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Acid Reflux / GERD Message Board

Acid Reflux / GERD Board Index

Acid reflux aspiration is typically associated with the acid reflux form called LPR (larngeal pharyngeal reflux) - it's different than GERD because the acid goes into the throat (with GERD it usually stays in the esophagous).

It is very strange that your doctor was able to diagnose reflux, but he didn't even give you a sample of reflux medication? Instead he put you on asthma medications? If it is reflux, you have several options:

1. Proton Pump Inhibitors (PPIs)
These are drugs that shut down most of the acid production in your stomach, so less acid can rise up and out of it. They can be very very effective in treating your condition. Only Prilosec is sold over-the counter, and you could try that. However, there are several prescription PPIs, including Nexium, Prevacid, Aciphex and Protonix. Nexium is made by Astrazenca, the pharma company that also invented Prilosec. But when the Prilosec patent expired and Prilosec went OTC, they debuted Nexium, which is very very similar to Prilosec, but is slightly different. My bias leans towards Nexium as I've tried all the others except for Aciphex, and only Nexium has worked. Not only did it work, it worked perfectly. This is important - if one dose of a PPI doesn't work for you, you may need to take 2 doses together. 2 doses is a standard treatment for LPR sufferers who don't respond to 1. Most GERD sufferers suffice with 1 PPI. This isn't true for every last one of us - but I take 2 Nexium every day, and I don't have asthma symptoms or the cough anymore. Please note that all these PPIs are only effective between 12 and 17 hours of taking them. If you sleep very little, you may need another dose at the end of the day or before you go to bed.

2. H-2 Inhibitors
This is the acid reflux medication group that was invented prior to PPIs. They are now all sold OTC under brand names like Tagamet, Zantac, etc. The generic form of Zantac is called Ranitidine, and for some people, it can be used in place of a PPI. It's cheaper than the PPIs, so it may be worth trying. I occasionally take 300 mg or Ranitidine at bedtime when the Nexium has worn off. It's not a perfect substitute for me, but Nexium is expensive. My father-in law has GERD, and when the PPIs gave him dry mouth, his doctor switched him to a 300 mg dosage of Ranitidine as well. 300 mg is a lot higher a dosage than what is on the package, but it can be safely tolerated. I don't know anything but doses higher than that.

Finally, you may want to visit an ENT, who can determine the amount of damage to your laryngeal area and confirm diagnosis. LPR = red and swollen larynx from the acid hitting it. If your diagnosis is correct, you are coughing because your poor larynx has no natural protections, yet it's getting splattered with acid. That's why your cough is non-productive. You are just trying to cough off the little bit of acid that is hitting the larynx, or possibly the little bit of acid that is getting into your lungs as well. An ENT will scope you by numbing your nose with spray, then inserting a very thin probe with a camera up your nose and down your throat. Sounds gory, but it doesn't hurt at all - it just feels a little weird.. Then the image comes up on a TV monitor - and the doc can see your larynx.

I don't know how long this has been going on for you, but if you have had this for more than a few weeks, you may or may not want to visit a Gastroenterologist. They do endoscopies - which is scoping your esophagous under heavy sedation or general anasthesia. It's ambulatory, and takes about 20 minutes for the procedure. The doc then takes biopsies of the esophagous (and stomach?) to look for cellular changes and dysplasia, which can be indicative of Barrett's esophagous, a condition which often develops after long-term acid reflux, and is a precursor to esophageal cancer. The PPIs are considered to be an excellent way to lower your risk of esophageal and laryngeal cancers.

It souns like you haven't had the reflux for too long because your tone was so mellow in your post. People who have had it for a long time and have gone untreated are typically a little frenetic! The great news is that this condition is typically highly treatable. Sometimes you need to play with the meds to find the right one for you, but you should be able to control your symptoms pretty easily once you begin some form of PPI or H2 therapy.

I've given you your options - but this is my personal advice - first ask your doctor for some samples of Nexium. Take 2 the first day, and see if you feel better. (When I did this, my 6 months of coughing ended in 20 minutes - AND I had been on 1x a day therapy for 3 months with no relief!!!).

If it works, at least you'll find some relief knowing you have a solution. If your insurance won't cover Nexium, I'd recommend finding out what they do cover, or trying the OTC med Prilosec. Prilosec did not work for me, but it's helped others.

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