gerd/features/workouts-without-heartburn

Article on exercise induced acid reflux
Posted 3/5/2013 8:09 PM (GMT 0)
Pat, thanks for finding an article on exercise induced reflux. Maybe I should re-word my argument: as of recently, there are a few websites that acknowledge exercise induced reflux, but they do not contain much information. They only say general things along the lines of avoid eating before exercising and avoid other reflux inducing foods.

The real problem is when none of my doctors will acknowledge it as a cause of my reflux. When I say breathing problem, every doctor I talk to wants to say its asthma, but its not. I have seen a pulminologist and he confirmed that I do not have asthma. I even had results on my ph probe that showed I have reflux while I exercise, but not even that would convince my GIs. Instead of answers, I get referrals to see new doctors, and it is really frustrating.
Posted 3/5/2013 9:24 PM (GMT 0)
A referral to a new doctor may simply mean they have told you everything they can. It doesn't necessarily mean that they think you have a problem that needs further exploration.
Posted 3/6/2013 5:51 PM (GMT 0)
Acid, i read your old thread because iv just had a 'normal' ph test. Been sent for a barium swallow and straight to a surgeon for NF even with the negative result though because ppis have helped the pain and i have a large hiatus hernia.

Was wondering what happened for u after u got te normal ph result?
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