Silent reflux and voice box paralysis

[Jherm21]

Ok I just went to ENT yesterday and he scoped my throat because I have been complaining of shortness of breath and no one ever thought it was asthma, he told me he saw reflux pretty bad in the throat and said I'm having silent reflux (I have absolutely no heart burn) and having laryngeal spasms from it causing me to be short of breath. I know we're not talking about celiacs but has anyone made a correlation to a diagnosis after celiacs about reflux and vocal cord dysfunction? He prescribed omperazole 2x daily and ranitidineat night. Is this a treatment for this does anyone know I'm a little skeptic on the omperazole considering I was told I had SIBO and I know proton pump inhibitors can cause further damage to the bacteria. I'm so confused. Why are the doctors not putting two and two together. I have so much mucus in my throat I can barely swallow. Only time of day I have relief is when I'm sleeping. I guess my question is has anyone ever tried those combined medications together and have they shown improvements

[trents]

So I'm not clear on a couple of things after reading your narrative.

First, are you a confirmed Celiac or are you saying you are suspecting you have Celiac disease?

Second, is this excessive mucous a new phenomenon after being put on the anti Gerd meds or was it present before?

[cyclinglady]

Was EOE discussed?  Your doctor might be trying to rule this out.

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[Jherm21]

I was diagnosed with Celiac in January and still having symptoms without dairy and gluten.. I haven't started the PPI's yet, just received the "silent reflux" diagnosis the other day. My gi doctor wont really see me until I get ahold of the rifaxaimin to see if my symptoms subside. All I know is I have always had a lot of mucus in the throat and do have seasonal and perennial allergies but my chief complaint to my ENT was the shortness of breath. Its debilitating. I went to my allergist today and he did a food allergy test and I of coarse came back positive with some allergies but just wonder how accurate the food allergy testing even is. I was told I am allergic to almonds (use almond milk as my milk substitute), brazil nuts, pistachios (have these everyday), BLACK PEPPER, cherries, peanuts (what the heck I thought you had to go into anaphylaxis to have this allergy) and my least favorite news of the day CHOCOLATE! What do I do he said give up these foods for two weeks and come back and see him if my symptoms don't get any better than I can reintroduce them back slowly. What am I suppose to eat now? peanut butter and apples was my go to snack and almonds as well.. And I am not sure I can live without chocolate considering I am a woman still in menstruating years:( I have not been diagnosed with EOE not sure when I will see my GI is that who diagnosis that condition?

[trents]

I'm very skeptical of food allergy testing. I had an eye opening experience with it when I had two different labs evaluate the same test samples but report vastly different results. I also saw poor correlation between symptoms and test results. And I think if you do some research you will see there are a number of variables that often render food allergy testing ineffective. Many or most MDs don't put much stock in food allergy test results.

And what do you eat when your testing turns up 30+ foods that supposedly are fighting with your body? I'm with you on that one. It makes it pretty tough to sort out the real offenders through and elimination diet before you die of starvation.

Concerning your mucous issue, have you had opportunity to spend time in another climate or sleep in other beds (dust mites) and if so do you see any improvement?

[Posterboy]

3 hours ago, Jherm21 said:

I was diagnosed with Celiac in January and still having symptoms without dairy and gluten.. I haven't started the PPI's yet, just received the "silent reflux" diagnosis the other day. My gi doctor wont really see me until I get ahold of the rifaxaimin to see if my symptoms subside. All I know is I have always had a lot of mucus in the throat and do have seasonal and perennial allergies but my chief complaint to my ENT was the shortness of breath. Its debilitating. I went to my allergist today and he did a food allergy test and I of coarse came back positive with some allergies but just wonder how accurate the food allergy testing even is. I was told I am allergic to almonds (use almond milk as my milk substitute), brazil nuts, pistachios (have these everyday), BLACK PEPPER, cherries, peanuts (what the heck I thought you had to go into anaphylaxis to have this allergy) and my least favorite news of the day CHOCOLATE! What do I do he said give up these foods for two weeks and come back and see him if my symptoms don't get any better than I can reintroduce them back slowly. What am I suppose to eat now? peanut butter and apples was my go to snack and almonds as well.. And I am not sure I can live without chocolate considering I am a woman still in menstruating years:( I have not been diagnosed with EOE not sure when I will see my GI is that who diagnosis that condition?

Jherm21,

Please don't start the PPI's.

While you can taper off of them. . . it can be near impossible to stop once you have started them (PPI's).

see this thread about EoE.

I also recently updated the gastritis or glutening post since it five pages long I will quote my response for easy reference to user "justsayno".

quoted below in it's entirety.

justsayno,

"going low CARB can help the heartburn symptom's. or even Ketogenic which is basically NO carbs or atkins's on steroids for lack of a better term.

here is a great thread that talks about the pro's and con's between me and Ennis_tx that he referenced in this thread but did not cite.

but basically people have "rebound heartburn/acid reflux" when trying to go off PPI's cold turkey.

newer research even indicates that taking PPI's can cause you to be locked into them.

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quoting they say

"Although this radical change in the concept of how acid reflux damages the esophagus of GERD patients (it) will not change our approach to its treatment with acid-suppressing medications in the near future, it could have substantial long-term implications," said senior author Stuart Spechler, M.D., Open Original Shared Link. Dr. Spechler is a professor of Internal Medicine at UT Southwestern and chief of the Department of Gastroenterology at the Dallas VA Medical Center."

no surprise there they even mention in the article Nexium alone generates $2.5 Billion a year by itself.

Even if people don't get better taken their medicine . . . take it anyway because now you are locked on the medicine due to inflammation issues.

because we are not changing our "approach to it's treatment with acid suppressing medications in the near future"

read the whole article for yourself.

but the "acid reflux" is not from acid at all or at least in some cases and probably more than they estimate since this is new research without many years of confirmed research behind it yet.

quoting

"In the new study, Kerry Dunbar, M.D., Ph.D., and her colleagues looked at 12 patients who had Open Original Shared Link (when the esophagus becomes irritated and swollen), a complication that isn't seen in every GERD patient. Each of the patients stopped taking their proton pump inhibitors for 12 weeks. The doctors took biopsies and closely observed what happened both before as well as 1 and 2 weeks after the patients stopped taking their medication.

The patients did end up developing more damage, as the researchers thought they would. But the tissue didn't show a chemical-like burn that might be expected from stomach acid splashing into the esophagus. Instead, they found white blood cells, inflammatory proteins, and signaling molecules (known as cytokines), which are more consistent with what you would find when the body reacts to an injury."

But inflammation is inflammation.

Think more like EoE . .. .

I hope this is helpful.

Justsayno, I also recommend chris kresser's 3 part series on this topic.

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where he highights many of the same points. Justsayno is a good attitude to have to staring PPI's if you have not already started because they are very hard to get off of once they have been started. . . but not impossible."

Jherm21 it is me again.

just search for the difference between "nerd or gerd" and a lot of good articles will come up about it.

here is a quick search and one of the first one's that come up is the fox news article.

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I will quote from it wither it is GERD or NERD: new type of heartburn doesn't respond to  drugs/PPIs.

"But up to one-half of GERD patients don't get complete relief from even the strongest acid-reducing medications, called proton-pump inhibitors (PPIs), and most don't have any evidence of acid erosion when doctors examine their esophagus with an endoscope. "

and taking PPI's lock you in to taking them a lot longer than they ever were intended.

pretty bad odds if you ask me? 50/50 and oh you  will 90+ of the time never get off the PPI's once you start.  Not to mention many of the side effects you develop why taking PPI's low Magnesium Levels and brittle bones etc. et al. not to mention possible kidney issues one of the first signs that PPI's are  not nearly as harmless as once thought.

***this is not medical advice but I have seen it work for others.

going low carb can help with your heartburn.

please read all the links when you get a chance if you have not read them before especially the EoE thread.

again I hope this is helpful.

and that you will consider what I a say this included.

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things”

posterboy by the grace of God,

 

 

 

 

 

[trents]

I tried to quit PPI cold turkey this summer. Went without them for 3 weeks and by then I thought the rebound would be past but my symptoms just got worse. I can go without the PPI for two days and the heartburn starts to come back. Not sure if a more gradual titration would have helped or not but it would have to be very incremental to work at all. And I gave up my one cup of coffee per day to help with process at the same time but began to get migraines every day. Had to go back on both.

[Posterboy]

16 hours ago, trents said:

I tried to quit PPI cold turkey this summer. Went without them for 3 weeks and by then I thought the rebound would be past but my symptoms just got worse. I can go without the PPI for two days and the heartburn starts to come back. Not sure if a more gradual titration would have helped or not but it would have to be very incremental to work at all. And I gave up my one cup of coffee per day to help with process at the same time but began to get migraines every day. Had to go back on both.

trents,

I don't know if this would help you or not.  but if the stomach acid is too low from taking PPI's taking betaineHCL can/would help if indeed your stomach acid is already too low from taking acid reducers.

it can take two or three tries often to get off PPI's.

Taking BetaineHCL helped me in place of taking PPIs.

this was in the medhelp link  I will provide "sickboy"s response for anyone who wants to try his/their way. .  . but taking betaineHCL should help going cold turkey if you try and step back off PPI's again.

obviously if you use his "toast" method to soak up your gastric juices it should be a "gluten free" toast.

for context here is the medhelp link and post

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UNCONTROLLABLE BILE REFLUX!! PLEASE HELP!!

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"Hello.  I have recently been diagnosed with bile reflux.  I have SEVERE, CONSTANT burning in my stomach, abdomen, and chest area.  The bile is refluxing not only into my stomach but my esophagus.  It is so out of control that is has caused my esophagus to not open properly from the burning not being controlled.  And most of all it has caused tachycardia with my heart to the point that when the burning is at it's worst I get heartrates in the 180's.  It has been narrowed down that the bile reflux is causing my problems.  I have a constant fire raging in my stomach/chest/abdomen.  I was prescribed Questran and Welchol, both of which gave me severe heartburn and gas, which did not help because it just went from one type of burning to another.  The only thing that seems to even help a little is Carafate, but not that much.  The docs have told me that they don't know what other meds to try.  Can anyone who has had experience dealing with bile reflux please offer some suggestions as to how I can control this.  It has not been determined what the cause of the bile reflux is.  I have had many tests done (hida scan, mri with mrcp, blood work, egd) the only thing I haven't had done is a small bowel follow-thru, gastric emptying study, and a colonoscopy.  I am not sure what happened to my body.  Prior to having bile reflux I had acid reflux for over 20 years and after seeing a post that said "activia" yogurt cured my acid reflux I decided to try it and after the 14th day my body exploded with excess gas, rapid heartrate(198), and uncontrollable belching(up to 20 min at a time), and severe burning that has not let up for the past 2 1/2 months.  I don't want to leave this out because also during the 14 days that I ate activia I also went on a yeast/candida free diet and and sugar free diet and got 2 IV iron infusions for iron deficienty anemia.  Not sure if these things had anything to do with it but I was pretty much healthy before I embarked on this 14 day diet change.  Based on the testing apparently "activia" did cure my acid reflux because I no longer have acid reflux I now have alkaline/bile reflux.  I am currently typing this from the hospital.  During the last 2 1/2 months I have been hospitalized 8 times.  All docs are puzzled and can't seem to help me.  When I take any type of PPI, H2 blocker, or acid med even something as simple as tums or rolaids, the burning gets worse.  When I tell the docs that they don't believe me but I have found many articles and posts that say that when you have bile reflux these meds make it WORSE....how come the docs haven't read this info?  If anyone has any suggestions on how I can control this bile reflux thing please let me know.  I am very desperate and in misery.

Also, not sure why the bile reflux developed.  I did have abdominal surgery but that was to remove fibroids and they used the same scar as a previous c-section about 3 months prior to this happening.  I do have adhesions from the surgery but bowels flowing normally.  When I ate the "activia" yogurt I am lactose intolerant, I think, and could I have possibly caused an ulcer in my colon.  I read that ulcers there could cause bile reflux, but haven't had a colonoscopy yet.  

Right now I just really need a suggestion of what I can take to get out of this constant burning and pain and then I will continue my search for the cause. "

here is sickboy's response

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I have a cure that worked for me, bile relux has been plaguing me for 5 years and i had been getting misdiagnosed with acid reflux, until i started getting the severe esophageal pains that you described, so i went to 100% acid neutralization and was still getting the esophageal spasms/cramping, thats how i knew it was never acid reflux, i also had the abdominal buring, hydrochloric acid can not cause this, only bile can cause this burning sensation in the stomach, i also had the other clear bile reflux symptoms but doctors did not pick up on any of them? What a joke!! I eventually got a 24 hr pH test which clearly showed non acidic liquids jumping up from my stomach, contrary to what people think, bile acid is actually alkaline.

What you need to do is realise that any acid blocking medication is making the problem worse, due to "Delayed gastric emptying", PPI are also known to aggrevate symptoms and cause attacks to be more frequent although not as severe. When i realised what i had to do to cure myself i panicked, i thought if i stop taking acid blockers i will be in agony within 12 hours, and i was right, i had intense esophageal pains that lasted 8 hours all through the night, i only ate dry toast and sipped water in between for 1 day, that night i slept with stomach pains and burning, the next morning, my condition was 10 times better, the burning had gone and my esophagus was breathing a sigh of relief.

Its so simple when you think of it, bile is getting into the stomach! solution is to stop it getting into the stomach and to stop bile production, you do not need meds to do this just some bravado.

How does this work? when we first went to the doctors are condition was not as bad as it is now, am i correct? We had bile in the stomach, our pyloric valve was weak, we had burning sensation, so we got put on acid blockers, they cause delayed gastric emptying which causes excess gas, and high pressure fat destruction dilates the stomach valves making the problem worse, allowing more bile in and alows it to damage the stomach for longer, delayed gastric emptying causes back flow and hey presto the bile goes into your esophagus and causes severe damage, this problem spirals downwards and the condition gets worse over time and causes additional problems. When we first got the problems, we probably were not looking after ourselves as we should fatty foods? late night snacks? overeating? If all we had done back then is changed our eating habits and lifestyle instead of going to the doctors we would have been cured years ago, in fact the problems would have gone in 24 hours.
So this is how it works, which is all the opposites to the above, the problem causers, we need to improve digestion and gastric emptying, to do this we need to stop the acid blockers or any acid neutralizing drugs, we need to eat non fat non dairy products, small ammounts regular, the gall bladder reduces the ammount of bile produced, this meansevery time that stomach valve opens to empty, it takes the bile into the intestines with it, in the meantime the bread soaks up all excess stoch acids and bile like a sponge and stops it splashing up to the esophagus, hence why you should not drink until you feel your stomach empty, you do not want fluids splashing around.
Imagine your valve is a door, imagine you are bile, you are on one side and every time that door opens you tries to run through, but when it opens a 1000 people on the other side coming running through the door in the opposite direction, your going to have getting through arent you, the doors is slightly ajar, so you sneak through and 1000 people are all stood still, so you make your way through the crowd, before you can get through the crowd surge's forward and drags you back to the other side of the door and down the street, lol.
I can laugh about it now because it is all so simple, i spent years in agony and depression, get through that 24 hours and you come cback and tell me you do not feel 10 times better, the day after you will feel like the illness never happened, whenever you get a bit of reflux, eat dry toast and it will work 10 times better than any acid blocker did.
Gradually build up your diet, rice and fish, fresh vegeatbles,the odd banana, sleep elevated to combat reflux, because no doubt you have lower esophageal impedence and you will find a new lease of life, forget drugs, the only thing that might help is Bile diversion surgery, but why even have that when it is so easy to self heal.
Because you stomach acids will be back to normal level and food is being broken down properly to release nutrients you will also get all your energy back, because of the new healthy diet you will probably live longer and happier life.
Natural things are always best, get plenty of excercise once you get your energy back, your stomach will empty even faster and your body will get even stronger and so on, just build on it and appreciate you got a second chance.

 

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Sorry, i should summarize.
The Problem
The problems is bile getting into the stomach.
The catalyst is delayed gastric emptying, causing backflow of acids into the esophagus
The cause of delayed gastric emptying is acid blockers, low stomach levels.

The Treatment(so simple it blows the mind)
Speed up gastric emptying by stop taking acid blockers or any other medication and by eating small meals regular.
Do not eat foods that will promote the production of bile.

The Result
You are cured, you have broken out of the viscious cycle and are in the recovery process, every time bile comes into the stomach it gets flushed back down into the intestines before it can do any damage.
Long term your body gets stronger to the point where you actually cure the problem completely, the lower esophageal sphincter recovers from the constant bombardment and gets its strength back,reducing reflux symptoms, stomach muscles start to contract strong again, nutrients, vitamins, proteins and calcium get released from the food and absorbed, due to the stomach acids being at the correct level again and everything just starts spiralling back up.

The Conclusion

If you do not break the viscious cycle you will be plagued by this for the rest of your life, everything you try to do and every medication you take will cause other health problems and make symptoms worse."

 

It is me again.

 

This provided for anyone else who is still suffering maybe it will help the next person to read this thread.

 

BetaineHCL supplementation should be researched for/as the best way to take it.

 

here my blog post  on celiac.com bout how I struggled with low stomach acid misdiganosed until helping my stomach acid issues helped most of my GI problems.

 

taking more betaineHCL helped me more in the beginning.

then I was able to taper off.  taking only a little might cause some burning.

so study about how much you should be taking but if it really low stomach acid then taking

betaineHCL will improve your digestion unless you truly have bile reflux instead.

This doesn't work for everybody but it works enough for most you should consider researching it more.

but it helped me more to take 3 to 4 capsules with each meal in the beginning instead of only 1 or 2 capsules.

**** this is not medical advice but it (taking betaineHCL) might help you transition off your PPI's for good.

I hope this is helpful.

posterboy by the grace of God,

[cyclinglady]

I found this today.  GERD might be a result of inflammation and not too much acid as once thought:

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Note: It was a very small study.  

[Posterboy]

cyclinglady,

I could not access that link.

I went back and looked at the yahoo article it had a link to the JAMA site without being behind a wall.

here is the JAMA link.

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it is newer research so it might be awhile before doctor's start taking this into account when they treat

heartburn/GERD.

Even though they estimate as much as 70% have NERD instead.

quoting from the fox article originally reported in the WSJ.

"Gastrointestinal experts now estimate that 50 percent to 70 percent of GERD patients actually have NERD"

which I believe when treated with PPI's leads to Bile Reflux.

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And can be very difficult to recover from.  . .  especially if treating them with PPI's locks someone in to taking them forever exasperating the original condition.

*** this is not medical advice.

I realize there are no easy answer's but if people don't know about NERD or Bile Reflux they can't research it more.

Knowledge and awareness is the first step to health and wellness.

Again I hope this is helpful.

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things”

posterboy,

[Wheatwacked]

Here is a partial list of what I no longer suffer from as a result of not eating wheat. Some like the sleep apnea and gerd and back pain and addiction to alcohol were almost immediate. The foot pain is improved to just numbness sometimes. My long term depression went away when I added vitamin D 10,000 iu a day for a year, but the improvement started almost immediately. Muscle tone and energy improved when I added iodine. one sheet sushi seaweed a day. My Fibromyalgia is controlled with 15 mg oral Prednisone a day. I remember as a kid waking up and having to pick the dried mucuos off the roof of my mouth. That is gone and for the first time in my life I am a nose breather. Drink lots of water to help with the mucous if it is thick. Some mornings mine is like rubber cement. I need to quit smoking now.  You can improve have faith, but healing takes time. Stay the course. A Romaine lettuce salad everyday helped the gut pain.

1. Gerd

2. shortness of breath

3. sleep apnea

4. back pain

5. snoring

6. prostrate hypertrophy

7. contact lens protein buildup

8. night vision improved

9. cataracts reduced

10. head hair growth

11. foot pain

12. sleeping no more than 2 hours at a stretch

13. slow healing

14. no energy. Pretty much bed ridden.