Alkaline reflux?

Question:

– Hide quoted text — Show quoted text -> I was diagnosed with LPR a few weeks ago. I know I’ve had it off and > on for years. Also have irritable bowel and hiatal hernia. But all has > been under control, through a lot of natural means, until the past few > months. So ENT put scope down my nose to throat and confirmed that it > was LPR (no heartburn, just pain, chronic throat clearing and > coughing). > He wanted me on Zantac. But my internist said no and I should use a > PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they > don’t help. In fact, tonight, after taking an Aciphex this morning and > last night, I have that drawing hungry gnawing in my gut. > I even tried DGL licorice for about three days, and no help as well. > Even though I’ve read that H2 blockers are not as good, I’m trying > that. > It’s so bizarre that the meds seem to increase the acidity instead of > decrease it. Same thing happens when I take natural enzymes. > Now, I have been reading and see there is an alkaline reflux. I’m > wondering if that’s what I have, so that’s why digestive enzymes and > PPIs make things worse. Anyone have any experience with this and can > suggest what someone with this can do to heal it?

The next step is a complete diagnostic workup. Technically, the ENT can’t diagnose LPR since reflux, its character and extent, hasn’t been diagnosed yet. There are other things that can cause such laryngitis/pharyngitis. I agree that given your symptoms, it’s a reasonable presumption, but you need to have your upper GI tract evaluated. You need to have EGD, ambulatory pH testing, esophageal manometry. Your internist should be quite willing to get a consultation from a surgeon or gastroenterologist. Acid reflux, if that is indeed what you have, that does not respond to PPIs will usually require anti-reflux surgery. The only other thing you might try is a prokinetic agent, metaclopromide (Reglan) in hopes that it will aid in esophageal clearing and gastric emptying enough to control your symptoms. In the meantime, diet, weight loss, eating habits etc as detailed by many previous poster here on this newsgroup. HMc

Response:

I was diagnosed with LPR a few weeks ago. I know I’ve had it off and on for years. Also have irritable bowel and hiatal hernia. But all has been under control, through a lot of natural means, until the past few months. So ENT put scope down my nose to throat and confirmed that it was LPR (no heartburn, just pain, chronic throat clearing and coughing). He wanted me on Zantac. But my internist said no and I should use a PPI. Well, I’ve tried Nexium, Prevacid, and finally Aciphex. And they don’t help. In fact, tonight, after taking an Aciphex this morning and last night, I have that drawing hungry gnawing in my gut. I even tried DGL licorice for about three days, and no help as well. Even though I’ve read that H2 blockers are not as good, I’m trying that. It’s so bizarre that the meds seem to increase the acidity instead of decrease it. Same thing happens when I take natural enzymes. Now, I have been reading and see there is an alkaline reflux. I’m wondering if that’s what I have, so that’s why digestive enzymes and PPIs make things worse. Anyone have any experience with this and can suggest what someone with this can do to heal it? Thanks, Susan

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