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Old 02-23-2018, 09:31 AM   #41
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I do find it puzzling that some people say reflux is due to too much acid, so take PPI's; while others say it's because stomach acid becomes less effective with age, so supplement it with vinegar. How would you know which is which?
It's not from an excess of acid -- it's the sphincter that keeps the acid out of the upper tract that weakens. Doctors will tell you that some popular beverages also cause that sphincter to relax, increasing the potential for reflux.

People who take apple cider vinegar use the raw, unfiltered stuff, which has probiotic qualities. Theories have emerged that an imbalance in the gut bacteria can create reflux, so probiotics in the form of cider vinegar, yogurt (if not lactose intolerant) and probiotic capsules are recommended.

I've heard some doctors on medical call-in shows (anyone listen to "The Peoples Pharmacy?") say that intestinal gas can back up into the stomach and produce reflux.
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Old 02-23-2018, 09:43 AM   #42
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A sphincter is muscles, right? I bet there's a way to strengthen it. Probably more of a mindfulness/relaxation type of activity than what we'd call an exercise, since it's inside the abdominal walls.

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It's not from an excess of acid -- it's the sphincter that keeps the acid out of the upper tract that weakens. D
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Old 02-23-2018, 09:49 AM   #43
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A sphincter is muscles, right? I bet there's a way to strengthen it. Probably more of a mindfulness/relaxation type of activity than what we'd call an exercise, since it's inside the abdominal walls.
Your oesophageal sphincter keeps food in your stomach. It is made of smooth muscle, which is not under voluntary control. So mindfulness won’t work.

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Old 02-23-2018, 10:05 AM   #44
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  • I've had seasonal allergies/sinusitis for ~30 years and use Flonase to stave it off. Two years ago I had an allergy test series (the kind where they stick little needles in your arms). I only react to pollen.
  • Late last December, trees were bare, grass was dead, snow on the ground; no pollen. I developed sinusitis, then bronchitis, so bad I could hardly breathe, and ended up in Urgent Care where they took a chest X-ray (showed nothing serious) and gave me antibiotics.
  • I now have sinusitis, in mid February. The trees and grasses won't start blooming for another couple of weeks.
  • Between bouts of sinusitis, I seem to be always having to clear my throat.
...
I don't know about acid reflux but I do have my own experiences with pollen. It can be highly variable. Some years con be worse then others.

Could you be allergic to tree pollen and perhaps some grasses? In our region trees can pollinate in cold weather. My worst symptoms occur in January and February. Juniper and Cypress may be the cause in my case but it is hard to pin down the exact causes. It is probably also regionally dependent. Once I was in Yosemite Valley in the winter. Terrible pollen from Cypress I think. You could even see the pollen on the car windshield and the snow.

We went to the coast a few weeks ago and the wind flowing over the hills seemed to kick up the grass pollen (my guess anyway).

In addition to the Fluticisone (similar to Flonase) I go in for allergy shots. These have helped a lot over the years. But I don't think anyone I've mentioned this to who has allergies has decided to do this. However there are plenty of people in the waiting room so it is a popular solution. Medicare will help out a lot on this cost. You have to get up to a maintenance dose and then come in maybe once per month thereafter.
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Old 02-23-2018, 10:29 AM   #45
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A sphincter is muscles, right? I bet there's a way to strengthen it. Probably more of a mindfulness/relaxation type of activity than what we'd call an exercise, since it's inside the abdominal walls.
The problem is that it's not under your control so it would be hard to use your mind to strengthen it. A severe deficiency in the sphincter can be remedied surgically e.g. lapraoscopic fundoplication. There are other less invasive procedures that can have mixed results. The most intriguing to me is https://www.stretta-therapy.com/ and I have at times considered it but there is no one local that does it. I would have to go to San Diego or the L.A. area.
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Old 02-23-2018, 01:34 PM   #46
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There are other less invasive procedures that can have mixed results. The most intriguing to me is https://www.stretta-therapy.com/ and I have at times considered it but there is no one local that does it. I would have to go to San Diego or the L.A. area.
My then-BF (in his 30s/40s at the time) had terrible eating habits and terrible gastric reflux. He was taking Prilosec (available as an Rx at that time) at an alarming rate. I was concerned about his developing Barrett's esophagus or cancer. His doc had him coming in 2x a year for scoping of the esophagus, etc.

In my research, I ran across the Stretta procedure. Then-BF found a local doctor who was trained in Stretta and he had the procedure done at Univ. of Michigan hospital. Sadly, it did zip, zero, nada to alleviate his issues.

Last I knew, then-BF was still consuming Prilosec at an alarming rate.

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Old 02-24-2018, 07:09 AM   #47
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Thanks...I hate taking meds even more than I dislike going to the Dr. I have yet to take anything that didn't have some noticeable side effect. Hope your symptoms stay away for good.

May I ask, did your Dr. do any tests before prescribing? Or just "Oh, you have reflux, here's an Rx"?
Yes, He looked through a scope which went up into my sinuses, through a nostril, and (possibly) all the way down to the larynx. Felt strange but not painful. No tube down the throat. BTW, he said my cough was caused by stomach acid actually getting up the esophagus, then into the trachea and causing lots of phlegm to be created to carry out the acid.
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Old 02-24-2018, 07:54 AM   #48
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I'm not sure if this will help, but where is your location, and what kind of heating system do you have?

For a lot of us, winter has been pretty cold, with temps in the teens and single digits. Winter air is very dry, it's why mining disasters always occurred in winter months. Swampy, muddy areas underground became deserts, and forced air heat makes the air that much drier, drying the sinuses and throat. That in turn makes one more susceptible to viruses, dust and the like. Add some moisture to your air, but not too much, because that will trigger molds.
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Old 02-24-2018, 08:01 AM   #49
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Thanks Ian, I doubt I would ever have heard of Stretta if you had not mentioned it. Surprising that no one in your area (Arizona, your profile says) would do it, since AZ is such a retirement mecca and GERD is associated with age. I was curious enough to put in my zip code, and several doctors came up w/i 25 miles.

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The problem is that it's not under your control so it would be hard to use your mind to strengthen it. A severe deficiency in the sphincter can be remedied surgically e.g. lapraoscopic fundoplication. There are other less invasive procedures that can have mixed results. The most intriguing to me is https://www.stretta-therapy.com/ and I have at times considered it but there is no one local that does it. I would have to go to San Diego or the L.A. area.
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Old 02-24-2018, 08:09 AM   #50
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Thanks for your thoughts...In the mid-Atlantic area, ragweed (my Nemesis) can indeed persist into late fall if it is warm, while maple trees (my other nemesis) can pollinate as early as late February in a warm winter. But my 2 episodes occurred outside those extreme times. There are online pollen reports for every zipcode, and the current report is "low/no pollen." I react when the report is "medium" or higher. Also I do not react to every kind of pollen (at least, according to the tests). Just certain species - ragweed, English plantain, maple, ash. Thank goodness, since I love flowers and love to stick my nose right in them to sniff.

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I don't know about acid reflux but I do have my own experiences with pollen. It can be highly variable. Some years con be worse then others.

Could you be allergic to tree pollen and perhaps some grasses? In our region trees can pollinate in cold weather. My worst symptoms occur in January and February. Juniper and Cypress may be the cause in my case but it is hard to pin down the exact causes. It is probably also regionally dependent. Once I was in Yosemite Valley in the winter. Terrible pollen from Cypress I think. You could even see the pollen on the car windshield and the snow.

We went to the coast a few weeks ago and the wind flowing over the hills seemed to kick up the grass pollen (my guess anyway).

In addition to the Fluticisone (similar to Flonase) I go in for allergy shots. These have helped a lot over the years. But I don't think anyone I've mentioned this to who has allergies has decided to do this. However there are plenty of people in the waiting room so it is a popular solution. Medicare will help out a lot on this cost. You have to get up to a maintenance dose and then come in maybe once per month thereafter.
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Old 02-24-2018, 08:13 AM   #51
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I know! We spent January in Florida, where the humid winter air was helpful in so many ways. My hair doubled in volume, I lost (temporarily) 5 years off my face, and my sinuses felt better. I bet all the 80-year-olds we saw are actually 90 or 100 due to this youth effect Too bad I cannot tolerate the long hot summers, or we would be living near the beach in FL.

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I'm not sure if this will help, but where is your location, and what kind of heating system do you have?

For a lot of us, winter has been pretty cold, with temps in the teens and single digits. Winter air is very dry, it's why mining disasters always occurred in winter months. Swampy, muddy areas underground became deserts, and forced air heat makes the air that much drier, drying the sinuses and throat. That in turn makes one more susceptible to viruses, dust and the like. Add some moisture to your air, but not too much, because that will trigger molds.
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Old 02-24-2018, 08:49 AM   #52
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Thanks for your thoughts...In the mid-Atlantic area, ragweed (my Nemesis) can indeed persist into late fall if it is warm, while maple trees (my other nemesis) can pollinate as early as late February in a warm winter. But my 2 episodes occurred outside those extreme times. There are online pollen reports for every zipcode, and the current report is "low/no pollen." I react when the report is "medium" or higher. Also I do not react to every kind of pollen (at least, according to the tests). Just certain species - ragweed, English plantain, maple, ash. Thank goodness, since I love flowers and love to stick my nose right in them to sniff.
My personal experience is to not rely on the on-line pollen counts. I mention my case just as an illustration. In my case I don't always know the source or its location but I might have itchy eyes and a runny nose in January-February. I have a bit of a runny nose all year but January and February are obnoxious and bother my sleep in the late morning hours.

Allergist's tests probably identify major allergic reactions. My guess is that one might have a low level of allergic reaction to some sources (rhinitus, untreatable by allergist shots) that is additive to a seasonable source like tree pollen which might be treatable by shots.
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Old 02-24-2018, 05:58 PM   #53
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Severe acid reflux and/or GERD is not something to be trifled with. Especially if the onset seems sudden and you haven't had any big changes in eating habits. A visit to to your GP will probably result in a prescription for a PPI drug like the generic version of Protonix. If your health plan permits seeing a specialist without referral, you may want to directly consult with a gastroenterologist who will still likely prescribe a PPI but may also be concerned enough with how your symptoms began to consider an endoscopy.

Whatever you do don't ignore the problem; GERD can lead to Barrett's esophagus and potentially (although rarely) to esophageal cancer. My GERD was more of a nuisance and flareups were easily treated with a drink of milk or liquid antacid. But I'm now on a high dose of a PPI and have been diagnosed with Barrett's meaning an endoscopy every few years to catch cancer early should it ever appear. I've known two people to die of esophageal cancer and it's a miserable way to go.
Do this right now. Go see a gastroenterologist. I am in this field. In the interim go to the drugstore and buy otc Prilosec or nexium. The tooth decay and your other symptoms speak of erosion. Don’t waste your time with a family physician.
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Help w/Dr. visit: Acid Reflux and Sinusitis (LONG)
Old 02-25-2018, 09:12 AM   #54
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Help w/Dr. visit: Acid Reflux and Sinusitis (LONG)

My daughter has some serious health issues.

To help me remember and avoid repeating myself I provide a printed timeline of her symptoms and any other providers we have seen. You might add what you have tried to the list.
Make clear your concerns about acid reducers.

Since your situation seems severe, I would push for a specialist referral. Because of the history of coughing I’d want to see a pulmonologist for asthma screening as well as a gastroenterologist. They would send you for that anyway if you were being screened for reflux surgery.

If you end up on a medication, try for prescription zantac. I have not experienced any constipation with it and it’s less scary than ppi’s.

My nocturnal reflux was tied in with mild sleep apnea. Gasping for breath causes the reflux.

A prompt care doc taught me that if you can taste your nasal spray you are using it wrong and irritating your throat. Don’t “sniff” after!
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Old 02-25-2018, 09:36 AM   #55
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My nocturnal reflux was tied in with mild sleep apnea. Gasping for breath causes the reflux.
That is interesting. I've been putting off a sleep study till I enroll in Medicare, but this convinces me I should get it done sooner. Thanks for the info.
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Old 02-25-2018, 10:30 AM   #56
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I took omeprazole for years but developed some vitamin deficiencies and wanted to quit. It took a while before the prescription zantac was enough but most days it is now. I might take a tums during the day as well but it’s calcium so I need that anyway.

My ex died of carcinoid syndrome. There’s not much info about the cause but I read an article possibly linking the two (ppi and the cancer). That was enough for me.

Honestly, I feel better overall but hard to say if that’s why because I’ve made many changes in my life in the last year.

Fwiw - I had a throat infection from the reflux so it was getting pretty bad, but my scope was clear. No damage.

I read an article about ear infections actually being reflux - maybe your sinusitis is related?
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Old 02-25-2018, 10:32 AM   #57
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Reading your post of symptoms was like looking at my own history! Frequent sinus infections, post nasal drip, stomach upset/acid, severe choking occasionally when eating, etc.
It has taken a while to root out what resolved them, and testing to rule out certain diagnosis.
Did have Upper GI and barium swallow, then EGD with dilation. Testing showed very small hiatal hernia, no reflux, but small schatski's ring. (thus the dilation). Allergies to pollens, also.
I have stopped flonase and take daily antihistamine. At least once weekly, I mix 2 tablespoons Braggs live culture apple cider vinegar, one tablespoon natural honey and hot water to drink. I eat live culture yogurt. If I notice stomach upset/acid,(which happens far less frequently now) I do take OTC omeprazole daily for a few days to stop the acid production (I rarely need to do the 10 day regime). I will never take omeprazole on an ongoing daily basis, but it certainly helps as needed.
I have no idea if the sinus stuff is related to the stomach/acid stuff, but since I have started the changes above, my symptoms have decreased dramatically.
Not sure this info helps you or not, but definitely need to give your doctor a full report as Meadbh recommends, and request/follow up on tests.
Best of luck in your quest to better health.
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Old 02-25-2018, 11:32 AM   #58
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My primary care Dr. said the same thing. She said to aim for the nasal turbinates (had to look up where they reside within my nose!) since that is where the nasal irritation mostly takes place.

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M

A prompt care doc taught me that if you can taste your nasal spray you are using it wrong and irritating your throat. Don’t “sniff” after!
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Old 02-25-2018, 12:00 PM   #59
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As a former physician, I appreciate your wish to be an organized historian. I recommend you write down your responses to the following points (many can be yes or no). If you have a patient portal available, you can copy and paste your summary into it.

1. Describe the symptoms of your Principal Complaint in detail. Looking through your OP, I couldn’t find sufficient detail. Your doctor needs to know:
- what is the sensation? Pain? Burning? Acid in your mouth? Nausea? Vomiting?
- how bad is it on a scale of 1-10?
- what are you doing when it happens? Lying down? Does it wake you up? Does it ever happen when you are standing?
- how long does it last?
- what, if anything, makes it better?
- what makes it worse?
- is it accompanied by other symptoms, e.g. shortness of breath, choking, coughing?

2. Once the Principal Complaint has been described in detail, outline any relevant recent and past history:
- diet including alcohol
- weight changes
- smoking history
- medications
- self medication if any
- past abdominal or chest surgery
- respiratory infections including sinusitis
- any cardiac problems
- thyroid issues
- anxiety

This should make it easier for you and your doctor to focus on a plan of investigation and subsequent treatment. Best of luck!
This is very helpful. I can see that I have not been very good at describing what is wrong with me in the past, when I have gone for doctor's visits. This gives me a better idea of what to keep track of when I have an ailment. Thank you.
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Old 02-25-2018, 06:22 PM   #60
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I have been taking omeprazole for almost 10 years. Somehow, a nerve, probably my vegus nerve, gets irritated by gastric juices, and gives me heart/chest pain. As long as I am medicated, I'm fine, if I forget, well, I get full blown symptoms of a heart attack.
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