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Trying New LPR (Silent Reflux) Treatment
Old 01-23-2020, 08:55 AM   #1
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Trying New LPR (Silent Reflux) Treatment

I talked about my LPR, caused by acid reflux, in this thread.

My symptoms are controlled pretty well with a wedge pillow and frequent gum chewing. However, it's still a problem now and then.

I'm trying a new treatment with an OTC suspension that creates a foam on top of the stomach contents and helps avoid reflux. The treatment is the UK version of Gaviscon Advance. The US version is different; only the UK version has this property. It's about $20 a bottle because it must be imported:



Although I find testing difficult because the symptoms tend to vary widely from one night to the next, I experimented last night by having a big steak with about six fluid ounces of wine. I took the stuff and had very little coughing. That's not conclusive, so I'll continue testing.

Here's an article on it:

https://www.refluxgate.com/gaviscon-advance

and here's a double-blind study that showed that it was effective:

https://www.ncbi.nlm.nih.gov/pubmed/10621921

I found that the suspension contains no sugar.

I'll bring this up with my doc and I'll keep you posted on what I find.
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Old 01-25-2020, 01:31 AM   #2
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what's "LPR"
LEF.org had a product called esophageal guardian that makes the foam on top.
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Old 01-25-2020, 04:33 AM   #3
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My wife suffered with gastric reflux the last 15 years--terrible hiatal hernia. She took all the meds, including the ones that have been since taken off prescription status. And she's slept on a big pile of pillows until we got her an adjustable bed. Her eating habits changed to the point where she didn't enjoy food, and she couldn't even eat ice cream.

She would awake terrified when she aspirated in her sleep. And she's had pneumonia and been in the hospital 3 times in recent years--in serious condition. Her internal medicine doctor always advised against having the hiatal hernia fixed.

It finally got to the point where she was in misery all the time, and she decided to get our local surgeon to fix the hernia laproscopically. The surgery was successful, and she now has a new lease on life--including enjoying meals. She's sorry she didn't get it done many years ago. Only problem is eating rice or grits fast, as they get stuck halfway down.

If you are miserable and wake up nights terrified, consult your doctor and/or general surgeon. You don't have to be that way. Wait too long, and your esophagus may be too damaged, and with bad reflux comes increased chances of esophageal cancer.
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Old 01-25-2020, 09:21 AM   #4
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Quote:
Originally Posted by Bongleur View Post
what's "LPR"
LEF.org had a product called esophageal guardian that makes the foam on top.
AKA Silent Reflux. Screenshot_20200125-072045_Chrome.jpeg
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Old 01-25-2020, 09:23 AM   #5
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Have you tried eliminating all sugars and grains from diet? Including alcohol? I had horrible acid reflux and went NSNG a year ago and the reflux is resolved. Many other benefits also
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Old 01-25-2020, 09:39 AM   #6
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Quote:
Originally Posted by Bongleur View Post
LEF.org had a product called esophageal guardian that makes the foam on top.
Yes, that's the same idea, although the Amazon reviews suggest that chewing the tablets is unpleasant.

I put some vinegar in a jar then poured in some of the Gaviscon Advance. It first went to the bottom and then floated to the top. When I shook it up, however, the stuff remained in suspension (didn't create a visible barrier). Of course, stomach acid is different/stronger than vinegar.

I've had very little coughing/throat clearing on the three nights I've tried it, but the symptoms vary a lot without treatment, so that doesn't tell me anything.

The goal is to be able to have a beer with dinner.

>Have you tried eliminating all sugars and grains from diet? Including alcohol? I had horrible acid reflux and went NSNG a year ago and the reflux is resolved. Many other benefits also.

Yes, I've been very-low-carb for over ten years.
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Old 01-25-2020, 06:39 PM   #7
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Have two wedge pillows. Not anywhere near your issue. I hope you find a solution that doesn't include no alcohol
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Old 01-26-2020, 12:27 PM   #8
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Quote:
Originally Posted by Bongleur View Post
what's "LPR"
LEF.org had a product called esophageal guardian that makes the foam on top.
Here's what everyone wants to know: the acronym LPR stands for Laryngopharyngeal Reflux. Obviously referring to involvement of the larynx and the pharynx.
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Old 01-26-2020, 12:36 PM   #9
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Al, I'm, watching this thread. I just went off Prevacid, and am doing sort of OK. Lots of coughing now and then, and I have to sleep propped up if I have anything to eat after 5 PM (but not always! Sometimes I get away with eating after 5 PM). Also consuming about 5 to 10 calcium antacids per day. Life is easier when just taking the Prevacid, but I became worried about the long term effects (not absorbing enough calcium due to low stomach acid, and whatever else they find out in the future, lol)
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Old 01-26-2020, 12:46 PM   #10
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The PPIs never did anything for me, and that's common for LPR sufferers.

Strangely, the problem seems less when I'm on a trip. One hypothesis is that it's sitting in a recliner at home after dinner that makes a difference. On one recent trip I had two shots of gin (my daughter is a very bad influence) then a big meaty dinner with wine at 6 PM or later. No coughing!



I'm pretty sure that making an effort to burp as much as possible between dinner and bedtime helps. I often have the experience that I start coughing, then have a good belch, and I stop coughing. It's as if the pressure is causing the coughing.

The other day I had dinner at 3:30 PM. The LPR was no different from when I eat at 5 PM.

As I've said before, there's so much variability that it's hard to test things.
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Old 01-28-2020, 03:19 PM   #11
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I have a hiatal hernia,GERD, LPR and gastritis, that was really bad three years ago. I didn't want to live on pantoprazole forever and after some research I did the elimination diet. By doing this it gave time for the gastritis to heal and find my guts worst enemies. That means giving up everything for eight weeks. No coffee, beer, wine, no pepper of any kind (black pepper,hot pepper bell pepper), all tomato bases (spaghetti, pizza, catsup), onions, garlic and much more. The above was found to be my major triggers. After six weeks I was off of the pantoprazole.

Now days I'm able to have a little morning coffee and a little of the other but still no pepper of any kind, anti-inflammatories or hard liquor. Some days even a cold glass of water will trigger and I'll be coughing up slim for thirty minutes.

Google the elimination diet for gastritis. It helped me but now, I have to be watchful of what I eat.
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Old 01-28-2020, 03:30 PM   #12
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My impression is that with LPR, there's no healing involved. The culprit is stuff going the wrong way in the esophagus. IOW, there's no longterm aspect to this. Either I do something that causes the reflux, whether it's eating something in particular, lying down, etc, or I don't.

I know that booze weakens the LES, but is this an effect that lasts an hour or a week?

Maybe the way to ask it is this:

If I eat all the wrong stuff, drink booze, lie down after dinner etc. for six days, then on the seventh do all the right stuff, will my LPR be bad on the seventh day? That is, worse than if I did all the right stuff for seven days straight?
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Old 01-28-2020, 03:43 PM   #13
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Originally Posted by happ View Post
I have a hiatal hernia,GERD, LPR and gastritis, that was really bad three years ago. I didn't want to live on pantoprazole forever and after some research I did the elimination diet. By doing this it gave time for the gastritis to heal and find my guts worst enemies. That means giving up everything for eight weeks. No coffee, beer, wine, no pepper of any kind (black pepper,hot pepper bell pepper), all tomato bases (spaghetti, pizza, catsup), onions, garlic and much more. The above was found to be my major triggers. After six weeks I was off of the pantoprazole.

Now days I'm able to have a little morning coffee and a little of the other but still no pepper of any kind, anti-inflammatories or hard liquor. Some days even a cold glass of water will trigger and I'll be coughing up slim for thirty minutes.

Google the elimination diet for gastritis. It helped me but now, I have to be watchful of what I eat.
Have you ever talked to your family doctor about having the hiatal hernia fixed? My wife says it's the best thing she's ever done, and she is sorry she suffered for 15 years. Now she doesn't wake up frightened out of her mind that she aspirated into her lungs.
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Old 01-28-2020, 03:58 PM   #14
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Her internal medicine doctor always advised against having the hiatal hernia fixed.
DW's mother died as a result of hiatal hernia so I think there can be a risk to the "no treatment" route. Result in her case was a blockage and a "nothing to be done" situation. She essential died of starvation 2-3 months later.
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Old 01-28-2020, 04:00 PM   #15
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I have acid reflux and sleep with a wedge pillow and take collagen hydrolysate along with probiotics, seems to help. I stopped taking prescription strength pepcide due to the potential longterm effects
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Old 01-28-2020, 04:02 PM   #16
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My son and my best friend swear by Gaviscon.
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Old 01-28-2020, 07:10 PM   #17
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Another thing I've tried to do is find things for dinner that are quickly and easily digested.

One day, I had only 8 fl oz of protein powder in water for dinner (at 5 PM), thinking that by bedtime my stomach would be offline, but that wasn't the case.
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Old 01-28-2020, 09:01 PM   #18
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My gastrologist didn't think it was severe enough for surgery. Later I discovered I also, have a umbilical hernia and they said the same thing. Maybe it's because I'm with a Advantage HMO and not the company insurance I had years ago which didn't tie doctors down.
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Old 01-29-2020, 10:44 AM   #19
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Chiming in to say I have started eating about 4 ounces per day (is that even enough?) of Cabot Greek Yogurt, to get the 'good' probiotic bacteria. It has 3 different kinds listed in the ingredients. A retired nurse I know suggested the is. Been doing the yogurt for about a week now. Hasn't made anything worse. Maybe the night time acid is a little less? To recap, I've been off my meds (Prevacid) for a few weeks now, and my cough has returned and some minor burning in the throat sometimes, but the nurse assures me it is not serious enough to be worrying about Barrett's esophagus, lol. And the good news is that sometimes I can go to bed and have no acid coming up into my throat, but I don't know why. Seems to be random, not connected to my behavior.
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Old 01-29-2020, 11:18 AM   #20
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Misan, there had to be something else going on with your MIL. My friend had cancer surgery that ended his ability to eat and he fed himself by putting a special liquid into himself by a tube in his stomach. He did that for years.
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