Question:
I got a letter from the GI with my pH probe results. In summary, I do
not have actual reflux but apparently I do get some acid where it
doesn't belong because of belching. Please read the following and help
me out with some of the details. My ENT and GI were locked in a turf
war and I guess the GI is technically right...but the ENT wasn't wrong
either because I'm getting some acid up into my pharynx...I think. I'm not sure if I should go back to the ENT or not. The thing is I had
symptoms waaaay before I started belching all the time. The belching
started only after a three-week course of antibiotics. I still wake up
with an irritated throat but according to the test, I have 0% supine
reflux. Would the sore throat be from the irritated area being dried
out while I sleep?
Answer:
Oops, I have been here for a bit, but just in case, the background is
that the ENT thinks I have both nasal inflammation and LPR. I've been
doing nasal irrigation which have helped but it has never alleviated my
9 month-long sore throat. I also get post nasal drip which has also
benefitted from the irrigations but have never abated.
My acid reflux was diagnosed from my symptoms, The reflux was there in
the morning from during the night.
I was told to use Pepcid AC and Prilosec if I got more complications
like coughing as it was in my esoph. track. Two years later I had a endoscope and no acid reflux damage .
I sleep with my head raised 4" so I get very little reflux now.
Were I you, I would video tape myself several different nights to see
if I was breathing through my mouth. It might not hurt to also use a
sensitive microphone right above your head so you can listen to your
breathing as well. I would also ask the ENT to do a review of your
nasal and soft palate part of your airway because if it becomes
obstructed at night, you will be breathing through the mouth.
Yes, I would probably at a minimum go back and see your general
practicioner for a full work up and follow up with your ENT to make
sure you sinuses are clear.
Before my nasopharynx and oropharynx was open and I was breathing
through the mouth at night all the time, I was able to get some relief
by using both a STEAM humidifier in the room and a vaporizer next to
the bed. I used distilled water in both units and would clean them out
every couple of days with an antifungal and antibacterial cleaner, i.e.
5% bleach solution (5 minutes setting time), rinse, then isopropyl
alcohol rinse, clean water rinse.
My airway had multiple problems that had to be addressed.
1. Block sinus drainage pathways. I at least sought treatment before
any more serious complications.
2. Moderate left side obstruction from previously broken nose.
3. Enlarged turbinates in the nose from chronic allergy problems.
4. Significantly enlarged and growing tonsils as an adult (not normal). While I cannot recommend surgery to anyone unless there is simply no
other option and you seek a couple of different opinions to look at the
benefit versus the risk, most of my problems required surgery.
1. Septoplasty to straighten out the nose, while the ENT was there he
reduced the turbinates with Somnoplasty, and opened up the sinus
drainage channels.
2. About 8 months later the tonsils had to come out, after delaying
this almost three years. As it turned out the tonsils had started to
grow into my cheek, lower gums, soft palate, and one side was nearing
the voice box. This was a significant and painful surgery recovery.
The plus side was due to the tonsils into the soft palate near the
uvula, a soft palate resection was required to get everything back in
place. 4 weeks of serious pain and healing, followed by a couple of
months of final healing.
3. Very careful control of allergy symptoms. Careful choice of bedding
and being proactive with prescription antihistamines and occasional use
of prednisone during the worst allergy times, grass pollen and corn
pollen, now prevent the sinus airway problems from allergies.
4. Control of minor acid reflux, especially at night due to hiatel
hernia. No eating food within two hours of bedtime. Pecid AC at
night. Raise entire head of bed a couple of inches.
