ENT procedures

Hi Can anyone tell me if you need a thoat scope(think that is what you call it) to diagnose LPR can you GP (UK) just refer you or do you have to be referred to the ENT Clinic for them to decide.  I remember when I had a sinus scan some years a go that I had to go the ENT clinic first.  Also is this the sort of procedure that requires a pre op.  Many thanks.

If your referring to an endoscopy then this does help but not diagnose LPR in itself depending on your symptoms and test results over time will fully diagnose your problem.  And yes your gp can refer you directly for an endoscopy he may also refer you to an upper GI consultant  hope this helps as o can only speak from my own experience from diagnosis to treatment 

Thanks for your reply.  No I did not mean an endoscopy which I know about as my son in law had one for normal reflux not LPR.  I was referring to the tests which are done by an ENT doctor to look at throat vocal chords etc.

Ok but an endoscopy will diagnos LPR 

You cannot see if someone has acid reflux through l LOOKING. This can only show if it has done damage not if it is happening. The doctor has to refer you .

I disagree but as usual you know best. 

I was diagnosed with LPR yrars ago after an endoscopy.  I still have the report. It also showed aesophogitis 

I amnot sayng you wer not diagnosed with it. But some people are not diagnosed this way because there is no damage there to see. So if I go for the same tests they find nothing - I had this test for this a few months ago - they find nothing beasue there is no damage to see.

I was referred to both ENT/GI.

ENT will use a very thin short camera up the nose and as far as the throat (using a local anaesthetic). This will see if you have any inflammation/damage to the vocal chords etc.

You may need a barium swallow/endoscopy and a 24 hour pH test. Although barium came back negative for me - but I think this looks more for acid reflux

The pepsin saliva test will also give an indication.

This is what I said. It sees if you have damage. If there is no damage it sees nothing. Most doctors go by your history and symptoms and do not bother with thiese tests. My doctor said he gets about 30 new cases each week. And the usual way they deal with it is to give the pp1s or pp2s medication instead of all of these tests.

I canot see the point of asking this question if you are going to contradict the answers ans say you know best.

This is exactly to a T what o had first the endoscopy then finally the barium swallow the ph test was horrible but togerger they were able to be more specific about the treatment they offered me

Maybe because we differ in our opinion I'm very pro doctors both gp & hosp consultant they have a very difficult job and can't just refer everyone straight away in this case ppis are the first defence then only further down the line shoukd they consider other options depending on the facts 

I suffered for many yrs with reflux & gerd etc and for a while was ok with ppis only when my symptoms became a lot worse Ws I referred to an upper GI specialist now I have my LINX I'm symptom and med free 

Hi Carmel and other posters,  Sorry if I have caused a disagreement between you all.  Carmel as you know I am going for a barium swallow on Friday.  My gp requested this to diagnose or rule out both reflux and hiatus hernia.  I must say I am not looking forward to it because the possible constipation after (IBS easily upset) and I am also concerned about drinking the thick solution because of my throat mucus and coughing which is of course not anything like as bad as it was.  The reason I asked about the ENT and throat scope was because I am concerned about damage to throat and vocal chords.  Singing in a choir I am due to go back tomorrow but am wondering whether I should because I don't want to course further damage never mind paying the choir fees if I find I can't carry on.  That said I realise that if no damage is seen it still does not rule out LPR.  Am I right in thinking that an endoscopy would show any inflammation ulcers etc in stomach and esophagus.  If you saw my last post will will know that I have now been off the omeprazole for 1 week and my stomach is more or less back to normal.  It is just the mouth and throat clearing, mucus etc that I need to control. To be truthful I did let the diet slip last week when my family were here but getting back on track now as you have said it is finding your own way and what suits you. 

No worries.I have better things to do with my time than get into long debates or arguments. You ask if you are right about if an endoscopy would show inflammation and ulcers - yes - which is what I said in my previous answer. If the person has not got actual damage then nothing will be found even if there is a problem. It is always the same when people come off of ppis, their stomach returns to normal after a while. That has nothing to do with the acid reflux anyway, two separate issues.

If you go off a diet for a while that is human, I am not sure these diets are worth doing anyway, such a lot of messing around, compromising, going without, and what for when you can take bicarbonate of soda, acid cider vinegar or something else insted.----

I had the camera up the nose at the ENT dept. first. I now have an appt. for a swallowing test as I have MS and depending on that result I may have the endoscope test. Seems to me it's very hard to diagnose although I have every symptom, post nasal drip constantly, throat clearing and reflux plus heart burn. I have been suffering these symptoms ever since I had a full knee replacement almost two years ago. I wonder if it could be connected to the tube they put down my throat during the operation. I know it's taking a heck of a long time to get the tests done. I also had no anesthetic when they put the camera up my nose and it hurt like hell. The doctor was young and very up himself. I could have hit him.

I was interested to hear that you are receiving treatment.  What is the treat ment for silent reflux .o what eve er the long unpronounceable name for it is?

Throat scope can be done in ENT's office with a spray of some numbing stuff...I had one done....took 3 minutes and no pre op. I did have a referral from Gastro doctor cause he said I didn't have acid reflux....that it was LPR

 

Thank you can I ask what treatment you were given and did the throat scope show any damage.  I am now off the omeprazole and feel much better for it.  Just trying to sort out anxiety which I think is my main trigger.

I am having a barium swallow on Friday and will see what that shows and go from there.  

Libra lady 

How long were you on PPI

They say there is a rebound effect of even more acid when one stop them, I hope not because I am stopping mind PPI today.

I am on 20mg ompreazole for the last 10 days.

Wish me luck.

From all I read taking PPI long term is not even advised by the manufacture.

Wish you improvement in your throat.

Hello Dreaming  

Short background symptoms throat clearing,awful throat mucus, sneezing resulting is same throaty mucus, dry sore throat, slight hoarseness belching but not real heartburn, slight swallowing problem at times.  All this around 2/3 months ago.  Was put on omeprazole.  Going for barium swallow later this week.  Had 20mg omeprazole for 2 weeks then 40mg for 2 weeks started having trouble with constipation and bloating and stomach ache (I suffer from IBS as well).  Reduced the dose back down to 20mg for 2 weeks then 1 week every other day.  Have now been off them for 1 week.  Stomach now almost back to normal some belching no actual heartburn as before.  Yes I believe you can get a rebound until the acid is balanced again.  I believe some get a lot of indigestion/ heartburn once they stop the PPI. As you can see I was only on it for around 6/7 weeks.If If you have only been on it for 10 days then maybe you will be fine as well.  Just watch your diet and don't get stressed as that causes more acid to be produced which I now believe is one of my main problems. You could replace thePPI with ranitidine or another similar tablet just until you adjust or use an antacid or DGL licorice to cover any heartburn attacks.

I think though you should be ok.  Good luck.

Thanks Libralady,

I am going to see how today goes.

Watching what I eat is a understatement.

I am wanting to keep my stomach happy.

I had oatmeal with raisin and shredded coconut for breakfast at 10am followed by 16 ounces of water at 11am

I chewed a DGL before eating and included digestive enzyme and krill oil tablet with meal.

Going to eat an apple now here at 1230pm

I am getting fresh air and sunlight which I feel heal the body.

I accept all the luck you have to share and advice too.

Wishing you well on your journey too