HealingWell
Search Close Search
☰

TheSickness journey, VCD,LPR, Non acid reflux

Support Forums
>
GERD & Acid Reflux
✚ New Topic ✚ Reply
1 23
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 5/29/2013 1:38 AM (GMT 0)
13 proximal refluxes on PPI's. That still seems a little bit high. I wonder what normal is considered though. Yeah, it would be interesting to see what your number of refluxes and your number of proximal refluxes would be off meds. On mine it really didn't seem to differ all that much.
Posted 5/29/2013 1:43 AM (GMT 0)
Just got my celiacs numbers back>

Tissue Transglutaminase Ab, IgA 7 reference range 0 - 19

Looks like I'm a negative.

Also,

I've been trying to find an answer to my question. I found this article, which states in it's Conclusion: This study establishes the normative data for LPR. LPR events are extremely rare in patients without GERD or LPR symptoms as measured with HMII. One or more LPR events should be considered abnormal in patients with LPR symptoms regardless of whether there is a positive DeMeester score.

http://www.ssat.com/cgi-bin/abstracts/11ddw/o5.cgi

Normal people don't have any reflux reaching their throat.

Post Edited (TheSixness) : 5/28/2013 9:40:56 PM (GMT-6)

Posted 5/29/2013 2:40 PM (GMT 0)
Sixness,

That is one of the reasons I stopped the ppi, I felt my reflux events wouldn't change much. PPI don't stop reflux, they lower stomach acid, hence no ppi equals more acid reflux and less non-acid, the flip side is on ppis equals less acid reflux and more non-acid reflux. The "total number of events" would still be the same on or off, it's just a matter of do you prefer more acid or more non-acid events.

Posted 5/29/2013 2:58 PM (GMT 0)
I was told that everyone "reflux some", us gerdies just reflux more. I'd like to see 24hr test results for someone who doesn't have gerd.
Posted 5/29/2013 3:14 PM (GMT 0)
I believe PPI does have some effect on # of reflux events, but that pales in comparison to their ability to decrease acidity. So without specifying whether your reflux events were acid, weakly acidic, nonacid, the total # of reflux events doesn't tell much about what could be doing damage. You have to know how many are acidic.

As for normal proximal events. In 60 volunteers, median # of proximal reflux events: 8,  5 acid, 2 weakly acidic. (21, 14 and 5 are the 75th percentiles).

Those are 60 healthy normal volunteers. So 13 total events is normal according to that data (from: Twenty-Four Hour Ambulatory Simultaneous Impedance and pH Monitoring: A Multicenter Report of Normal Values From 60 Healthy Volunteers).

Posted 5/29/2013 3:30 PM (GMT 0)
I think the jury is still out as to what causes more damage. Some say it's the acid, others say it's the bile or pepsin. PPI lower the stomach acid but has no lowering effect on bile or pepsin, however if acid to bile/pepsin is for example 50:1 ratio and you lower acid it's now 25:1, which means the bile/pepsin is more condensed. If bile/pepsin is more condensed, I would think it would do more damage.
Posted 5/29/2013 3:37 PM (GMT 0)
I don't think it would do more damage.. all else being equal, the amount of material being refluxed shouldn't change from taking a PPI. So the bile/pepsin would still be diluted by the same amount of refluxate, even if the rest of the refluxate isn't acidic.
Posted 5/29/2013 4:02 PM (GMT 0)
I'm confused......ppi's lower acid so the amount of material (acid) would be less? If so, less acid would dilute the bile/pepsin less.
Posted 5/29/2013 5:20 PM (GMT 0)
The material I'm talking about is the reflux in whole, no matter what it's made from or how acidic. When a person takes a PPI, I don't think it generally affects the amount of reflux that escapes from the LES, but it does make it less acidic. So when the .25oz bile/pepsin is diluted by .75 oz of miscellaneous stomach juice, totalling 1oz of reflux, the mixture is still 25% strength bile/pepsin no matter what the makeup of the other 75%.

I guess the point is in my opinion, that unless a PPI or other acid reducer makes symptoms worse from some side effect, decreasing the acidity by using one should not lead to more damage from reflux.

What I don't know is if the % of bile/pepsin increases due to decreased stomach acid from taking an acid blocker/reducer, but I've never read it..
Posted 5/29/2013 9:29 PM (GMT 0)
The way I always looked at this was since the PPI's decrease the acidic content, when the reflux comes up there is a higher concentration of everything else. Less acidic = Higher concentration of pepsin per reflux. That's why some may feel worse on ppi's because there is a higher concentration of pepsin.
Posted 5/30/2013 4:53 AM (GMT 0)
So around 8 proximal refluxes in a normal person is considered normal. I'm not too far off with 25 on 40mg in the morning and zantacs 150 at night...
Posted 5/30/2013 10:51 AM (GMT 0)
Sixness,

I agree with that theory. tongue

Posted 5/31/2013 3:35 AM (GMT 0)
Just discovered some information reading through my doctors notes, I noticed that my doctor noted that I had irritation to my antrum and that he suspects bile reflux. This doctor also said that he suspects gastroparesis... this however was shot down by my Uw-health doctors...

I also noticed that I had ph spikes to about 7.8-8.8 on my ph exam...This was a gnawing pain that lasted like an hour...
Posted 5/31/2013 4:44 AM (GMT 0)
Just discovered some information reading through my doctors notes, I noticed that my doctor noted that I had irritation to my antrum and that he suspects bile reflux. This doctor also said that he suspects gastroparesis... this however was shot down by my Uw-health doctors...

I also noticed that I had ph spikes to about 7.8-8.8 on my ph exam...This was a gnawing pain that lasted like an hour...
Posted 5/31/2013 10:23 AM (GMT 0)
I thought UW was suppose t have the better dr's? Your spikes sound like bile reflux (IMO).
Posted 5/31/2013 6:46 PM (GMT 0)
I'm skeptical of everything they have done for me and everything they said to me. The last follow up I had with their doctors after my ph exam basically wasn't good. Whenever someone says "I don't mean to disrespect you", they do indeed mean to disrespect you. That's what this doctor told me, However, before this happened I told them about how I think it maybe bile reflux because I noticed when I was having stomach pains it seemed to correlate with a ph spike of 7.8-8.8 that lasted for an hour or so. This dr completely shut it down and told me that he is an expert in this field and that he didn't like me asking questions that we're detailed. I was hoping to learn more about bile reflux, unfortunately that didn't happen.

I was kinda surprised by this, usually when you get referred to a university center you would think that the best people in your state would at least act like it.

Post Edited (TheSixness) : 5/31/2013 12:51:52 PM (GMT-6)

Posted 6/1/2013 2:32 AM (GMT 0)
At times I thought their bedside manners sucked as well, I left disappointed more than once.
Posted 6/1/2013 6:19 AM (GMT 0)
Yeah, that feeling sucks. You go into these settings with specific dates or deadlines in your head, thinking that your going to be cured by going to these meetings or that your going to figure something out which will benefit you. However, there have been many instances, where I have thought I was at the end of the road and that my cure lays at the other end of an appointment, surgery or new prescription.

I'm still waiting on that day to come. As of right now my goal is to get my breathing under control and to reach the point where I can sleep next to my girlfriend at night. On a different note, I talked to my surgeon who did my TIF. He referred me to a great surgeon outta Milwaukee. It seems like no surgeon will touch me without an accurate measurement of LPR via a dual probe ph-impedance exam. Will have a probe in my hypopharnyx and one in my esophagus. Anyways, my area doesn't have this exam, so I have to travel to Milwaukee or Madison to do it. Since I've already been to Madison, I think I'll try my luck with this Milwaukee surgeon.

Throughout my journey to madison though, I'm still puzzeled as to why I didn't have this done by the GI department. My symptoms we're mostly related to LPR when I first consulted with them. SO I suppose the Journey continues... But in the mean time I'm going to try and get ursodeoxycholic acid prescribed as a trial. Hopefully this will help with my nausea, which seems to be refractory to 80mgs of ommie a day. Might as well, bile reflux is basically the only thing that I haven't been treat for haha.
Posted 6/3/2013 11:31 AM (GMT 0)
Sixness,

Good luck in Milwaukee....keep us posted.

Posted 6/6/2013 1:54 AM (GMT 0)
Met with the surgeon at Milwaukee's teaching school. I believe it's called foerdtert hospital. Overall all the experience was better than Madison's. Less people, quicker appointment times, a better analysis of my condition.

However, the surgeon said that there's alot of factors to consider and doesn't know if moving forward with the nissen would be the best decision at this time. He said he was going to present my case when the Ent's and the GI doctors come together at their monthly meeting. He'll make a decision than on what to do with me.

He did tell me though that prior to my surgery, there was signs of gastritis in my stomach, so it seems like my condition is looking more and more like bile reflux to me.

On a downward note, ate some chicken to that was marinade with lemon and pepper. My throat has been on fire and has tightened up a lot, my breathing was affected quite a bit... The surgeon wasn't convinced that my VCD/breathing issues is caused by reflux...I beg to differ.
Posted 6/6/2013 2:45 AM (GMT 0)
Also, he noted that I shouldn't be to concerned with a stomach emptying time of 170 mins... normal for men is 120 mins. Will have to rename the thread haha. Jeez... I feel like a flap jack. I keep getting flipped around with peoples opinions.

Another note for the thread. My speech therapist says I fit all the classic signs for vocal cord dysfunction. It's made much worse from my reflux and stress. So, I'm gonna go ahead and say that I've been official diagnosed with VCD by my speech therapist and ENT.

The muslces in my neck also contribute to my VCD, they are extremely tight. I'm required to apply a heating pack to my neck twice a day and massage my hyoid bone and the muscles around it. This seems to relieve the tightness and breathing issues momentarily.

Post Edited (TheSixness) : 6/5/2013 8:57:38 PM (GMT-6)

Posted 6/6/2013 10:43 AM (GMT 0)
Sixness,

Glad to hear Milwaukee was actually listening to you. The pepper was probably a big no-no. I know the feeling getting bounced around and nobody agrees with each other on anything. I have noticed my neck is tight alot aslo which seems to go hand and hand with my throat tightness as well. I have high hopes for you in Milwaukee and I'm interested in how thier surgeons compare to UW.

Posted 6/6/2013 10:28 PM (GMT 0)
I went and saw Dr Gould. He just came out and said it... You must be pretty frustrated being tossed around like this... Which surprised me because it was true haha. He didn't seem overly knowledgeable about the scope of LPR, but he did treat me with a good amount of respect, which was a pleasant surprise.

Compared to the UW-M surgeons I'd say that the Milwaukee surgeons aren't in a hurry and have less patients to treat. I was able to get in and see him immediately. Also, I didn't have to drive through the city to get there. I just drove south on 41 to 45 and the hospital was right off the highway... Unlike madison, which takes a half hour to drive through the city. Another thing that I noticed was that there was barely any wait time. At UW-M I waited for hours just to talk to the Surgeon or Gi docs... Here I waited 20 mins. Overall it was a better experience. Felt like I was in better hands, was treated with respect, there was less waiting, easier to get to, better appointment times and the surgeon seemed very confident with his ability to do any surgery without being cocky.
Posted 6/7/2013 10:50 AM (GMT 0)
Thats very interesting given UW is suppose to be the best WI has to offer. Keep me posted on your future appointments with Milwaukee. Did you need a referal to go there?
Posted 6/13/2013 6:26 PM (GMT 0)
I did not need a referral with my insurance, but I'm thinking others may. I should be hearing back from them sometimes next week on what to do with me. I'm thinking I'm just going to be referred to a GI doctor there.
✚ New Topic ✚ Reply
123