Laryngopharyngeal Reflux October 15, 2007

I’ve had a lot of problems with reflux lately. A long while back, I was diagnosed with GERD (Gastroesophageal Reflux) , which causes heartburn and regurgitation, but I suspect I may also have LPR (Laryngopharyngeal Reflux). Whereas in GERD, the acid flows from the stomach into the esophagus, in LPR the reflux flows into the throat and voice box.
 
My LPR symptoms are most troublesome when I swallow large pills. My throat burns terribly and I feel like something is stuck there no matter how much water I drink to wash it down. Since I started taking antidepressant pills a couple of weeks ago on a daily basis, my chest has also felt uncomfortably tight and I’ve developed a dry cough. I wake up in the morning with a bitter taste in my mouth. Occasionally I lose my voice and become hoarse. 
 
But it appears I may have had LPR even when I wasn’t swallowing large pills. Apparently a voice that tires easily or changes in quality or pitch is indicative of LPR. I always attributed my weak voice to lack of use. When I laughed too hard, sang too long, or spoke too much, I’d start coughing and my voice would change. I’d also have to clear my throat often. Hoarseness was typical, especially in the morning.
 
Postnasal drip was another persistent problem of mine. I have chronic sinusitis, which flares up from time to time and turns acute. Whenever I had a sore throat, I used to think it was the postnasal drip from a sinus infection. But now I realize any sign of postnasal drip could have very well been the LPR.
 
Right now my throat is sore and I’ve got excessive mucus, but it’s more of a clear sticky liquid than green/yellowish gunk. I also feel some tickling at the top of my sternum, which is what makes me cough. The chest pressure is a lot better, though, since I started treatment, and as a result it’s gotten a lot easier to breathe.
 
I take a proton pump inhibitor (PPI) – Nexium is known to be the most efficient – twice a day, first in the morning 30-60 minutes before breakfast, then in the evening before dinner. I also take a H2 blocker (Zantac) right before going to bed.
 
For the treatment to be effective, I will have to follow this regimen for the next six months . I will also need to alter my diet, avoiding exacerbating foods such as fried foods, tomatoes, citrus fruits, garlic, caffeine, carbonated drinks, and chocolate (boo-hoo).