Dealing with Laryngopharyngeal Reflux (LPR)

Gaviscon is excellent because it keeps stomach acid and contents right where they belong, preventing them from rising. It works best before bed, though you can take it after meals during the day too—just make sure you don't eat or drink anything for a little while afterward so you don't wash it away. I used to take Gaviscon years ago, which works on the same principle, and I found it helpful; I haven't tried this specific one yet.

I received my test results, but I'm having a hard time interpreting them... and it looks like I'll be waiting a while for a follow-up appointment based on these findings. If the manometry was done correctly, it shows a hypotensive lower esophageal sphincter—meaning it’s likely weak and doesn't close properly—which explains why I feel liquid rising sometimes, like if I drink a lot of water and then lie down or sit in bed... There is also an unspecified peristaltic disorder in the esophagus. I'm not entirely sure what that entails. The 24-hour pH testing points toward acid reflux. I showed the results to my primary care doctor and described my symptoms, and he prescribed Zoprax 40mg in the morning (a PPI) for me to try. They didn't have it in stock at the pharmacy when I went to pick it up, so I haven't even started yet. In the meantime, I'm trying to schedule an appointment with a gastroenterologist to see what they think, whether they agree with the current treatment, or if I need more testing.

The worst constant symptom, though, is this unrelenting feeling of hunger that doesn't go away even after eating... I honestly don't know what it is. Two years ago, my gastro specialist noted quite a bit of bile reflux. I haven't tried many different remedies, so I'm not sure what would help most. On top of that, I deal with typical LPR symptoms, like throat burning, hoarseness, postnasal drip, and that constant need to clear my throat...

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Zachary Gomez, thanks for getting back to me. I was prescribed Prilosec and took it for maybe a month, but honestly, things just felt worse, so I pulled the plug on that. Right now, my symptoms are mostly this mild burning sensation, a sour taste in my mouth, and a white coating on my tongue. It isn’t life-threatening, per se, but more of a mental drain—it wears you down psychologically. Stress was definitely the catalyst; I dealt with far too much of it this past year. I recently tried those mastic chewing tablets, but it feels like they might actually be making things worse. I even gave the whole apple cider vinegar in warm water thing a shot because I heard it works wonders, but it just sent my stomach into spasms. A lot of people have told me their symptoms cleared up once they started anxiety medication, which I am currently on, but I refuse to take anything for it right now since I'm planning to get pregnant. From what I gather, you've navigated pregnancy before—how did you handle it? Did the symptoms tend to ramp up during that time?

Zachary Gomez said:Gaviscon is excellent because it keeps stomach acid and contents right where they belong, preventing them from rising. It works best before bed, though you can take it after meals during the day too—just make sure you don't eat or drink anything for a little while afterward so you don't wash it away. I used to take Gaviscon years ago, which works on the same principle, and I found it helpful; I haven't tried this specific one yet.

I received my test results, but I'm having a hard time interpreting them... and it looks like I'll be waiting a while for a follow-up appointment based on these findings. If the manometry was done correctly, it shows a hypotensive lower esophageal sphincter—meaning it’s likely weak and doesn't close properly—which explains why I feel liquid rising sometimes, like if I drink a lot of water and then lie down or sit in bed... There is also an unspecified peristaltic disorder in the esophagus. I'm not entirely sure what that entails. The 24-hour pH testing points toward acid reflux. I showed the results to my primary care doctor and described my symptoms, and he prescribed Zoprax 40mg in the morning (a PPI) for me to try. They didn't have it in stock at the pharmacy when I went to pick it up, so I haven't even started yet. In the meantime, I'm trying to schedule an appointment with a gastroenterologist to see what they think, whether they agree with the current treatment, or if I need more testing.

The worst constant symptom, though, is this unrelenting feeling of hunger that doesn't go away even after eating... I honestly don't know what it is. Two years ago, my gastro specialist noted quite a bit of bile reflux. I haven't tried many different remedies, so I'm not sure what would help most. On top of that, I deal with typical LPR symptoms, like throat burning, hoarseness, postnasal drip, and that constant need to clear my throat...

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Where did you have that 24-hour pH test done?
And did the gastroenterologist refer you, or was it an ENT?
Is it possible to go privately? I'm waiting forever through the US healthcare system; I was only just scheduled for a gastro appointment seven months ago. It'll be a year before I even get a diagnosis. During my endoscopy, mild GERD was visible, but it's possible everything worsened after surgery on my teeth.
Do you have bile reflux?
I rinse my mouth and throat with Prolom water and baking soda, and take Gaviscon after meals.

I'm worried they'll just put me on a PPI; I'm dealing with the same thing as the post above, and things were worse than that.
I don't even know if there's a cure for tongue burning, or if that involves a PPI...
I took Nexium, but it doesn't help me; the only issue is that once I stop, I get terrible burning in my tongue, mouth, and nose for three days.

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boldnomad45, where do you pick up your bottled water, and does it actually make a difference for you? Also, have you dealt with a white coating on your tongue? For me, things are at their absolute worst in the morning, right after that first meal. I had a few days of constipation, so I finally managed to relax, and now everything feels terrible again. I'm honestly not sure how much just getting a diagnosis will help; from what I've managed to dig up, there isn't some kind of magic bullet for this condition. It turns out it might actually be better to just deal with standard heartburn.

Sarah Peterson59 said:boldnomad45, where do you pick up your bottled water, and does it actually make a difference for you? Also, have you dealt with a white coating on your tongue? For me, things are at their absolute worst in the morning, right after that first meal. I had a few days of constipation, so I finally managed to relax, and now everything feels terrible again. I'm honestly not sure how much just getting a diagnosis will help; from what I've managed to dig up, there isn't some kind of magic bullet for this condition. It turns out it might actually be better to just deal with standard heartburn.

Yeah, I know it's a nightmare.
I get the white tongue when the burning starts, along with diarrhea.

I buy my magnesium supplements at the pharmacy; they have a directory listing all the locations in Washington, D.C.

Taking Gaviscon after every meal helps, and definitely before bed. I also chew sage lozenges, rinse my mouth and tongue with magnesium and baking soda, and occasionally drink some magnesium water.

I've switched to smaller meals and avoided anything that triggers acid. After eating, I either sit up straight or walk around the apartment. I sleep on a reflux pillow, wait at least two hours after eating before drinking any water, and finish my last meal and water by 6:00 PM. I'm also taking probiotics and vitamins D and B. Most importantly, I have to keep my anxiety in check; I'll be starting an AD soon.

I'm going to try everything to get this under control.

I read somewhere that PPIs don't even help with this. I don't get why, especially since I'd prefer to avoid them.
This is actually "gas reflux"—gas and pepsin rise all the way up to the sinuses, eyes, and tongue.
My weight is normal.

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What have your gastroenterologists actually told you regarding Laryngopharyngeal reflux? Is a gastroscopy even necessary at this stage? I came across some claim somewhere that ENTs handle LPR while GI specialists deal with GERD, though frankly, that distinction seems a bit nonsensical to me.

Sarah Peterson59 said:What have your gastroenterologists actually told you regarding Laryngopharyngeal reflux? Is a gastroscopy even necessary at this stage? I came across some claim somewhere that ENTs handle LPR while GI specialists deal with GERD, though frankly, that distinction seems a bit nonsensical to me.

I haven't a clue; I still need to see an ENT. Honestly, I've spent most of my life seeing ENTs trying to fix sinus issues, never once realizing it was actually silent reflux.
I'm also not sure what kind of medications an ENT would even prescribe for this.

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Unfortunately, most ENT specialists just prescribe a heavy dose of PPIs for three to six months straight. It’s a bit of a blunt instrument, really. In my own case, my doctor gave me that exact diagnosis, and I was fully convinced I was dealing with chronic sinus issues myself.

https://www.refluxgate.com/pepsin

Here is the latest research on Laryngopharyngeal reflux.
It’s starting to click: that burning sensation in my throat? It’s the pepsin.
There’s practically no effective medication out there.
PPIs don't work; if they provide any relief at all, it's fleeting and usually causes much larger issues.
The link explains everything.
Whether you're in Germany or the US, progress is minimal. Doctors don't know much either; they just keep prescribing PPIs. People end up depressed because Laryngopharyngeal reflux makes everything feel even worse.
I’ll print this out for my doctor, though I doubt they'll care.
Over there, they actually run pepsin tests. They have specialists who focus specifically on pepsin—that aggressive enzyme that's supposed to stay in the stomach, but with reflux, it ends up outside, where it just eats away at everything.
I am literally digesting myself.

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Nicole Newman4 said:Hey there!
Can anyone recommend a solid ENT specialist in Washington, D.C. who actually knows what they're doing regarding LPR? I've been dealing with LPR symptoms for years now, and honestly, after seeing several different doctors, my impression is that most of them just aren't properly informed about this specific issue. If someone could point me toward a truly knowledgeable physician, it would be a huge help 🙂

I'm looking for this too.

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Zachary Gomez said:Gaviscon is excellent because it keeps stomach acid and contents right where they belong, preventing them from rising. It works best before bed, though you can take it after meals during the day too—just make sure you don't eat or drink anything for a little while afterward so you don't wash it away. I used to take Gaviscon years ago, which works on the same principle, and I found it helpful; I haven't tried this specific one yet.

I received my test results, but I'm having a hard time interpreting them... and it looks like I'll be waiting a while for a follow-up appointment based on these findings. If the manometry was done correctly, it shows a hypotensive lower esophageal sphincter—meaning it’s likely weak and doesn't close properly—which explains why I feel liquid rising sometimes, like if I drink a lot of water and then lie down or sit in bed... There is also an unspecified peristaltic disorder in the esophagus. I'm not entirely sure what that entails. The 24-hour pH testing points toward acid reflux. I showed the results to my primary care doctor and described my symptoms, and he prescribed Zoprax 40mg in the morning (a PPI) for me to try. They didn't have it in stock at the pharmacy when I went to pick it up, so I haven't even started yet. In the meantime, I'm trying to schedule an appointment with a gastroenterologist to see what they think, whether they agree with the current treatment, or if I need more testing.

The worst constant symptom, though, is this unrelenting feeling of hunger that doesn't go away even after eating... I honestly don't know what it is. Two years ago, my gastro specialist noted quite a bit of bile reflux. I haven't tried many different remedies, so I'm not sure what would help most. On top of that, I deal with typical LPR symptoms, like throat burning, hoarseness, postnasal drip, and that constant need to clear my throat...

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Zachary Gomez, could you please describe how these tests are performed? Are they uncomfortable?

I deal with that constant hunger too; I find myself eating all the time, and I've actually gained quite a bit of weight over the last two years.

At first, I thought my Gaviscon wasn't doing anything, but when I forgot to pack it for a trip abroad, I realized pretty quickly that it actually does make a difference.

I don't have any burning, but I do have a dry throat, a constant feeling of hunger, frequent coughing, and hoarseness. My voice gets strained if I talk for too long. My doctor says it's LPR because they can see that my throat and esophagus are irritated by the acid.

@boldnomad45, what exactly is a reflux pillow?

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ironsurfer10 said:Zachary Gomez, could you please describe how these tests are performed? Are they uncomfortable?

I deal with that constant hunger too; I find myself eating all the time, and I've actually gained quite a bit of weight over the last two years.

At first, I thought my Gaviscon wasn't doing anything, but when I forgot to pack it for a trip abroad, I realized pretty quickly that it actually does make a difference.

I don't have any burning, but I do have a dry throat, a constant feeling of hunger, frequent coughing, and hoarseness. My voice gets strained if I talk for too long. My doctor says it's LPR because they can see that my throat and esophagus are irritated by the acid.

@boldnomad45, what exactly is a reflux pillow?

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I'm dealing with pretty much the same stuff. For me, it's more about that constant post-nasal drip and occasional heartburn—nothing crazy, though. It usually hits when I eat bananas or anything spicy, but once I cut those out, the heartburn stays away.
The only thing is, I have no clue what to eat for dinner, and I just can't seem to skip a meal after 6 PM since I don't head to bed until midnight. If I don't eat, I'll be starving myself by bedtime!

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ironsurfer10 said:Zachary Gomez, could you please describe how these tests are performed? Are they uncomfortable?

I deal with that constant hunger too; I find myself eating all the time, and I've actually gained quite a bit of weight over the last two years.

At first, I thought my Gaviscon wasn't doing anything, but when I forgot to pack it for a trip abroad, I realized pretty quickly that it actually does make a difference.

I don't have any burning, but I do have a dry throat, a constant feeling of hunger, frequent coughing, and hoarseness. My voice gets strained if I talk for too long. My doctor says it's LPR because they can see that my throat and esophagus are irritated by the acid.

@boldnomad45, what exactly is a reflux pillow?

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It's available on Amazon.com. https://amzn.eu/d/4PpTyv1

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boldnomad45 said:It's available on Amazon.com. https://amzn.eu/d/4PpTyv1

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Wait, isn't that just what we call a "wedge pillow" for babies?

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Nathan Diaz54 said:Wait, isn't that just what we call a "wedge pillow" for babies?

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I haven't a clue. You could wedge something under the mattress to tilt the whole bed, but I can't manage that. I just picked up a pillow on Amazon.com after reading some reviews. They seem fine. Just search for "reflux pillow"; there are plenty of them.

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Ugh, I tried that before, but I kept sliding down so much that I’d end up with half my legs hanging off the edge of the mattress 😁 Eventually, I tried bunching up some pillows to prop my feet up, which actually helped for a little while, but honestly, my spine was taking a beating. Now I’m on the hunt for a way to elevate my legs at the head of the bed—basically tilting the whole mattress upward—but I haven't found anything particularly clever or practical yet.
I know Ergoactiv makes a bed like that, but let me tell you, it is eyesore incarnate!

ironsurfer10 said:Ugh, I tried that before, but I kept sliding down so much that I’d end up with half my legs hanging off the edge of the mattress 😁 Eventually, I tried bunching up some pillows to prop my feet up, which actually helped for a little while, but honestly, my spine was taking a beating. Now I’m on the hunt for a way to elevate my legs at the head of the bed—basically tilting the whole mattress upward—but I haven't found anything particularly clever or practical yet.
I know Ergoactiv makes a bed like that, but let me tell you, it is eyesore incarnate!

People on YouTube suggest wedging a brick under the bed frame to tilt it.

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ironsurfer10 said:Zachary Gomez, could you please describe how these tests are performed? Are they uncomfortable?

I deal with that constant hunger too; I find myself eating all the time, and I've actually gained quite a bit of weight over the last two years.

At first, I thought my Gaviscon wasn't doing anything, but when I forgot to pack it for a trip abroad, I realized pretty quickly that it actually does make a difference.

I don't have any burning, but I do have a dry throat, a constant feeling of hunger, frequent coughing, and hoarseness. My voice gets strained if I talk for too long. My doctor says it's LPR because they can see that my throat and esophagus are irritated by the acid.

@boldnomad45, what exactly is a reflux pillow?

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Manometry feels like a thicker straw; it's relatively quick, lasting about 10 minutes, but it does force you to swallow. You have to hold it for about thirty seconds without swallowing, then swallow only when the nurse tells you to—you get a sip of water via a syringe roughly ten times during the process. For the 24-hour pH testing, the probe is much thinner, though slightly stiffer and it can feel a bit scratchy during insertion, but it’s fine once it's in... My advice is to eat and drink immediately to get used to it. While I was eating, I barely felt it, except for an occasional tugging sensation in my nose. Just be careful not to catch any wires on anything... I was worried about how I would sleep, but in the end, it was perfectly fine... By morning, I had completely adjusted, so if I had to, I could have managed like that for a few more days.

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Do you get any kind of local anesthesia for that?

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No, they won't provide anything like that... Not for a gastrointestinal endoscopy, let alone for this. You might only be able to get it through a private provider. I believe Helena has those specific tests available.
https://mayoclinic.org/tests-procedures/...esophagus/ though from what I can tell, that's just for pediatric cases... Try reaching out to some other private clinics instead.

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