A previously unknown (to me) form of reflux
-
Medical stuff warning. Nothing gross, but just a heads up...
I kept thinking I was coming down with a cold. I was waking up with a sore throat, runny nose, and lots of sneezing. No heartburn. Seems that what I'm experiencing is called LPR - Laryngopharyngeal Reflux. It's also called silent reflux because a lot of people like me only get nose/throat symptoms and no heartburn like regular GERD.
PPIs and H2 blockers don't really help LPR because part of the problem is that it's not just acid causing the symptoms, it's also pepsin and in my case, probably bile. Apparently LPR is relatively common in people who have had their gallbladder out.
Tried all the regular advice for GERD. Diet restrictions, elevating the head of the bed, not eating before going to bed, and saw some improvement (maybe 70% better) but wondered if there was something else I could do.
After a bunch of research, I discovered that alginates, which are an extract from a particular species of brown seaweed, are used for people with reflux problems. The alginate
is combined with a bit of sodium bicarbonate and calcium, and when that combo hits the acid of the stomach it forms a foam raft/barrier that keeps the reflux from occurring. Studies show that alginates are as effective or better than PPIs, especially for LPR.OTC alginate meds are common in Canada, the UK, and elsewhere; they're made by Gaviscon.
https://www.gaviscon.co.uk/products/
There is some alginic acid in the US formulation of Gaviscon, but from what I read, the Canadian and UK products seem to be a lot more effective. The Canadian version has a pretty simple formula, various strengths (different amount of sodium alginate in the various types), no aluminum or magnesium, and no artificial sweeteners.
I ordered some of the Canadian Gaviscon tablets via Amazon. I was thrilled; I got very good results. You chew up the tablet completely before swallowing; you can feel it start to foam in your mouth. I take a sip of water as a chaser.
Anyway, just thought I'd share my discovery in case you're a fellow reflux-er looking for alternatives.
-
Huh, interesting. My spouse and my mother both have lots of GI problems and are regular users of Gaviscon. I'll share this with them. How does one get a diagnosis of LPR?
BTW @wtg could you share the link that you used to order it? I'm seeing lots of different products.
-
@ShiroKuro said in A previously unknown (to me) form of reflux:
How does one get a diagnosis of LPR?
This site has some very good information:
My mom had reflux problems, so I got a real education going through it with her. I hadn't heard about LPR before, but it seems to be something that doctors have become more aware of in the last 10 years or so.
All my symptoms add up to LPR, big time. There are tests that can be done by a GI doc, but I'm not going to put myself through them. I just don't think they would add anything of value to the pool of information available to me. I have a great doctor who works with me on things like this. I didn't want to go the PPI route because of the long term side effects. Plus it's not effective for LPR because it's the pepsin, an enzyme, that's the troublemaker.
As far as the Canadian/UK vs US Gaviscon, I did find a lot of discussion on various sites about the comparative efficacies of various products. After doing my analysis I decided the Canadian tablet product was the best route to go. Various vendors on Amazon carry it. I have all three strengths of Gaviscon, Regular strength, Extra Strength, and Max Relief. They're all the same except for the amount of alginic acid they contain. I ordered the Max Relief first as an experiment to see if it works for me.
I decided not to do the liquid formulas because I've had trouble with Amazon shipments of liquid stuff. Broken open bottles. Too much of a hassle.
They're all third-party sellers who carry it. I look for the ones who have Amazon do the delivery, as opposed to a third party who ships on their own. I figure I have more leverage with Amazon in the picture if I have a problem. I worried a bit about getting an expired product, but haven't run into that at all. And of course I check the seller's rating on Amazon. I like to see a reasonable number of sales in the last year as an Amazon seller, and a rating at 90% or above.
I've ordered from Manga Naturals and everything has been fine.
Regular strength (200 mg sodium alginate, 100 tablets)
Extra strength (313 mg alginic acid, 60 tablets)
Max Relief (360 mg alginic acid, 50 tablets)
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aum么nier
-
-
Don't know how much you reviewed on the refluxgate site, but I picked it because it summarizes how LPR is different from GERD. The site seems to provide some good basic info and you don't have to slog through research papers, though I did a lot of that, too.
There are studies that compare the efficacy of alginates to PPIs, too. I can go back and dig those up if you're interested. The alginates have been found to be as effective as PPIs. Of course the PPIs and H2 blockers are usually once a day dosing, and the alginates are more fidgety as you have to take them multiple times a day. I think the tradeoff is worth it because I think the alginates have few side effects. Not so much the PPIs.
I think my problems started after I went through a period of having a lot of tea with honey and lemon in it. After a few weeks I started to have problems and sort of figured out the lemon might be triggering things. Now I'm trying to get things back on track with a revised diet that's especially low acid. And the Gaviscon. And the raised bed.
Good luck. Let me know if you need anything else.
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aum么nier
-
@wtg said in A previously unknown (to me) form of reflux:
Don't know how much you reviewed on the refluxgate site, but I picked it because it summarizes how LPR is different from GERD.
I sent it to my mom, but now I need to go through it with Mr SK.
@wtg said in A previously unknown (to me) form of reflux:
I think my problems started after I went through a period of having a lot of tea with honey and lemon in it.
OMG!! Mr SK has started drinking lemon water lately, I can't remember the details, but was diagnosed as prediabetes last year and he's doing all these things that are supposed to be good for preventing pre-diabetics from becoming diabetic. The lemon water (there's no sugar in it, he uses that "real lemon" stuff and squirts it in his water.
I never thought about the acid!!! Yikes! I think I need to tell him to lay off the lemon water!
-
Yea, he might want to at least experiment with stopping the lemon water and see what happens. I could never do the stuff out of the bottle; it always made my tummy grouchy, even when I was a kid. I was buying fresh lemons and squeezing a small wedge into my tea. But I think a steady diet of it was a tipping point, at least for me. I also suspect having my gallbladder out changed my overall digestion and coupled with ingesting more acidity with the lemon was just too much for my system.
One thing with a high acidity that surprised me was Coca-Cola. It's more acidic than lemon juice. Couple that with the carbonation and it's a stomach buster. I don't drink it very often, maybe a few times a year, so it's no big deal to avoid it. And I'm not an orange juice drinker either. I am missing my fresh citrus. This is the season for it.
I was already limiting pickled foods because of their sodium content. Now I've had to give up pretty much all vinegar (goodbye vinaigrettes!), at least for a while. So often it's a matter of just experimenting and figuring out how to balance things. I have definitely observed that there are things that I can no longer eat or drink as I've gotten older. This is just another chapter in the "wtg gets older" story.
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aum么nier
-
@wtg said in A previously unknown (to me) form of reflux:
Yea, he might want to at least experiment with stopping the lemon water and see what happens. I could never do the stuff out of the bottle
Yikes. He has been squirting this into his water for a while now.... and at the same time, just yesterday he was saying "I don't know why these stomach problems are so persistent right now"
I just messaged him "no more lemon water starting now, I'll explain later"
He doesn't drink coke, fortunately, and stopped all sweetened beverages when they told him he's prediabetic.
But given his off and on stomach issues, we need to pay more attention to acidic things I think.
I wonder how acidic the Japanese "pickles" are that he likes -- they're not really pickles,and not made from cucumbers, but I would guess since they're "pickled" they have vinegar? He will know...
-
There are a bunch of foods that are known to be triggers for a lot of people. Coffee, chocolate, vinegar, tomatoes (esp canned tomato products like sauces), pickled foods (most of which use a lot of salt and vinegar for pickling), alcohol, citrus, high fat/fried foods, onions (especially raw), black and cayenne pepper.
https://www.refluxgate.com/lpr/diet/core-guide
I think I remember our @RealPlayer said that he had to give up his tea because it was a reflux trigger for him. I had to give up green tea a long time ago, but black tea doesn't seem to be a problem.
It's one big experiment. Something that can be helpful is to do a quasi-elimination diet. Take out all the things that are known triggers for a lot of people, keep the diet simple and don't introduce a lot of new items. Watch for a week or two and see how he feels. If he improves, then add in one of the trigger items and see what happens. And keep doing that.
I also think that he may find that he can occasionally have one of the foods that can be a trigger, but that it's a treat and not part of his regular diet.
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aum么nier
-
@wtg said in A previously unknown (to me) form of reflux:
There are a bunch of foods that are known to be triggers for a lot of people. Coffee, chocolate, vinegar, tomatoes (esp canned tomato products like sauces), pickled foods (most of which use a lot of salt and vinegar for pickling), alcohol, citrus, high fat/fried foods, onions (especially raw), black and cayenne pepper.
Thanks for this! (and the link)
Mr SK has been dealing with stomach stuff for years, and made various changes at various times.... And then he has ups and downs. And since the pre-diabetic diagnosis, he's been changing things up, like add the lemon water.So now is a good to revisit the question of reflux triggers!
he may find that he can occasionally have one of the foods that can be a trigger, but that it's a treat and not part of his regular diet.
Yep.
And that's the thing with the lemon water. He went from never drinking that, to suddenly drinking it every day.
So that's an easy elimination, for starters!
What about decaf coffee? Is it the coffee, or the caffeine? He has a cup of decaf every morning.
-
Same here with lemon. I basically never had any and went to having a couple of afternoon cups of decaf tea with honey and lemon. Tipping point.
Decaf coffee may be tolerable even if you have GERD.
https://www.livestrong.com/article/511107-how-to-neutralize-the-acid-in-coffee/
The thing to keep in mind that the diet guidelines are just guidelines. Some things on the list may be a trigger for Mr SK, and he may be totally fine eating things that are on the list.
FWIW, I still have a cup of half-caff in the morning. It's the one obvious thing on the GERD diet no-nos that I haven't given up. If I weren't improving, I would definitely be switching to decaf, or even eliminating any coffee from my diet, but I think I'm good for now. Maybe the lemon was Mr SK's tipping point, too, and if his system has a reprieve, it may recover.
I hesitated initially posting about my minor health issue, but I thought there might be people here who might want to know about the alginates. Now I feel better about the thread, as it may be of some value to someone else!
When the world wearies and society ceases to satisfy, there is always the garden - Minnie Aum么nier
-
@AdagioM Here's a great discussion about PPIs, H2 blockers, and alginates for GERD and LPR. A professional bulletin from the American Academy of Otolaryngology鈥揌ead and Neck Surgery
https://bulletin.entnet.org/clinical-patient-care/article/22879164/are-alginates-all-that
I'm in the LPR camp and I'm one of the patients who would not want to go on a PPI or H2 blocker because of my concerns re long term side effects. My mom was on them for years and developed dementia. I've wondered how much they might have contributed to her condition.
-
@wtg said in A previously unknown (to me) form of reflux:
I hesitated initially posting about my minor health issue, but I thought there might be people here who might want to know about the alginates. Now I feel better about the thread, as it may be of some value to someone else!
Absolutely!!! I ordered that canadian gaviscon last night.
And even though I "knew" that citrus is acidic, and I knew that Mr SK was doing this lemon water thing, I knew even thought about the connection to reflux.
So THANK YOU!!!!!
-
Serendipity, eh?
Be sure to read the bulletin I just posted. It is hands down the best summary I've read so far, and being from the American Academy of Otolaryngology鈥揌ead and Neck Surgery, it carries a lot of credibility in my book as being solid medical information.
The Reflux Gourmet product (discussed in the link) is available, too. People had mixed reactions to the taste, and it's not cheap, either. I went with the Canadian Gaviscon tablets and have been happy with the results, but if I couldn't get them I'd definitely check out the Reflux Gourmet.
I hadn't heard about RefluxRaft, and that is another alternative. Doesn't get great review on Amazon, though.
-
And just a heads up...be sure to have Mr SK chew up the tablet really well before swallowing it. Won't do anything if it's in chunks! Also, should avoid food and drink for a couple of hours afterward. The raft can stay in place until the food in the stomach has mostly digested.
-
Gaviscon brand is expensive here in the UK. Luckily Asda, Tesco, Morrisons etc. sell their own versions at half the price.
Whether any or all of these have effects on body salt balances I don't know; a while back I recall magnesium trisilicate being the one medically recommended.
Seems to be rarely available here, mostly in tablet form, and you need to ask for it.Gaviscon is everywhere!
