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Acid Reflux / GERD Message Board

Acid Reflux / GERD Board Index

I just wanted to throw my own story on here for everyone's perusal. I am a 28-year-old male, dealing with reflux.

I'm a singer by profession and for the last three years I had been having unexplained phlegm in my voice that was extremely persistent and very difficult to clear. I had no idea where it was coming from. I tried diet modifications (like no dairy/no caffeine, etc.) to no avail. Finally went to see ENT and he was suspicious of reflux of the LPR sort, but wanted to narrow it down. My symptoms were--onset of phlegm right after eating, thick and difficult-to-clear on the vocal cords, post-nasal drip and the general feeling that there was a lump in my throat or that some small amount of food or phlegm was sticking somewhere in my throat. A look into my throat showed no damage to the cords.

We did a sinus CT scan to rule out a sinus infection, tried nasal sprays to see if they might decrease the drip, had allergy tests done to see if I was reacting to something. No incriminating results he was fairly sure it was some form of reflux.

I remained skeptical because I felt I didn't have all the typical symptoms that you read and hear about. No heartburn of any kind, no gagging, no regurgitation of food, no waking up in the middle of the night coughing, no pain. Just awful phlegm. I also experienced no change in symptoms after taking Prilosec and Nexium for prolonged periods. I thought maybe I was just having a swallowing disorder.

So he ordered a Barium x-ray of me as I swallowed. No disorders detected, but they did find a hiatal hernia. Hmmm...those can cause reflux, can't they? Well, I still wasn't convinced. My ENT sent me to the doctor he studied under.

This new doctor after listening to my case history, was also fairly sure I was suffering from this silent reflux, LPR--or as he called it, LERD...a modification on the acronym GERD. He even pointed out small irritated bumps in the throat as well as pronounced tooth enamel decay, both evidence of prolonged exposure to acid and stomach juices. I was put on Nexium twice a day as well as Zantac at night. I followed a strict diet. I raised the head of my bed. I didn't eat for three hours before bed. I avoided bending over. I was religious in following these changes. Still--no improvement.

I submitted myself to a 24-hour pH probe test to see if there really was reflux activity. To my surprise, the results were shocking--in a 24-hour period I had over 30 cases of reflux, more than several making it all the way up to my throat and almost all occuring when I was upright...not when I was lying down, as is the case for most GERD sufferers. It was then that I realized that the doctors were right and I was the one being pig-headed. It seemed that I was one of those people that no amount of Nexium was going to help...there was something physically wrong with the sphincter that lets food into the stomach. It was shooting up not only acids, but stomach enzymes and juices--things that the throat and esophagus are not designed to handle, at least not for prolonged periods of time. And no amount of acid-blocking medicine is going to stop a physical problem.

I decided to have surgery. Specifically, I had a laparoscopic Nissen Fundoplication. It has been almost 4 weeks since the surgery. Recovery has been okay--the initial diet changes to allow the healing process to occur have been difficult. Anyone for another glass of Ensure? Blecch. I have lost more than 10 pounds and it has been difficult trying to gain the weight back so I can stop looking like a waif. Yes, I had and still have occasional pain as a result of the surgery. It's mostly esophageal pain right now, but I am optimistic that as time passes, the tissues will heal and the muscles will strengthen. The days following the surgery were very hard for me, but I am so much more mobile now--I can walk, drive and stand up for prolonged periods of time.

As for whether or not the surgery has helped the phlegm problem....the jury is still out on that. I have noticed some changes, but I was told by the doctors not to expect a drastic improvement, especially with the kind of symptoms I was having. It can take time for the tissues of the body to adapt. Some people have immediate improvement of symptoms, they said, although these patients are primarily the ones with GERD. LERD or LPR patients can take longer to improve, possibly months to notice any change. This medical team I am under has taken such good care of me, I do feel like I am in good hands and I trust them. So I am being patient.

Hopeful, but patient.

If any other LPR/LERD sufferers had the Fundoplication Surgery, I suppose I would be interested to know what your recovery was like, just for the sake of comparison.

Thanks for reading. I'll try to update you as I continue to heal.
Mike--I don't think I had a pH manometry test, so I can't tell you what the results were there. I do think it was pretty apparent that the lower esophageal sphincter was weak, but I don't have any way to tell you just how weak. I believe I had a full wrap and left that decision up to the doctor. I do know that they inserted a tube down the esophagus during the wrap to make sure that it would not be too tight. Side effects from surgery included massive dull shoulder pain from the CO2 gas dilation during surgery and total lack of energy due to the liquid diet on the first week. The intestinal gas was also quite painful because, of course, there was no real food inside me, just liquid. I would say make sure you have at least 1 week of rest and relaxation and following that, very little in the way of strenuous activity. I still haven't gotten back to the gym and have been told to avoid lifting anything over 10 lbs to make sure that everything inside can heal properly.

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