Laryngeal Granuloma and LPR: A long tale about a small bump

[EDIT: I've posted a follow up to this here.]

[EDIT: there is now a second update here.]

[EDIT: I've just posted a final update on my LPR adventures. I'm going to lock the comments on this and the other LPR posts now, as I really want people to use the LPR Facebook Group instead of posting here (or emailing me) - you'll get much better responses and support there! ]

And now time for some health catch up...

This has been a long time in the making. It's kinda complicated and I've mainly written it for my own personal documentation, for anyone who may want to know more about my throat issues, or anyone who may have been struggling with similar issues. There's not a ton of info about this online, so hopefully this will help clear a few things up.

It took me a while to figure out the entire history of how this particular health issue came to be. As it's become clearer and clearer, it is obvious to me that it was years in the making. I'm going to start as far back as I think may be useful to anyone suffering from similar problems, and do sort of a timeline/progression.

1996 - 2006ish (?)

During highschool, my BA, and my MA, I took copious amounts of Gravol (an anti-nausea drug) because of my IBS. It was one of the only things that helped it. Around 2006 it became clear to me that I'd become both physically (and I'd go as far as saying psychologically) dependent on this OTC medication (I didn't realize this was a potential issue), and quit using it immediately (I now only use it when I am desperately nauseous from travel/motion sickness). 

I mention this because I recently learned that anticholinergics (anti-nausea meds) like Gravol can cause GERD [NY Times - full list of medications that can cause GERD here].

Sidenote (this will be relevant later) I started eating candied ginger for my nausea, and it was super effective!

1998 - 2007, 2012 - present

Took birth control pills (I've been mainly on Alesse and for a little while Evra patches). These can also cause GERD [NY Times] (and contributes to candida issues which can complicate all kinds of chronic health problems).

Summer 2008

I had a terrible bout of bronchitis #1, which started after the flu. It lasted about 8 months, while I was given roughly 7 courses of various stronger and more broad-spectrum antibiotics. Most of these months, my breathing was so restricted that walking 3 blocks to get groceries was extremely tiring and difficult.

Spring 2009

My stomach went berserk, I started getting even worse constipation (part of my ongoing IBS), and a lot of trapped gas and burping. (I can only guess that the copious amounts of broad spectrum antibiotics the previous months did something drastic to the bacterial balance in my already sensitive gut.) 

I finally saw a respiratory specialist at the Pacific Lung Center, who couldn't believe that I've been treated this long with completely unnecessary antibiotics. She took me off the antibiotics and starts me on Advair (a cortisone and salbuterol inhaler that decreases inflammation) and more frequent Salbuterol (rescue bronchidilator) inhalers.

My lungs improved about 50% in a matter of a couple of weeks, and slowly continued to improve after that, but I had to keep using the inhalers indefinitely (if I stopped, things get worse). Chronic phlegm, coughing, throat clearing continued despite the bronchitis dissipating.

Summer 2009

I got a colonoscopy to see if there was an obvious reason for my new digestive symptoms. Nothing was found, so it was blamed on the IBS. Constipation, bloating and burping, as well as flared asthma, chronic coughing and throat clearing continued.

Spring 2010

In late winter/early spring, I got a stomach flu that set off the worst IBS flare up of my life. For about 6 weeks, I couldn't digest anything. I had diarrhea all the time. I couldn't eat fibre or fat, or anything even slightly flavourful. I lived on potato, rice, and chicken broth for the better part of a month or more. I lost almost a tenth of my already low body weight, bringing me down to my lowest adult weight of 85 lbs. (Yes really, yes I know...it's been really slow to gain it back but I have gained most of that loss back and am working my way ever upward. Don't you dare say "that's a nice problem to have", because it's absolutely not.)

Doctors were generally completely useless until on yet another visit to the walk-in clinic, I was prescribed some tiny little opiate pills that are usually not prescribed because they can be addictive or sold on the street. These potent little things made me stoned and sleepy, but they also after under a week started to finally get my intestines to calm down. Finally things started to settle and the extremely slow recovery began.

Just as I was starting to feel better, I caught the flu (influenza) which turned into a brutal cough. Possibly the most violent cough I've ever had. My mom flew to Vancouver (after my uncle who lives here came and took care of me the first night) to take care of me as I was completely incapacitated. She stayed for a week, and I was barely improving by the time she went home. At least this time I knew to just go nuts with the inhalers, and they helped once the worst 10 days or so were past. 

My poor body had been through so much in 2 months that it took me a very long time to really start recovering. In fact, I'm not sure I ever did fully recover from the sicknesses of 2008 - 2010.

Summer 2010 - Spring 2012

The next couple years, I continued to have a lot of asthma, allergies, and sinus issues. I was still constantly clearing phlegm from my throat, and coughing. My voice progressively got more gravelly and weak as time passed. I went to the doctor, but they couldn't see anything. I began to have trouble with my voice at work, as I often did long client calls, and talked a lot with the team. I stopped being able to sing without triggering coughing.

I drank a lot of Emergen-C vitamin C packets and mint tea, and sucked a ton of throat drops trying to calm my throat. I also kept eating a lot of candied ginger for nausea. (I learned later that all of these contributed to the problems in the long run - Vit C is acidic and contributed to irritating my larynx, mint tea decreases lower esophageal sphincter tone which keeps acid from coming up into the esophagus, and the ginger was burning my already irritated throat.)

By winter 2012, I was absolutely sure something was going on. I know my body, and something really didn't feel right. I was having throat pain, a lot of trouble with speaking, and waking up to coughing fits, which I initially thought were from dryness (I live in what I believe to be the driest house in Vancouver, go figure).

I decided to an old doctor I used to go to downtown, who was technically my "GP" though I didn't really feel like he listened to me, so normally I just went to walk-ins. He said (just like the rest) that he couldn't see anything, so there's nothing he could do. I pushed and said that's not okay. He said all he could do is refer me to an ENT (ear nose and throat specialist). I said, "Great. Do that."

I waited three months for my ENT appointment.

Spring 2012

I finally had my ENT appointment. She said it's probably nothing. She stuck a camera on a tube up my nose and down my throat. I gagged a lot. She took the camera out. She saw something.

I have a laryngeal granuloma [warning: nasty photos]. It's small and on the edge of my left vocal chord, right where I've been feeling the pain. That's why my voice is so screwed up.

She told me it must be because of laryngopharyngeal reflux (LPR), and handed me some photocopies to read and a prescription and before I could ask any questions, I was shown out the door.

I went home and read... Lifestyle modifications: more dietary restrictions, sleep on an incline, no food or drink 3 hours before bedtime. The prescription was for a proton pump inhibitor (PPI) medication. 

Risks of PPI:

  • headache, nausea, diarrhea, abdominal pain, fatigue, and dizziness
  • decreased vitamin B12 absorption and eventual deficiency
  • an elevated risk of developing food allergies (which I already have)
  • an increased risk of community-acquired pneumonia
  • an increased risk of Clostridium difficile (good lord, can you imagine??)
  • hip fracture
  • "rebound hyperacidity" when trying to stop taking the medication (this is extremely common, many people can never stop taking it once they start)
  • bacterial overgrown/dysbyosis (already a problem for me)
  • vitamin D deficiency
  • calcium deficiency
  • potassium deficiency
  • magnesium deficiency
  • increase in certain heart arrhythmias 
  • kidney disease

Sure, not everyone is going to have any or all of these. But with a long standing belief I actually have low stomach acid, the risk of increased food or drug allergies as well as getting C. diff or pneumonia are extremely undesirable for me.

I went back to the walk-in clinic about my concern, and the best doctor there was in. He agreed it's not the most ideal solution for me to go on a PPI. He prescribed me Sulcrate Plus, a liquid that coats the throat to protect it from acid damage. I started taking this at night, and also using Gaviscon to try and keep my stomach acid from getting into my throat.

I started the lifestyle modifications and start the medications, and stuck with these for 2 months until my follow up with the ENT. My never ending asthma, throat clearing, coughing, etc. finally subsided. It just stopped. At some point between the bronchitis in 2008 and medication 2008 - 2010, my coughing and phlegm and asthma had changed from being residual bronchitis irritation to reflux and a laryngeal granuloma. What in the heck?

Summer 2012

I went for my follow up with the ENT. My throat was feeling a fair bit better by then. She scoped my throat again and said the granuloma is already gone, and that she couldn't believe the walk-in doc put me on Sulcrafate, because there's no way it would work for that. She told me I can go off the medication, and try easing out of some of the lifestyle modifications, and see how it goes.

I did this, and 6 weeks later, my throat was a disaster again. Possibly even worse. I went back to the walk-in doc, and back on the meds + lifestyle modifications, first half-assed, then whole-assed. It turns out that although 2 - 3 months can be an appropriate treatment for GERD, LPR and laryngeal granuloma sometimes need to be treated for 6 - 12 months (or even longer). Thanks internet. No thanks ENT.

Fall 2012

No improvement. Desperation setting in. In late fall I set out to find the best throat doctor in the city, and discovered there's a Pacific Voice Clinic at VGH and it sounds like the specialist there is very, very good. I got a referral by saying I want a second opinion from what the original ENT's approach was.

My throat gets so bad at times that I am unable to speak for days, and at its worst, 2 weeks straight.

Winter 2012/13

I waited.

I got extremely desperate and came close to caving and going on a PPI or H2 blocker. I read about the risks again... I resisted. I started researching root causes of reflux and any other alternative methods to help it stop and help my throat heal.

I discovered that reflux can be caused by nerve pinches, especially in the upper spine or vagus nerve disorders. I have had constant pain in this area for years. I discover reflux can be exacerbated by a tight ribcage or tense abdomen, both also chronic for me because of my digestive and respiratory issues. [Pediatric/Adolescent Gastroesophageal Reflux Association, National Digestive Diseases Information Clearinghouse (NDDIC), and many anecdotal/less reliable websites and forums]

I discovered that several of the medications I have taken in the past and am even currently taking have likely contributed [NY Times, Nutrition for the Older Adult], some because they loosen the lower esophageal sphincter (LES). I discovered that some vitamin deficiencies such as calcium [Journal of Pharmacology, American Journal of Physiology] and magnesium [Ultraprevention] can cause reflux. I have virtually no calcium in my diet and have low magnesium levels.

I discovered that there are a lot of supplements and vitamins [Dr. Mark Hyman, Journal of Pineal Research if you are dealing with these kinds of issues yourselves, these are the two best articles about alternative approaches] that are known to help digestive issues, reflux, LES tone, and throat healing, and that most of them overlap with the supplements and vitamins my new awesome, integrative/functional medicine GP has recommended for my digestive/chronic pain/fatigue issues. 

Postscript

Learning what I've learned, and finally having found a great GP (who practices integrative/functional medicine) to work with, I have decided to resist getting on acid blocker meds for as long as I can, and focus on the vitamins and supplements that are recommended. I'm also going to work with my massage therapist to try and address any possible nerve related causes.

I can't just accept that this is my body's "natural state", and that the only answer is dangerous medication for an indefinite amount of time. I know that for me there are root causes for this condition, and I truly hope by addressing them that I will start to see progress, and be able to avoid a long or even short course of acid blockers.

If you're reading this and going through a similar challenge with laryngeal granuloma, largopharyngeal reflux (LPR), or even GERD, I would love to hear from you on your experiences and how you've been working on healing. 

Comments

I used to take PPI's as well to cure my symptoms of acid reflux. I was on Omeprazole for a little while. At first it seemed to help with my issues. Then I suddenly began to get headaches and nausea. I also noticed that I was more tired throughout the day. Some days I would simply give in and just take a nap. This lead me to conduct some extensive research on the drug I was taking.

I later came to realize that the Omeprazole was causing my symptoms. I then went to my doctor and told him that I did not want to take the PPI any more, and he just suggested I take another type of drug. I really didn't want to take any drugs, so I looked into changing my entire lifestyle. I changed my whole diet, I started exercising, drinking more water, and avoiding trigger foods. Though I still do get the symptoms from time to time, they are nothing like they used to be. At least now my symptoms are a lot less frequent and are at a level where I can tolerate them.

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Hi Ariane,
I too have been struggling to find treatment for LPR for the past 2 years. I've got it under control somewhat and I believe that stress and anxiety is a big trigger for me. My worst symptom has been the constant dry cough and post nasal drip either brought on by my allergies or from the acid or pepcin. I find that keeping a strict diet, probiotics, pepcid complete (a night to keep reflux down), treating my allergies and I'm even trying vitamin D3 to see if that works. Since your post in January, have you found any treatment that works well to keep your symptoms in check?

Thanks,
Mike

Hi Mike - 

Well, as much as I'm glad that dietary and other lifestyle changes seem to totally fix a lot of people's problems, sadly that hasn't been the case for me... I do everything by the books, and it's still only a minor improvement - though probably the biggest is trying to force myself to sleep on my left on a slight incline (I'm naturally a right side sleeper).

I did eventually see the other ENT and he was no help at all and fairly dismissive (not to mention kind of traumatic as far as the testing went). The only option he offered me is a very high dose PPI. I eventually worked up the nerve to try it (with the monitoring of my GP) and unfortunately I reacted very badly to it. I felt extremely ill the next day, bad intestine and stomach pain, bloating, hadn't digested my dinner at all, nauseous... So that was a no-go.

One interesting thing is that I recently stopped taking Gaviscon at night, just as an experiment - I had been getting progressively more and more burping at night and more and more strong acid in the throat/mouth in the morning. And wouldn't you know, after only a couple weeks, the burping and acidiness have dropped by about 60%. It would seem that I was producing extra acid to neutralize the Gaviscon's pH and then it's bubbliness was making me burp it up more. Talk about counter productive - I wish I'd realized earlier that it was the culprit, but it happened so gradually that I didn't clue in!

Now I'm just on the Sulcrafate at night to make a bit of protective coating, still no food/minimal water 3 hrs or so before bed, still avoiding eating any acidic food/chocolate/mint etc. 

As far as vitamins and supplements, I'm on a big cocktail my GP has prescribed, including a very high dose Vit D3 (I've been pretty deficient in my blood tests, even on 5000UI/day), high dose 100B probiotics, DGL (licorice) and licorice tea, L-Glutamine and a bunch of other stuff. I'm about to try out a slow release melatonin supplement as well, as it's been discovered to be one of the few things that can actually help increase LES sphincter tone. (Regular fast release melatonin messes with my sleep if I take it when I'm not sleep deprived, the irony...)

At least now that I've stopped the Gaviscon, it no longer seems to be getting worse, so I can only hope with time it'll slowly improve. I'm also doing some interesting massage experiments with my RMT (registered massage therapist) who is extremely skilled and has trained in organ visceral manipulation. She's been doing very subtle work on the motility of my digestive system and organs, and I've been feeling some interesting (though yes also subtle) results from that. Will be neat to see if it helps over time.

I think that's most of what I have to report in the last many months. Thanks for the feedback + keep me posted if you make any discoveries!

Hi Ariane -

I know it's been awhile since I posted, but in the last few months my symptoms have been dramatically better. What I've discovered with my particular case is that I in fact have low stomach acid and not too much stomach acid. My stomach hasn't been capable of digesting foods like proteins and carbohydrates because of the lack of acid. So I've been supplementing with Betaine HCL With Pepsin (Hydrochloric Acid + enzymes) to stimulate the my stomach's low levels of acid. I also started drinking Kefir (fermented milk with tons of probiotics), which has been really great for digestion as well. It's my belief now that a majority of people with acid reflux simply have low stomach acid and are being treated incorrectly (with antacids and PPI's). Undigested carbs will sit in our stomachs and cause bloating and gases that push the acid past the LES and into the esophagus. Another thing that I may attempt is going on a strict Paleo diet. From what I hear, many diseases like LPR are cured pretty quickly. I've adjusted my diet enough that my LPR symptoms have been reduced significantly, but I could probably take it even farther. Anyway, I hope that whatever treatment you're on is working for you. If you haven't tried HCL yet, I highly recommend it. There's a doctor in LA who has a blog about low stomach acid, his name is Chris Kresser. If you look him up online there's a lot of information about how to determine if you have low stomach acid.

I still get bouts of coughing fits during the day (after meals), but overall I feel like I have a lot less reflux and that includes at night. My anxiety levels have also dropped considerably and that helps with my overall well being as well.

Mike

Hey Mike - 

Great to hear that things are improving for you! 

I totally agree on the low acid/acid supplementation and paleo approaches being a pretty ideal combo to try out. I've read a ton on these and have followed paleo eating at different levels of strictness for quite a while now, it's been one of the main factors that's helped stabilize my digestive issues and my weight (which was dropping frighteningly low every time my IBS flared). I haven't been able to try the HCl supplements though, my larynx is still extremely hypersensitive, and any acid intake beyond what's in, say, berries, typically sends me into crazy uncontrolled coughing. I'm hoping one day as things improve slowly it'll be able to tolerate more and I'll be able to try that out as well (I've suspected for a long time that I have low stomach acid). 

I'm familiar with Chris Kresser's work, and I think a lot of the advice and research on his site is solid. He's not actually a doctor, but a licenced accupunturist who has done extensive research in integrative medicine. I actually did consultations with him for a while last summer, but didn't feel it was a good fit, so discontinued after a few months. Luckily, I had learned enough to know integrative medicine felt like the right path, and found a wonderful integrative MD where I live, and have been working with him for about 10 months now.

It's really a slow and steady approach, but I feel like I've been making the right decision trying to discover and treat the source of the problems rather than mask them with pharmaceuticals that will just cause other problems. It's frankly shocking how the ENT specialists I've seen have "treated" my issues in comparison (big disappointment). Anyway, stories for another day. ;)

Thanks for sharing Mike. I was diagnosed with LPR a couple months ago and it has all but ruined my career (as a speaker/singer) so I've been scrambling here and there and found some remedies which I'm experimenting with one at a time. The problem/fix you mentioned is something I recognized from Dr. Mercola's website as being the cause of LPR, although you're the first person I've read from to actually follow a treatment based on that--plus having positive results! Thank you and God bless.

arianek,

I'm interested, what is the role of the L-glutamine in the amelioration of your symptoms?
What dosage of it are you taking? I have had some here for over a year now, but have yet to try it.

What you mentioned on the slow-releasing melatonin improving LES tone is also interesting, and I have yet to try that form of it. (Does it work right away or do you have to take it several weeks to notice a positive effect?)

I hope you're doing better these days, and thank you for your informative posts.

~Ian

Funny enough, I've completely stopped taking L-Glutamine, though I was just thinking of getting back on it to see whether I feel any difference (I've never been 100% sure). Though I do eat protein powder daily that has some glutamine in it.

And I also stopped taking the melatonin, as I've developed the symptoms of an autoimmune disorder (called "Sjogren's Syndrome") that only compounds the LPR symptoms, and melatonin is contraindicated for autoimmune disease! I was never really sure if the melatonin helped the LPR at all anyway, I'm pretty sure it's a slow effect in any case.

I can't say I'm cured by any stretch, but there's been a small improvement over the last couple years - I at least don't have the coughing fits or complete voice loss too often, but I still can't really sing, talk for long, or ease up on my lifestyle modifications.

Best to you!
Ariane

Feel free to post here with the info, I prefer to keep the conversation public (also so it can help others who might come across the post!)

First off, great blog and thank you for sharing your story, and I hope you get back to normal health. Thank you for the slow release melatonin info, never would I have known about it, will give that a try.

I know a for a fact that I got Lpr from an antibiotic named Doxycycline, cause right after I finished a 10 course of it, I got the typical symptoms, burning throat, cough after eating, and remind you my asthma was like 2/10 in the past now it's off the roof and the puffers don't work. imo doxy messed up my digestive system. I had at first difficulty swallowing, I went to the ER, all they did was the typical blood work and gave me something to drink to numb my throat and told me to follow up with my GP and sent me off.

Hi Halil - 

Thanks for the comment! That's really interesting - one of the antibiotics I took in 2008 was indeed Doxycycline... I was in such bad shape I don't think I would have been able to tell if one thing in particular flared it up, but I do remember having some other strange side effects from that one and refusing to do any further courses of it.

I'm trying a new change in my medication regime right now, and will be sure to report back in the comments (for anyone who may be subscribed to them) if anything works! 

Best of luck + do write again if you have any success treating it.

in early 2014, I started having classic symptoms of lrp also pretty much right after i took 2 rounds of antibiotics. I believe it was doxycycline but am not 100% sure, but I do know that I also took flouroquinones after and I felt so ill that I couldnt even finish the presciption.
My throat was hurting and so tight that I thought I was going to die and checked myself into the ER twice. The doctor dismissed it and said I have gerd and sent me on my way.
Here I am about 10 months later and I still have a tight chronic sore throat and also lately ive been having numbness in my hands and other parts. Ive read there is a vagus nerve that can be affected somehow.
Ive had a few endoscopes done and also 2 barium swallows and everything looks fine except for a little swelling in the throat are. Ive been on double doses of ppis for many months with no improvement.
Next month im scheduled for an upper GI endo so maybe that will give me more insight.
Im not sure if that can tell if I have a loose LES or not but hopefully I will learn something more about this condition. In the back of my mind, sometimes I wonder if its something more sinister like cancer but ive been told many times that its not.
Everyone here can describe their symptoms the best that they could but every person has a different subjective way they physically and mentally feel about their condition and this condition has symtoms that cross over to other conditions, thats what makes it so complicated.

Oh really? That's no good! Silly spam filter can get a bit overzealous, especially if there are links involved.

Thanks for the links, I'll check that out!

After what I now realize was years, maybe decades, of LPR damage, I finally went to an ENT in February of 2013 to take a look at my constantly inflamed tonsils, hoarse throat, drippy nose, throat clearing and weak voice. He scoped me - no granuloma, but major redness and swelling. He prescribed Prilosec OTC 2x a day, a low-acid diet and a fantastic nasal antibiotic (mupirocin).

After five months, I have to admit it's all working. The nasal antibiotic was the best - one course and my allergies and drippy nose are GONE. My ENT said sometimes people become allergic to the bacteria in their own noses, which was apparently my case.

The Prilosec works, too, even though I hate being on it. My voice is back to normal after years of being weak and crackly, and I don't wake up with a phlegmy throat or clear my throat after meals. I feel much better... just looking forward to eventually getting off the meds. I'm very interested in the study where they gave 200 people 6 mg of melatonin along with l-tryptophan (200 mg), d, l-methionine (100 mg), betaine (100 mg), folic acid (10 mg), vitamin B6 (25 mg), and vitamin B12 (50 mcg) and it cured their acid reflux. Wonder if it works for LPR?

Hey! Thanks for adding to the conversation here, this post is becoming quite the little repository of knowledge!

That's pretty interesting about the mupirocin - I hadn't heard about it before, so looked it up, and I wonder if they thought you had Staph/MRSA bacteria in there or something... It seems odd to use it otherwise, as it's so easy for the bacteria to become antibiotic resistant. Definitely great that it helped you though! (I have a lot of sinus problems but they are extremely seasonal and I've tested very reactive to grasses, so I'm pretty sure it's hayfever.)

Over time, I've had pretty good results so far with the diet changes and the regimen of vitamins and supplements I'm on - not exactly the one you mention, but some of those plus a bunch of other things, similar to what Dr. Mark Hyman recommends if you look up his articles on reflux. (I wanted to persist with this regimen for a good while before going back to try the PPIs.) But if it works for you, then I kind of think do whatever works - this condition seems to be so hard to treat and so different for each person, it seems to partly be a matter of just trying a lot of things and seeing what sticks!

My ENT did do a swab my nose and found staph and some other bacteria... he said most people have those in their nasal cavities, but only some people become allergic to them. Lucky me! The mupirocin is a topical antibiotic, so I felt a little better about taking it. Especially since it was such a total success.

I got the list of GERD supplements from this study: http://www.ncbi.nlm.nih.gov/pubmed/16948779 and another medical site that listed the dosages. If the study is accurate, it's groundbreaking. What's more, the other medical site mentioned that after the study, researchers put the 34% of people who didn't respond to omeprazole onto the supplement plan and their symptoms disappeared, too. Something to think about anyway.

Hey All,

I've got some very important information to share.

To give you my background, I've been diagnosed with LPR/GERD, 3 sleeping disorders (REM apnea, REM behavior disorder and insomnia), vocal cord disfunction, laryngospasms and inhaling reflux into my lungs at night and breathing aerosolized acid during the day. I tested positive for pepsin (enzyme produced in the stomach to breakdown protein) in my airway using the the PepTest from RDBiomed in the UK (you can order the test in the US/Canada by going to this site www.rdbiomed.com and contact them via email. Harvey is fantastic to work with.The method I used to collect the sample was the Exhaled Breath Condensate.) I've had the lump in the throat, reflux into the throat during the day, sore throat, and problems with my voice.

With all of this in mind, I want to let you know I've been able to get better and now I can eat and drink anything. Only the "vapor" (breathing problems) remain which was the first symptom I had. All my other symptoms are gone. With the continuation of my Vitamin D and Melatonin, I suspect the breathing problems will go away.

I'm taking the following vitamin's, minerals and supplements: Vitamin B12(250mcg), Calcium Citrate(500mg), Zinc (22mg), Vitamin D (3,000 - 5,000IU/day), and Melatonin (9mg at night - Spring Valley available at Wal-Mart).

It's clinically proven Melatonin strengthens the LES (lower esophageal sphincter) here is the study http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821302/
Scroll down and click on "Table 2" It states the LES Pressure doubles after 2 months of taking Melatonin.

I'm not sure if you've heard of Dr.Gominak but she's is completely correct about sleep disorders and our bodies getting sicknesses and diseases. Great info from Dr.Gominak http://drgominak.com/vitamin-d-3/ scroll down to "What does D hor­mone defi­ciency look like?" and she specifically talks about reflux.
Her video on youtube regarding sleep (very important) http://www.youtube.com/watch?v=xF24xmJQK1k
She also has 2013 updates on youtube. Just search Dr.Gominak

Important video on Melatonin
http://www.youtube.com/watch?v=EnUK3Z3Lyfo

Great video about sleep - The NeuroScience of Sleep
http://www.ted.com/talks/russell_foster_why_do_we_sleep.html

Currently my Vitamin D is at a 55ng/ml with the intention to get it to about 70 (how they measure Vitamin D up in canada might be different). Dr.Gominak recommends getting your Vitamin D to between 60-80ng/ml. The specific test to request from your doctor is Vitamin D 25 (OH).

I took 3mg of Melatonin for about 6 weeks and had some benefit, then I increased it to 6mg and experienced more benefit. Currently for the past 2 weeks I've increased it to 9mg which made a significant difference.

In closing, I suspect if you suffer from LPR/GERD, there's a good chance you have a sleep disorder and Vitamin D deficiency - the two are related as stated by Dr.Gominak. I hope this information helps.

Jason

Hi Ariane,

I was also diagnosed with laryngeal granuloma last week. After having a sore throat for 3 weeks, I went to see my ENT doctor. He took a look at my throat and found a granuloma, and then prescribed Nexium 40mg twice a day for 2 weeks. He said the granuloma was because of acid reflux, even though I never felt any reflux. After the first 2 days taking it, I felt awful, and then he switched me to another PPI - Omeoprazole. The same deal, I kept belching and burping, and my throat started to burn. I decided to quit it altogether after 5 days. PPI drugs are really dangerous. I had a case of c-diff from taking too much antibiotics two years ago and the prospect of taking PPI (c-diff is one of the side effects) really scared me. I feel worse now than I did when I went to see the ENT. I found this NIH article about a study done in the UK for treating this problem. In that study, they use Gaviscon Advance, which is mostly natural, but only sold in the UK, and it is highly successful in treating granulomas. I ordered a bottle from Amazon.com, and I'll give it a try, and I asked my GI doctor for a prescription for Carafate. In addition, I've been using organic apple cider, and I will try a few other things.

http://www.ncbi.nlm.nih.gov/pubmed/18506466

I second the call to watch out for apple cider vinegar... I tried that before I went on Prilosec and nearly killed myself. It's probably fine once you've fixed the damage from the acid reflux, but until then, the acid in the vinegar just keeps injuring your throat.

For what it's worth, I also felt crappy my first week or two on Prilosec. It took about a month for it to really start working and then it worked great. I don't plan to stay on it any longer than I have to, but it has totally stopped my acid reflux and is reversing my throat damage. (I was scoped last week and it's almost back to normal.)

Keep the updates coming y'all. I can't get back to each of you right now, but I think I'll have to write up a new update blog post with all my recent details... there's just too much to include!

ps. Bill, be careful ingesting any acid (including apple cider/vinegar) until the granuloma heals, it just exacerbates things! 

pps. I suspect the Sulcrafate/Carafate and my antihistamines (Reactine aka. Zyrtec) were causing a rebound effect with acid and histamine intolerance - too long to explain right now, but that's what I'm doing a trial off of right now - too early to report for sure!

Thank you for sharing your story. I have been suffering of GERD/LPR for two years and chronic constipation since I was a kid.
What helped me most with LPR is using a bed wedge, taking melatonin, vitamin D3,L-glutamine and aloe vera. I have read about Cricopharyngeal spasm and I think it might be related to LPR.

Anto, I am most curious about the L-glutamine connection in relation to LPR and throat tightness management. I know it is a stimulatory amino acid in the brain, and because of the fact I am also a migraineur I have to be very cautious about anything of this nature. Yet I am desperate for relief of this throat tightness and pressure because without pain management it would be impossible to sleep with it. I am aware that glutamine combines with certain amino acids and vitamins to manufacture GABA in the brain. Thing of it is I am also on what they refer to as GABAnergic medicine, i.e. Lyrica for management of severe pain. However, I would rather take something natural if it cut the mustard for me.

All the other supplements you've mentioned I have tried for the unbearable throat pain and none have cut it for me, sadly. My ENT just said I have cricopharyngeus spasm with LPR based on a probe down my pharynx that showed redness behind the larynx, and my medical history of a having a small hiatal hernia over the last ten years.

Please let me know if you have any further information on the glutamine or helpful intormation on possible natural remedies. These last two years have been hell since this monkey wrench came out of left field on January 28 of 2013. You'd think that if it is a muscle spasm that it would gradually let up and eventually abate. Here it is almost two years later and there is no change in the globus pressure; it is no better, but thankfully no worse.

I still need to have a mammotry and 24-ph test. It may be helpful to get all the information I can obtain on the LPR, and the globus pressure which is the worst part of it all to me.

Thank you for your input here,

Ian

Hello Everyone,

I finally got my Vitamin D level up to 72.5. I had problems taking oral Vitamin D (nausea) in the past. I decided to try Complementary Prescriptions brand of Vitamin D from my doctor and I didn't experience any problems and was well tolerated. I was taking 5,000IU.

I've reduced my melatonin down to 5mg - I was getting too drowsy in the morning. My sleep has improved dramatically since last August.

Still doing pretty well on the Prilosec, but about a month ago, I found out I have chronic dehydration. Apparently I've had it for years and didn't realize it. (You don't feel thirsty with chronic dehydration.)

Interestingly, chronic dehydration can be a contributing factor to acid reflux. I've upped my water intake to 7 14 oz. glasses per day for a month and all sorts of things are improving - including my reflux. Foods I couldn't tolerate even on Prilosec are fine now.

It can take 2-3 months to reverse chronic dehydration, so we'll see how it progresses. In the meantime, if you think you might be dehydrated (maybe your lips feel dry, your eyes are red, your mouth feels dry, you feel tired), find a water intake calculator online and find your recommended amount.

Fascinating! I have always been HORRIBLE at keeping hydrated... hmm... something to experiment with!

after undergoing carpal tunnel surgery on both hands I awoke from a general with a very sore throat - after insisting something was horribly wrong which took several weeks I was finally seen by an ENT who scoped my throat and announced I had a trauma induced granuloma on my vocal cords. Ironically I have been on protonix for several years to treat GERD which was under control, much to be relief. I had changed my eating habits, diet, due to being found with type 2 diabetes and really thought I had things under control. Now this - I have not been able to speak more than a raspy whisper for over a month. Is there anything one can do- I have been placed on a steroid inhaler which jars my system - it causes my bones to ache reminding me of every previous injury sustained in my last 60 years of life! I can't speak on the phone, hold a meaningful conversation or communicate my needs - buying gas for my car is a joke as who c an understand me and in our state you cannot pump your own! How do you treat these things? How long does it take? It is obvious the intubation performed on me is the culprit yet legal advice is I must wait a year before I can file a malpractice lawsuit. Thinking about going that long without being able to speak is very depressing... today I had to answer the phone and once again the caller thought I was pulling a prank and nearly hung up - my voice is that bad! This is the pits, it's emotionally draining and painful as well - it feels as if I have swallowed a pine cone and got it stuck midway down my throat. I never knew these things even existed - the ENT said they are rare but when you have one, believe me, they sure make themselves known to everyone around you.

All I can do is empathize Charline, even now in my somewhat improved state (thanks to all the reflux management), it only took an hour long doctor's appointment where I was doing most of the talking at the start of the week for me to lose my voice. I've been miming to my boyfriend all evening. 

Frankly, I don't think the doctors know what the heck to do with us. Whether it's injury from intubation, reflux, or something like post-viral nerve damage, none of it is easy to treat. I think it just takes a lot of time and a lot of patience...

Charline, I was wondering if you could help me with something. Did you experience any pain with the granuloma? Was it diagnosed the very first time an ENT did a scoping of your throat? What type of scoping was it?

I surely hope you are doing better now and getting your voice back. I know with my LPR, even with a high daily dose of 40 mg. Omeprazole---I become hoarse if I have just two cups of coffee a day. It is no fun at all, and you find yourself straining to talk with people, even on the phone.

Blessings, Ian

Hi Ian - 

I don't know if Charline is still watching this thread (I can't tell who's subscribed to the email notifications), but for whatever it's worth, I did feel pain when my granuloma (which was on the edge of my vocal chord) happened. The strange thing is that even though the granuloma is gone now, it FEELS like it's still there. I don't know if it's nerve damage or scar tissue of some sort, but I did and still do get hoarseness, coughing, pain, muscle tightness, globus, burning, and when it really acts up also voice loss and mild swallowing problems.

I completely avoid acidic food and drink, it helps so much. And still do the usual - sleeping on the incline, no food and minimal drink 3 hrs before bed. And then I'm still taking Nalcrom (mast cell stabilizer) and Gaviscon before bed each night. (PPIs made me feel awful and are contraindicated for some of my other conditions, and I have not ever tried H2's so far.)

Hope this info is helpful somehow!

Ariane

This is my 2nd time with LPR ... the first time I was given Dexilant once a day to rid of my reflux.... the first time was bad because I couldnt swallow food -- I went to an ENT and he looked at my throat and noticed some minor burns near the airway... he assumed acid shot up and caused it -- also you guys want to check your tongue - if your tongue is visibly lush white or yellow you really have an acid thing going on -- I ate apple sauce Motts in the morn... a banana... bought some Jayone aloe vera juice or The Sun(?) aloe vera to cool burning feelin in my tummy. -- Mostly at lunch I would eat brown rice, baked chicken and chicken noodle soup... and at nights... since I'm Korean... I had option of tofu soup (soon toboo) or miyuk guk aka seaweed soup - go to any korean supermarket and they actually sell it in a tupperware plastic container - you just take it home... boil it up and eat --- The one thing I'm upping on is calcium as that is the sole reason why the LES is widening to allow acid to shoot up thru the esophagus and into my throat.

I have currently issues with overproduction of saliva in my throat. ---as for your nasal passages... get the nasal irrigation .. Neilmed. Greatest invention ever.... spray through your nose and clean out your germs, bacteria, snot etc out of your system and your airways are cleaned..... right now... my issue is this stupid saliva overload and the occasional problem in swallowing...

when the ENT told me I needed a barium swallow... thats when the dexilant and all the nutritional changes i did to my diet improved and i was able to eat again

the reason why i think i got LPR again was due to extreme intaking of lemon <--acidic externally ... and the amount of salsas, tomatoes, onions, spices i been eating that did it.... what breaks me is avocados also cause LPR :( .... but... i have alternatives and possibilities in eating certain things and getting by:

apple
apple juice
melon - high alkaline
watermelon - majorly high alkaline
banana - safe fruit

brown rice

seaweed soup - very high calcium
tofu soup - protein and calcium
bibimbap - veggies galore (google it)

broccoli
sweet potato - very popular in korean snacks
lettuce
kale - i have a local smoothie shop that makes juices and they have a drink that includes carrot, kale, spinach, ginger, parsley and celery and cucumber... its called everpure.
i drink this every other day for its nutrients.

egg white (hard boiled egg)
skinless chicken breast - el pollo loco or anywhere that sells individual piece)
lean white turkey - havent tried yet
tofu - tofu soup from korean restaurants (mild)

oatmeal - look for the red mills oat bran - majorly good... i eat almost every morning with hot water only.. sometimes milk for that calcium
sashimi <-- good alternative for seafood
california roll --- i think this is OK ... not a bad lunch to have... stay away from soy sauce!

water - im gargling alkaline water occasionally with its high PH reading to try ridding of any pepsin enzyme that could be anywhere around my throat...

If you have any personal questions - you can email me at james909@gmail.com

I too have been diagnosed with LPR although how a cursory glance at the back of my throat warrants a diagnosis beats me. I was prescribed Omeprazole and sent away. I had gone to see a GP mainly because I was struggling to swallow and when I lay down at night I had a horrible sensation of my throat closing on me. Needless to say I was very ill with the meds and again with the second choice of Ranitidine - sickness, terrible stomach pain and general malaise.
I am not taking anything at the moment apart from alkaline water but my sleep patterns are shot to bits and I can't get rid of this awful feeling. I am going to try Gaviscon Advance as it appears to get some reasonable recommendations and tbh I am miserable with it all. GPs look at you as if you are neurotic but I think this has all been caused by a severe episode of stress combined with existing IBS. It's good to read all these suggestions as it comforts me to know I am not alone in this!

Hi there, reading your post is like describing what I am going through. I have seen 4 x GPs, 1 Gastro Doctor who didn't even know what LPR was and totally dismissed anything I said about my breathing problems being connected to my acid reflux. I was treated for H Pylori in November 2014 and although I felt a little nauseous for a time after this, I had never had acid reflux in my life. I then had an endoscopy which showed some mild Gastritis and some bile build up. The day after the endoscopy I started getting reflux which has now culminated into LPR. I am awaiting a pep test but am convinced my LPR has come from having either the anti biotics to treat the H Pylori or the Endoscopy has upset the sphincter. I have tried diets, vitamins, supplements, Manuka Honey you name it, cost my a small fortune, but nothing helped. I have just started taking Gaviscon Advanced and am waiting to see if there is any improvement, if there is I will try and come off the PPIs, I am on a low dose and do not believe they are helping at all but scared to come off them because of rebound. Will keep you updated. Kind Regards.

I have never heard of LPR until now. I'm 52 and was diagnosed after endoscopy with an incompetent sphincter muscle between my esophagus and stomach when I was about 25. Can't remember why they scoped me tho, and doctor prescribed Zantac, which really didn't help. I also have had stomach problems all my life and found at 40 that gluten was a problem. Diet changes helped a lot. But the last two years have been complicated. I now have burning mouth syndrome, tmj disorder, plugged ears, Eustacian tube dysfunction, hearing loss, swallowing problems, dry mouth but excess saliva, one nostril plugged, Tinnitis, sleeping problems, choking dreams and probably something else I can't think of. Anyway a nurse suggested Gerd, so I started googling and came up with Lrp. Doctors have not been helpful at all. They just don't really listen to everything I am saying. I feel like I have to figure it out. I'm going to try some of the recommendations like melatonin. I'm really hopeful about this!

I was diagnosed with LPR last Fall and have had no relief from pharmaceuticals.
My intuition led to chose a regimen of natural remedies that have worked in nearly making the LPR negligible.
I realized that the foundation of the LPR, for me, was another bout of systemic Candida and I've addressed that with anti-fungals and very high dose probiotics.
That protocol with digestive enzymes with every meal, 5000 Vit. D twice a day, and a very, very alkaline vegan diet and the LPR/GERD is vitually gone.
I do believe that systemic fungal growth is a foundation for GERD and LPR.

Hi Jeanna,
I am hopeful I might cure this LPR as well. How did you diagnose the candida, and how did you get anti-fungals? I have just started a digestive enzyme. How long before you saw results? Thanks!

Hi, My name is Caitlyn and for over a year I've dealt with the hell that is LPR. My situation, I think, is a little different though. Starting in around April 2014, I would wake up and immediately feel sick to my stomach, and a lot of the time I'd actually have to throw up. this happened for a few months until, everything I would eat started coming up my throat. it's always been a problem for me though, I just always thought it was normal that sometimes when you eat you'd regurgitate it but it got worse and worse. Eventually it came to a point where I would throw up like that every single day, multiple times a day. Even if I drank water, a few minutes later it would shoot back up my throat and into my mouth. Which is disgusting!

I went to a gastroenterologist after my symptoms were unbareable and he told me since I had a traumatic experience the year previous (witnessing the murder of a loved one) that it was probably psychological and sent me to a psychologist. After maybe 2 months of seeing a psychologist he said to me that there was nothing really wrong with me in that sense, and that maybe I should try another doctor.

My mom and I then decided to call and schedule an ENT appointment, I waited 3 months for the appointment as well. All while still throwing up every single day, I never wanted to go out or do anything. I was and to be honest, still am feeling run down. To lighten the mood when people would bring it up, I'd crack a joke like "tastes so good, I think I'll have it a second time!" like in that one episode of spongebob but none of this was fun for me. Doctor, after doctor, numerous blood tests, ER visits more frequent than holidays and no one could diagnose me. Then my ENT appointment arrived, and to make this clear, my symptoms started April 2014 and I didn't get to my ENT until February 2015 because of all the run around. He then stuck the camera up my nose and down my throat and diagnosed me with LPR and told me that the sensation that I had something stuck in my throat was because my throat was swollen from all the excessive vomiting. He gave me the prescriptions for ranitidine and omeprazole, not knowing what else to do and knowing that no one else has ever helped me I have taken it for 3 months and when I went back to the ENT a few days ago, he told me that it's not good that my throat symptoms still occur. (My throat still hurts and from time to time I still regurgitate food). So this Friday I have to go for an Upper GI Barium Swallow and he's going to review them and if there's anything abnormal he's sending me a gastroenterologist to "scope me further". And, it is very true that when I go off of my omeprazole, all of my symptoms come back like a flood either that day or the very next. And it scares me that it may never be over.

P.s- I forgot to mention that I have IBS as well, and for the most part practically all my ER visits were for vomiting and diarrhea. And in those visits they would put me on an all soup, etc diet. Nothing really heavy just soup, toast, crackers. It was nice to read this knowing I'm not the only one with this problem but It scares the hell out of me that when he told me that like 80% recover in a 3 month span of the meds he had me on recover. and I didn't. which makes me think if I'm in the lower quadrant of unfortunate people what else am I gonna luck out on, getting Laryngeal cancer or something. I know I'm just working myself up but reading this really did help me calm my worries. thanks a bunch. :)

I hope you stay well! -Caitlyn

Goodness Caitlyn - It sounds like something is very wrong...I'm no doctor, but that certainly sounds like GI territory (like maybe gastroparesis?), maybe time to try and find a different doc to see! That's way too long to be coping with that extreme of symptoms. Wishing you answers and improvement sooner than later!

- I drink 4-5 good chugs of alkaline Water first thing when I wake up.
- Wheat toast with peanut butter
- Couple hard boiled eggs
- Juiced veggie drink: carrot, apple, celery, spinach
- Red Mills oat bran oatmeal
- Glorybee organic raw honey
- Regular generic oats with the 2 above.
- warm cup of regular water, apple cider vinegar and Glorybee raw honey
- LUNCH: any (non-fried) chicken bowl with white or brown rice
- LUNCH: turkey sandwich with lettuce, tomato, avocado on either white french roll, multigrain or white bread
- Bento box - teriyaki chicken (no sauce), california roll, sashimi
- Seaweed, Tofu or Chicken noodle soup
- Grilled salmon or regular fish
- Bibimbap (Google it)
- Sushi rolls (California, avocado, tuna)
- Aloe vera juice (be very careful on ingredients)
- Alkaline water 4-5 good sips just before lunch (30 mins before)
- Alkaline water 4-5 good sips just before dinner (30 mins before)
- Melons, Watermelons, Carrot Juice <-- alkaline is amazing
- Strawberry, Banana, Apple Juice and Nonfat Yogurt - smoothie
- Activitia yogurt (green container) - 2-3 a day
- Several servings of kimchee (probiotics for good stomach health)

Please share what you eat (name brand included)

Right now, I don't take any meds at all ... since I had most of the Korean soups and meals + alkaline water + aloe vera juice + smoothies = my LPR is almost non-existent... I feel like I'm totally fine... .let me know what you're taking.

Try to add this in your daily intake. Tell me if you get better.
I know everyone is a different animal so were all different in responses to certain foods.

I like your alkaline diet James but I'm having trouble restricting myself to few food choices but I did try going on similar diet for a week or two since I had been diagnosed with LPR last November of 2014. I started taking PPI for a few days but I feel like it's not helping at all and got scared of the side-effects as I'm not really used to taking meds if possible. I got myself an inclined pillow which helps in sinus blockage at night. So far my condition has improved dramatically which I attribute to taking virgin coconut oil and honey regularly. I do eat all sorts of foods though less on wheat/dairy as it triggers my eczema but even my eczema flares is so much less now since I started taking vco and honey two weeks ago. I also do oil pulling using vco once in awhile as it helps clears the throat of mucus but it is advisable to do it regularly twice a day. Here's what I usually include in my diet:

2 Tbs Virgin Coconut Oil (Country Farm Organics)
2 Tbs Pure Honey (I use Rainforest Acacia Honey from Country Farm Organics)

These foods when possible:
Fruits rich in enzymes like papaya and kiwi
Foods rich in probiotics (miso soup,pickled veggies)
Green Leafy Vegetables

PS: I believe it's still best to go on a strict alkaline diet if you can manage it. Too bad for me I can't resist eating foods which are mostly acidic :(. My friend had an acid reflux and eat only boiled eggplant,okra and bittergourd for 6 months and he is totally healed but I don't eat these kind of veggies and I can't take eating only veggies either.

There are a number of things I do and do not with food:

1. Probiotics, alkaline, Vitamin B,D, Protein and alkaline water - I make sure I have a share of each daily. Whatever I lack in, I make sure to add that to my entree' in my meals/food.

2. STOP RED MEAT! ... Eat white meat or anything that can give you a considerable amount of protein (especially those who are losing lots of weight).

3. Smoothies have been a safe bet. (Strawberry, banana, yogurt and apple ONLY) - Take this a couple times a week. + Smoothie shops give boosts so I always get the vitamin boost so I have all the daily nutrients covered.

4. RAW HONEY. Words can't express how vital this is for your health. Make sure that you got the right raw honey - 'cause some of them are not real honey! - Take one spoonful early morning and one after dinner. This is before you give yourself 3 hours to digest your meal.

5. Our parents were right... balance is key. You have to eat a serving or two of every food group.. meat, veggies, fruits.. grain is optional but its ok for me. Grilled or bbq chicken has been my life saver for obtaining protein daily.

NOTE: Squash, seaweed, chicken soup with rice, turkey, brown rice, sweet potatoes are some secret gems that are good fillers for meals and/or special entrees to eat for your reflux.

I fear tomatoes, chocolate and red meat and will never eat those ever again.

Other fatty/semi acidic foods, I'll eat a little bit.... but I make sure before I know I'm gonna eat acidic stuff that I get that good swig of alkaline water... OR....

Drink arrowhead, fuji <--- these waters have high pH and are good before your meals!!

Goodness Caitlyn, I am strangely comforted to know that I am not the only one suffering with this horrific malady. And I do not use the word horrific lightly. My war began in late January of 2014, but unlike you, I got something of a diagnosis (though not official) by the first ENT I saw. But I was no better for the fact and all he told me to do was take the Prilosec, with a 3-month return. Here I am almost two years later and still dealing with this. For me the horrific aspect of it was the pressure in my lower pharnyx, as if a rope was being tightened around my neck. At night this "globus" made it impossible for me to sleep. I think what caused my issue was the fact that I went off my rantidine that I had been on for several years due to a small hiatal hernia, diagnosed in 2004. I was off it for most of 2013. Then wham bam Sam, the worst pain of my life hit me in January 2014 with this tightening sensation in my lower throat. The first ENT I saw put "cricopharyngeus spasm" down on his note pad ( I still have the slip of paper) because I asked him to spell it for me. But now I realize why I was constantly throat clearing, especially when working out on the treadmill. Evidently what happened was that this over-stressed the muscle at the top of the esophagus, (i.e. the upper esophageal sphincter or UES), from the constant coughing and throat clearing for a year. Then on January 28, 2014 I was standing in my kitchen feeling stressed and swallowed hard a mouthful of water. That very night I first experienced the unbearable pressure pain, making it impossible to sleep for months. Now because I also suffer from chronic daily headache (hemicrania continua)---it made my overall pain level unbearable. So I just continued to this day taking Prilosec 20 mg. twice daily, and since last September I have been on pain management. Specifically I am taking a non addictive opiate that is new, having been on the market only since 2003. It is buprernoprhine, 2 mg. total daily which is a small dosage. Fortunately it is NOT the type of opiate where you crave it and have to take ever increasing doses of it to obtain the same measure of pain relief. I have been on this low, 2 mg. dosage daily for a year now, because the throat component of my pain syndrome has not abated. One would think though, Kaitlyn, that if it was indeed a muscle spasm of the cricophayngeus, that it would gradually ameliorate with time. This is what freaks me out about it. It looks like the only other option medically I have is the botox injections of this muscle, which I have read are effective three to four months. (I am thinking about it, because I would rather not have to be on pain management if only I could cope with my overall pain).

The thing of it is, what happens is that a person can have 10-30 LPR events a day where the acid comes up from the stomach into the throat and enters the larynx; it is extremely irritating to pharyngeal tissue. That is why if i have as much as two cups of coffee a day, I am hoarse. (Even with the daily total dose of prilosec 40 mg.) I still haven't had a 24 hour ph test or mammotry testing to see how tight the muscle is. I know I need to have these tests, but you know what a run-around it can be. Last year I was on this medical-merry-go round and still all I know is most likely I have LPR because the ENT saw redness behind my larynx when he went down with a probe, supported by my history of having an hiatal hernia. He pushed in front of the neck and said, "Is this where you're feeling the tightening and pressure-pain?" "Yes, that's exactly where it is." I replied. So for me the worst aspect of it all is not at all nausea or burning pain in the abdomen, but this horrific pressure-pain in my throat that is unbearable without appropriate pain medicine. I do my best to eat a correct diet, don't drink or smoke, but have a hard time giving up coffee completely. Because I am also on Lyrica as an adjunct to my pain treatment and it makes me feel terribly sluggish, I need something to give me some energy during the day.

Anyway that is my LPR story in a nutshell, Caityln. Know that you are not alone. I hope you're doing much better this fall. God bless.

for you people suffering... try this and see if this works:

1 - Activia yogurt --- eat 2-3 yogurts a day. ...calcium/probiotics is a great weapon for the stomach
2 - Aloe vera juice --- watch out for drinks that has fructose (don't buy the brands that have it)
3 - chicken and rice (chicken bowls) --- (DO NOT eat fried.. other cooking styles is fine) white/brown rice is fine.. white does good for me.
4 - Alkaline water --- Try not to take omprezoles, acid controllers, etc.
5 - veggie juices and raw honey.
veggie juices --- use apple, carrot, spinach, ginger
raw honey - take one giant glob of honey in the morning... and once in the night.

try all of these and see if you improve.

Wow, just want to start off by saying this page discussion has some great information about LPR and ways to combat the disease, a hell of a lot more useful than any walk in clinic doctor. I too suffer from LPR for the past 3 years and have found answers and remedies strictly from the internet, I've been on all the PPI's prescribed with no good results. Long story short I have done my research and came to the conclusion that dieting helps the most out of anything else. Which makes sense because the food you digest controls the root cause of the acid to back flow to an extent. I have yet to find a way to strengthen the lazy LES without surgery until reading this form, will definitely be taking the advice about slow release melatonin supplement from here and applying it.

Another good anti inflammatory remedy I apply is a home made tea including: organic Tumeric, Honey and Ginger which has been great to really soothe the throat along with countless other benefits. Vitamins and supplements I am still working with to find the right fit but know once I do symptoms of LPR will diminish with persistent action.

Thank you for creating this page Ariane. I also live in Vancouver and would like to get into contact with some of the Medical Doctors and registered massage therapist you've been seeing so I can get on the right path to eliminating the problems!

I have found another type of food that has dramatically helped with my LPR/reflux:

Lately I have been getting lots of saliva developing in my throat on occasion - but I realize it has happened when I would eat fried foods or real acidic stuff.

MY NEW ALLEVIATOR FOR REFLUX?

FROZEN YOGURT aka YOGURTLAND or JOGHURT!

Frozen yogurt (find any that's sugar free) has been a Godsend .. with its high calcium ... I am able to attain vitamin D thru eating that as well as running/walking in the outdoors in the afternoon (after work) --- the sun doesn't go down until 730pm here in L.A. California.

Calcium helps to close the valve that allows acid to shoot thru the stomach.

By allowing yourself between 10-15 oz of yogurt a day.... you allow yourself enough calcium/vitamin D to aid you ....

I normally get plenty of vitamin A, C, E etc... but D has been my problem awhile ago.

Try frozen yogurt... its tasty + it can do wonders in alleviating that unwanted overflowing saliva in your throat!

Hi. I was diagnosed with a granuloma three years ago and a short four weeks of a PPI along with sleeping on an incline made me forget about it all.

However two spring colds in a row with sinusitis and the old throat symptoms made me wonder if we're actually prone to more colds or am I just getting paranoid?

I am going to go back on the PPI for two weeks even though this might just be a virus (the whole town is coughing from a spring cold virus with sinusitis being a common symptom).

Any advice?

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