Silent Reflux (LPR)

[Mad]

Hi all,

I believe I am suffering from Silent Reflux (laryngopharyngeal reflux). Since October 2017 I have had extremely excessive mucus in my throat. It usually only occurs at night. At first it was so bad, I would wake up not able to breathe throughout the night because the mucus was was blocking my airway. Doctor said I have allergies, put me on cetirizine and mucinex daily, and said it should clear up in a month. No such luck; I did not think I had allergies in the first place.

I have stopped the cetirizine but continued the mucinex since then; without it, I cannot breathe during my sleep. So for four months now, I have spent my days coughing up (mostly clear but sometimes not) mucus. All day. Every day.

I have tried to read on the forum about other silent reflux sufferers but am getting mixed and unclear ideas to try. Is there an acid problem (and it is too much or too little?) A dietary fat problem? A starch problem? Something else?

 

[stsfut]

I had a Nissen Fundoplication after dealing with this for years. I had this operation in Feb/2017 and before I started following Peat's theories. The operation partially fixed my issue. I believe that getting the surgery probably wasn't the wisest decision since the root cause was probably hormone/thyroid related. I am interested in the comments that your post receives.

 

[mangoes]

Personally, I think it's possible that LPR has a different etiology to the more common heartburn, GERD reflux. This is a personal theory based on my own personal experience and reading having suffered with this for years.

None of the recommendations from here or anywhere else I've tried have helped, not dietary changes, not gelatin, not glycine, not rantinidine, not thyroid, nada.

The theory of the cause is related to the autonomic nervous system being chronically overactive from nerve bundles alone the spine and causing retroperistalsis. This may or may not be accurate. It may be accurate for some and not for others, so whether it applies to you, who knows. There was a study done in Korea, where they injected lidocaine into nerve bundles and the vagal response was normalised, ceasing the reflux (according to the patients symptoms at least). If this is the case for you, you might (or not, who knows? Lol) show some other symptoms relating to the vagus nerve (or other ganglionic nerves), like an increased (or decreased?) gag reflex, heart rate, sweating disturbances, an increase (or decrease?) in goosebumps and possible emotional disturbances (lack of the ability to really really laugh for example). This is basically a hodge podge of many of the ideas I've had or read over the years, so I could be totally off the mark, but it's where I am rn.

I remember reading years ago about a percentage of people responding well to a certain drug, I forget which one, but which could lend support to the nerves being a cause theory, at least for a certain amount of the population with LPR.

There was a thread here recently which discussed excess adrenaline, which I'd check out too if I were you.

 

[theLaw]

I have tried to read on the forum about other silent reflux sufferers but am getting mixed and unclear ideas to try. Is there an acid problem (and it is too much or too little?) A dietary fat problem? A starch problem? Something else?

Personally, I had a whole host of digestive issues including an ulcer that disappeared when I increased my calories especially sat fat + sugar along with adding some thyroid (Tyromix) and cutting out starch.

My doc also said I had allergies and tried to get me on Zertex and Flonase, which is what actually led me to Peat's work, because they had no reasonable explanation as to why this happens. Carrot salad/AC to help sterilize the gut while removing starch and increasing fat + sugar worked for me.

 

[Mad]

I had a Nissen Fundoplication after dealing with this for years. I had this operation in Feb/2017 and before I started following Peat's theories. The operation partially fixed my issue. I believe that getting the surgery probably wasn't the wisest decision since the root cause was probably hormone/thyroid related. I am interested in the comments that your post receives.

Yeah a basic internet search about LPR usually brings up surgery as a possible fix, and even that is not guaranteed. Of course I want to avoid that. The other general suggestions seem to be:
- losing weight
- avoiding alcohol
- restricting chocolate, citrus, mints, caffeine, fats, spicy foods, tomato-based foods
- chewing gum to increase saliva
- elevating the head of your bed
- stopping eating three hours before bed
- avoiding tight-fitting clothes

I’m curious if any of these have worked for anyone here. I am starting to restrict some of the foods listed but it’s not easy to restrict them all at once!

 

[Mad]

Personally, I think it's possible that LPR has a different etiology to the more common heartburn, GERD reflux. This is a personal theory based on my own personal experience and reading having suffered with this for years.

None of the recommendations from here or anywhere else I've tried have helped, not dietary changes, not gelatin, not glycine, not rantinidine, not thyroid, nada.

The theory of the cause is related to the autonomic nervous system being chronically overactive from nerve bundles alone the spine and causing retroperistalsis. This may or may not be accurate. It may be accurate for some and not for others, so whether it applies to you, who knows. There was a study done in Korea, where they injected lidocaine into nerve bundles and the vagal response was normalised, ceasing the reflux (according to the patients symptoms at least). If this is the case for you, you might (or not, who knows? Lol) show some other symptoms relating to the vagus nerve (or other ganglionic nerves), like an increased (or decreased?) gag reflex, heart rate, sweating disturbances, an increase (or decrease?) in goosebumps and possible emotional disturbances (lack of the ability to really really laugh for example). This is basically a hodge podge of many of the ideas I've had or read over the years, so I could be totally off the mark, but it's where I am rn.

I remember reading years ago about a percentage of people responding well to a certain drug, I forget which one, but which could lend support to the nerves being a cause theory, at least for a certain amount of the population with LPR.

There was a thread here recently which discussed excess adrenaline, which I'd check out too if I were you.

Interesting...maybe you can get the shot and let us all know how it goes!

Yeah i read some statistic that there was some semi-successful drug, but that it also had basically the same results as a placebo.

Could you link that adrenaline thread?

 

[Mad]

Personally, I had a whole host of digestive issues including an ulcer that disappeared when I increased my calories especially sat fat + sugar along with adding some thyroid (Tyromix) and cutting out starch.

My doc also said I had allergies and tried to get me on Zertex and Flonase, which is what actually led me to Peat's work, because they had no reasonable explanation as to why this happens. Carrot salad/AC to help sterilize the gut while removing starch and increasing fat + sugar worked for me.

Starch elimination might be the next thing to try for me. I started my peating with no grains and low starch...then I tried high starch...then I just settled into eating what seems right without certain starch restrictions. I come from a history of an eating disorder, so anything restrictive can walk a fine line with sending me back to a bad relationship with food.
I have naturally been slowly increasing my dietary fat (mostly dairy fat) ever since summer was over, so I thought this could be the issue. Interesting that it was beneficial for you. I do have carrot salad almost daily but i don’t do AC with it - do you think this could be particularly helpful?

 

[theLaw]

Starch elimination might be the next thing to try for me. I started my peating with no grains and low starch...then I tried high starch...then I just settled into eating what seems right without certain starch restrictions. I come from a history of an eating disorder, so anything restrictive can walk a fine line with sending me back to a bad relationship with food.
I have naturally been slowly increasing my dietary fat (mostly dairy fat) ever since summer was over, so I thought this could be the issue. Interesting that it was beneficial for you. I do have carrot salad almost daily but i don’t do AC with it - do you think this could be particularly helpful?

Dietary fat can be a problem if mixed with starch for those with digestive issues. Even Ray suggests zero starch for those with significant digestive distress, which is rare for him to say zero to any food.

Also, if you're under-eating, which is alarmingly common here, then that can cause a whole host of issues that can be hard to pinpoint.

Carrots are good on their own, but adding the mct/coconut oil + vinegar is superior. Although probably not a night/day difference.

From my experience, starch or other foods that cause digestive issues, can continue to cause inflammation until they're removed for a short time (30-90 days).

From the perspective of an eating disorder, you're much more likely to gain unhealthy weight from starch + fat, than fat + sugar, so ice cram can be your friend.

I found that for women in particular increasing calories significantly can be a major mental hurdle, and keep them in a viscous cycle of caloric-restriction/stress. Then they have that "aha" moment, and realize that problem is the stress, not the calories.

Cheers!

 

[mangoes]

Interesting...maybe you can get the shot and let us all know how it goes!

Yeah i read some statistic that there was some semi-successful drug, but that it also had basically the same results as a placebo.

Could you link that adrenaline thread?

That's the plan but the logistics of moving to and living in Korea for 3 months can be somewhat difficult, but eventually I will let you know how it goes

This was the thread
Thoughts On Excess Adrenaline

The OP of the thread seems a really intelligent guy who came to similar conclusions as me in regards to his own situation and symptoms (I don't think LPR is one, but the postural/fascial stuff is relevant and important imo) but the reason I mention it is because excess adrenaline can create the surges of reverse persistalsis, probably histamine and serotonin are implicated too.

I think bacterial infection or just irritation of the intestine can cause it too, so there's some more to think about lol.

 

[Mad]

Dietary fat can be a problem if mixed with starch for those with digestive issues. Even Ray suggests zero starch for those with significant digestive distress, which is rare for him to say zero to any food.

Also, if you're under-eating, which is alarmingly common here, then that can cause a whole host of issues that can be hard to pinpoint.

Carrots are good on their own, but adding the mct/coconut oil + vinegar is superior. Although probably not a night/day difference.

From my experience, starch or other foods that cause digestive issues, can continue to cause inflammation until they're removed for a short time (30-90 days).

From the perspective of an eating disorder, you're much more likely to gain unhealthy weight from starch + fat, than fat + sugar, so ice cram can be your friend.

I found that for women in particular increasing calories significantly can be a major mental hurdle, and keep them in a viscous cycle of caloric-restriction/stress. Then they have that "aha" moment, and realize that problem is the stress, not the calories.

Cheers!

Thanks for the specifics, sounds like I should give it a try.

I definitely think my calories are sufficient now, especially with the added fat, but I’m just saying that the thought of restricting foods can sometimes bring a flashback of the constant stressing over food that used to plague me every minute of the day. Once I’ve gotten into a food groove that works for me mentally, it’s hard to say, “ok now you can’t have this or this or this anymore”. It’s instant stress and I’m worried that I’ll get carried away and carry constant cravings and always be thinking about what I can and can’t eat.

 

[theLaw]

Thanks for the specifics, sounds like I should give it a try.

I definitely think my calories are sufficient now, especially with the added fat, but I’m just saying that the thought of restricting foods can sometimes bring a flashback of the constant stressing over food that used to plague me every minute of the day. Once I’ve gotten into a food groove that works for me mentally, it’s hard to say, “ok now you can’t have this or this or this anymore”. It’s instant stress and I’m worried that I’ll get carried away and carry constant cravings and always be thinking about what I can and can’t eat.

I'm curious, when you were restricting foods, were you hungry?

 

[pimpnamedraypeat]

You probably have a hernia. 50% of americans have it

 

[Mad]

I'm curious, when you were restricting foods, were you hungry?

If you mean back when I had an eating disorder, yeah for sure. My eating disorder was a combination of extreme exercising with often extreme under-eating. I was starving all the time. I'd make sure I got my workout done first thing every morning so that it didn't matter if I was fatigued while I starved the rest of the day.
Since "peating", the only time I've really felt hungry is when I was doing very low fat for a few months this past spring/summer. It definitely helped me to slim down from some of my beginners peat weight gain, but I just find that I do better with some fat. (But perhaps not, since it wasn't too long after that that my LPR symptoms began...?)

 

[theLaw]

If you mean back when I had an eating disorder, yeah for sure. My eating disorder was a combination of extreme exercising with often extreme under-eating. I was starving all the time. I'd make sure I got my workout done first thing every morning so that it didn't matter if I was fatigued while I starved the rest of the day.
Since "peating", the only time I've really felt hungry is when I was doing very low fat for a few months this past spring/summer. It definitely helped me to slim down from some of my beginners peat weight gain, but I just find that I do better with some fat. (But perhaps not, since it wasn't too long after that that my LPR symptoms began...?)

Here's the reason that I ask.......

I think that hunger is a stress response, and should be avoided at all cost. I've now see many members here who have seen incredible health improvements and even weight loss while taking in a shocking amount of calories, while having a huge buffer for fat and sugar in particular. Same with me when I increased sat fat + sugar while dropping starch.

PROGRESS REPORT FASTEST FAT LOSS EVER THANKS TO RAYYY

Modern foods tend to be calorie dense, which can be difficult to replace with healthy foods, especially if your liver/digestion is compromised, so I think dosing throughout the day is key until those issue improve.

Fat can also help lower stress hormones in the beginning, which can give your system a chance to heal, and then lower-fat/high carb can be followed to loose weight if necessary, although many do it without dropping their fat intake.

It's also interesting to note that when asked about the healthy ratio of each macro-nutrient, Peat replied that he thought it was a bit different for everyone, but that it was probably around 1/3 calories from each, which is a lot of fat (Pizza is around 1/3 calories from fat). The longevity studies also back this up showing that 20-30% is the optimal range.

Bottom line, I think that undoing decades of damage might take several stages, but getting healthy through dietary changes shouldn't be uncomfortable.

I always think about Peat recounting his teenage years where sometimes he needed 10,000 calories/day to feel well due to hypothyroidism. If he were a young girl today, he'd probably have an eating disorder.

Cheers!

 

[stsfut]

Yeah a basic internet search about LPR usually brings up surgery as a possible fix, and even that is not guaranteed. Of course I want to avoid that. The other general suggestions seem to be:
- losing weight
- avoiding alcohol
- restricting chocolate, citrus, mints, caffeine, fats, spicy foods, tomato-based foods
- chewing gum to increase saliva
- elevating the head of your bed
- stopping eating three hours before bed
- avoiding tight-fitting clothes

I’m curious if any of these have worked for anyone here. I am starting to restrict some of the foods listed but it’s not easy to restrict them all at once!

Yes, I had the “anti-reflux” operation after years of poor sleep. I knew that it wouldn’t be a guarenteed fix but I exhausted all of the natural lifestyle changes.

 

[GAF]

• Sleep on left side
• Mouth taping
• Famotidine - 20 mg evening plus 20mg morning, if needed
• Frankincense essential oil under nose all day and night as needed
• Glycine for deeper sleep
• Un-bloat yourself
• Benzocaine throat lozenges all day and night calm the hypersensitive vocal chord nerves. 50cents for 9 at Big Lots. Buy all they have in stock
• Sinus Blaster from SPROUTS spray in back of throat as needed
• Avoid alcohol at night - day drinking okay

I do the above every day, except day drinking.

What did not work-

• Antihistamines
• Tums
• Mucinex
• Diet changes
• Salt water in nose and throat
• Bed head elevation
• Some Rx I got from India not available in US - can't remember name
• The other million things I tried

 

[theLaw]

One other idea:

GERD (acid Reflux) Is Caused By Inflammation, Not Stomach Acid

"Time will tell what is the exact cause of this inflammatory reaction, but in the meantime things like glycine/gelatin, caffeine, aspirin, vitamin E, and avoidance of PUFA seem to be a lot more relevant to the treatment and prevention of GERD than taking the dreaded PPI."

from Haidut:

I think it applies to all refluxes where damage to the mucosa/lining is involved. The chemical burn theory is just too simplistic to account for that. The real question is what is causing this acid being able to go up and the answer is high cortisol from hypothyroidism. The cortisol weakens many muscles, including the ones lining the esophagus and it is not a mere coincidence that GERD and LPRD usually start in the 3rd decde of life and increase with age. This coincides with the slowign of metabolism and the increase in cortisol/DHEA and cortisol/testosterone ratios, which leads to generalized atrophy and muscle loss and weakness. A very old study showed that ingesting some pure T3 completely eliminated GERD symptoms for a few hours. If cortisol is the main cause, then things like emodin/cascara, pregnenolone, thyroid, vitamin A, zinc, etc (all substances lowering cortisol) should be therapeutic.

 

[Mad]

One other idea:

GERD (acid Reflux) Is Caused By Inflammation, Not Stomach Acid

"Time will tell what is the exact cause of this inflammatory reaction, but in the meantime things like glycine/gelatin, caffeine, aspirin, vitamin E, and avoidance of PUFA seem to be a lot more relevant to the treatment and prevention of GERD than taking the dreaded PPI."

from Haidut:

Thanks, this is helpful. I haven't used gelatin or aspirin in a while, so I may give those another try. I'm also trying to eliminate starch again for a while... Today was day 1!

 

[Mad]

Yes, I had the “anti-reflux” operation after years of poor sleep. I knew that it wouldn’t be a guarenteed fix but I exhausted all of the natural lifestyle changes.

So just curious, have all of your symptoms disappeared since having the procedure?

 

[Mad]

• Sleep on left side
• Mouth taping
• Famotidine - 20 mg evening plus 20mg morning, if needed
• Frankincense essential oil under nose all day and night as needed
• Glycine for deeper sleep
• Un-bloat yourself
• Benzocaine throat lozenges all day and night calm the hypersensitive vocal chord nerves. 50cents for 9 at Big Lots. Buy all they have in stock
• Sinus Blaster from SPROUTS spray in back of throat as needed
• Avoid alcohol at night - day drinking okay

I do the above every day, except day drinking.

What did not work-

• Antihistamines
• Tums
• Mucinex
• Diet changes
• Salt water in nose and throat
• Bed head elevation
• Some Rx I got from India not available in US - can't remember name
• The other million things I tried

Thanks for the lists, this is something I can keep looking back to for new ideas. It's interesting about sleeping on the left side.
Surely sleeping on the right side would not be a cause for any of this, right? Or even a major agitator? I say this because I think it was around the time that my silent reflux started that I had just changed my sleeping position. For as long as I can remember I have been a stomach sleeper. Then recently I decided to make an effort to be a side sleeper. I bought a body pillow to rest my top leg and arm on and have been sleeping great on my right side every night since.