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Acid Reflux / GERD Message Board

Acid Reflux / GERD Board Index

Hi Sandy,

I second KJH Chemist's opinion. I am truly surprised that your doctor didn't put you on a prescription PPI. Usually doctors will at least tell you that if the Zantac (H2 Inhibitors) don't work, they'll switch you to a PPI. But not to tell you about PPIs is a complete lapse of judgement on your doctor's part - or else total incompetance and ignorance. You really ought to switch to an experienced doctor at a major university hospital who knows acid reflux. Sorry to be so strong about his - but you're suffering when you don't need to be, and that's not acceptable.

You will probably need to switch to a PPI, like KJH Chemist said.

There are 4 brands, I believe of PPIs available by prescription. Nexium, Prevacid, Aciphex and Protonix. Prilosec is a PPI that is available OTC.

Nexium is the most recently launched PPI and has excellent results in many laryngeal reflux sufferers, but it doesn't work for everyobody. Prilosec is the first PPI that was launched, and seems to be effective for heartburn sufferers, with more anecdotally mixed results for laryngeal reflux sufferers. If you have insurance, start with the prescriptions. If you don't have insurance and can't afford them, then give Prilosec OTC a try. If, once you're stabilized, you feel like trying the other brands, by all means to do, but start with the ones that are most likely to get you better.

I think you have larygopharyngeal reflux since your larynx is red. Most local yocal doctors don't know it has a name - they'll just say "Oh, you have some reflux". Laryngopharyngeal Reflux (LPR) describes the reflex that occurs when acid leaves your esophogous and enters your throat. This is in contrast to GERD, which is characterized by esophageal erosion and heartburn. For those who just have GERD, the lower esophageal spinchter muscle is flaccid. For those of us with LPR,the upper esophageal spinchter muscle is flaccid. But you can also have a combination of the two.

However, people with LPR need to be treated differently than people with GERD. The acid goes higher, so you need an extra dose of PPI every day. If you had GERD, it would be fine to take 1 PPI per day. But with LPR, you need 2 doses per day. I take mine together in the morning, but there are individuals on the board who take one in the morning and one at night. I personally take Nexium and have had an excellent recovery. For people who don't tolerate Nexium well, a comomon complaint seems to be that it makes them dizzy or nauseous. At 2 pills a day, I'm fine, but when I accidentally took 3 at one time a few months ago, I felt dizzy and nauseous too.

You may need to explain all this to your doctor when you ask for a prescription for a PPI (one of the 4 that I mentioned). Remember to ask for a prescription for 2 a day. If she argues, just tell her that you'll reevaluate your meds at 1 month, but want to start with a more powerful dosage. (Please note, many insurance companies require special approval for 2x a day PPIs). I got a special approval through United Healthcare, though it took a little while.

When I finally found my diagnosing doctor, she gave me an excellent article on LPR that explained everything. It was published by the Official Journal of the American Academy of Physician Assistants in 2002 and was titled "Laryngopharyngeal reflux—It’s not GERD". You can find it easily, and you might want to bring it with you to your next appointment.

Best of luck!

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