Silent reflux or something else

Digestive health
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Hello, I have a few health problems and am suffering a lot of pain with osteo arthritis at the moment and am on that forum.  I also suffer from anxiety.

To cut a long story short my gp thinks I have reflux, I also have asthma, well controlled.  My symptoms are continual retching and coughing trying to clear mucus from throat with only short lets up although it never really goes.  Last night a got about 2 hours sleep combination of arthritis pain and the retching.  I have tried everything from saline nose spray, head over bowl of hot water with oil of obus, salt water gargle and using asthma reliever (which I hardly ever have to do).  My gp has given me omeprazole 20mg once a day.  I have taken these in the past but as a stomach protector when taking ibuprofen (can't take these now because of side effects).  The retching and coughing in worse after eating and can go on for hours until it lessens.  I don't have any burning or heartburn just a little burping and sometimes the feeling food is stuck.  These are nothing compared to the continous mucus.  I am so tired this morning as I type this.  Can anyone tell me how long before the omeprazole starts to work 

and is there anything else I can try. I wasstarting to get back on track after a month of pain with knee now all this. Please can anyone offer any help.  Thanks  ps I also have IBS ok at the moment.

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Should have mentioned Gp has also given me a Beconase nasal spray

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Please take omeprazole half an hour before food. It will help to reduce stomach acid secretion. Also please avoid spicy, fatty and fried food; carbonated beverages; tea and coffee; alcohol; chocolate and citrus fruits.

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Hello Pat , Thanks for your reply.  My doctor has told me to take it 1/2 hour before evening meal.  Only one day at the moment.  I know about avoiding alcohol chocolate and citrus fruits, spicy and fatty food but not tea.  Do you know how long does the omeprazole start to work.  I sing in a choir and start back Monday I will be so sad if I can't go. I have to pay for a term ahead.  Thanks

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Wow, you've a full plate of stuff going on...so very sorry..

First regarding excess mucus...I suspect this could be from either an immune response..much like that of "dry eye"..the immune

system reacts by flooding the eye with liquid an/or could be an allergen...especially since you mention it's worse after eating

but improves over time. However,  its cause  might require Sherlock Holmes and his side kick Dr Watson.....when did this condition begin? (I don't think you've had it all your life?)...this could offer a clue...for someone following this thread who has some expertise..You have issues that should be attended 

by a specialiast...for IBS as an example  a gastroentrologist not a GP,

and the same goes for your other conditons...specialists. ..the PPI may or may

not be of any help, it certainly isn't helpful with osteoarthritis, nor the absorption of Iron, Magnesium, nor B12...

forwhatever it was prescribed for..has an "effective period of action"...example for excess acid, should work within hours (that is for most people but)...it is used in tripple therapy for hylori therefore it works "FAST" for this treatment...the immune system may need modulation..I haven't a clue of how..requires expertise"

so you'll need to do your own research...start with wiki...it may offer leads ..and I'm a no body without credentials..just some small knowledge and experience having been associated with a superb medical community. I hope an expert will respond to your "plea"...but I think you may also need to post a request in the auo

immune threads if any...try the forum Patients Like Me...if you can, provide a good clear history of your medical issues with both treatments, meds, results (really important)....I cannot offer any treatment/supplement/meds etc because of

inadequate info regarding cause..and I'm knowledge limited. btw...your GP is probably correct re GERD.  and "if" so...diet initially..."what..when...how much", use the Gastritis protocol that innes uses? (how I cured gastritis)..based on many GERD patient threads...diet seems to be the most promising treatment..if  ulcer or infections ruled out...

Claudio

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Thank you for being so kind enough to reply with interesting comments.

I will try posts in auto immune threads and patients like me.  I would like to add that I do suffer with blepharitis and dry eye also hypothyroidism an auto immune condition.  It is hard to understand how but I think at the heart of it is my stress and anxiety which although I have always been a worrier has been bad for last  4 years or so with better periods in between.  It is a long time since I could say I am happy and content today.  Thanks again  Carol

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I would agree with your thinking...anxiety can be harmful.and most likely the "leading edge".....but so are the meds used to treat it. With so many issues...where to begin? first...thyroid...hypo or hyper?

your guess as to "cause"? IBS...irritable or inflammatory?...your guess as to cause..and what helps...what "brings it on"?...lastly for this post.."Anxiety"...have you always had this or?

PPI's...these slow release anti acid guys are good for SHORT PERIOD...and must not stop "cold turkey"...There are several alternatives...some work and some don't...I personally do not like them except for a very specific treatment...the 2nd treatment for hpylori excludes the PPI and uses "Bismuth"...on another post I've responded to ines (how I cured gastritis) re % of HP treatment outcomes.here in the US its a tad less than 80% whereas the 2nd is over 90%. check it out. Carol unfornately I haven't the time to follow you on Patients Like Me as I am assisting a few others and following with keen interest two Brits who have ALS that seem to be 2 of the most intelligent bloats on the face of this earh vs all of the world's highly paid PHD researchers.....their posts takes me hours to comprehend merely one idea...but I try until I've a handle on it. Back to Anxiety...here in the US the most frequenty meds are what we call SSRI's...long term use of these present greater problems than the anxiety...biggest being liver failure...There are some natural alternatives...I haven't any research documentation on them except for 5HTP...you might investigate this...I suspect if it "might" work...would need a pathway boost past the BBB...maybe Vincepocetine? as a carrier?

I believe several D's have mucus problems...when I have the time will try and find a common genetic or mutation that might shed some light on your conditon...please keep in mind ...this is a stretch...may be a dead end road...my best regards...claudio

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Hey libralady.

Yes it sounds just like silent reflux. My ENT started me in a double dose of ppis, so if your ppi doesn't work for you, then you may have to take one morning and one evening until you are healed and then cut back. 

There are a lot of lifestyle mods you can make. The most important for me ( which stopped the retching in the middle of the night) was to raise the head of my bed by 8 inches - I put bricks under the legs. The mucus is your throat trying to protect itself from the acid. 

I also got prescribed Gaviscon Advance ( the UK version) take a tablespoon before bed. 

It took me about 4 weeks to get back to some normality. It does get better smile 

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Once a day omeprazole is sufficient as it inhibit the stomach acid secretion for around 72 hours and it start to work within half an hour after oral administration. Hopefully your symptoms will reduce soon. Please try to avoid tea as well, as it can trigger gastric acid secretion.

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Hi Everyone, Just to let you know have been taking omeprazole 20mg once daily today is day 5 and it the throat mucus has definitely improved and mouth is not so sore.  Still early days Have to go back to GP after 2 weeks.

Carol

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Hello Spoke too soon in my last post.  

Was feeling so much better after 5 days on omeprazole.  Had family round yesterday.  Yesterday was my wedding anniversary, was good 

did not have any alcohol and no usual saturday chocolate in front of tv.

I relented and had a packet of crisps.  This morning the mucus is back

almost as bad as it originally was.  Do you think it is the crisps.  I was 

looking forward to going out with friends on Tuesday for lunch and even more so to the first rehearsal of the Rock and pop choir I sing in, after a summer of arthritis pain, anxiety and staying in.  I have so many medical problems, this is about the last straw.  None of this helps my anxiety and I dread having to stay in again, even though I use a stick for walking I can now get out again.  Anyone offer any help.  I have given up chocolate, tomatoes and orange juice as advised by gp. 

Carol

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Hi libralady, are you in the UK? If so get some Gaviscon Advance liquid ( not the dual action or normal stuff) they usually have it behind the counter in the chemist. It's expensive, but is really good for silent reflux. It prevents any reflux coming up. I was prescribed it by the ENT consultant. One dessertspoon after meals and at bedtime. It really helps. X

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Thank you Stella,  Does it really work, I usually stay away from antacids because they affect my IBS and cause constipation.  I will certainly look at this I have some duel action just in the medicine chest and have taken it once when I had heartburn, but as you know with silent reflux you don't get much of the usual indigestion type symptoms.  Thank you for replying.

Carol

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Hi forgot to ask what can you drink with this condition.  I normally drink tea with skimmed milk and water, occasional glass of wine, no coffee coke etc.  What about dining out or going for a drink.  The list seems endless of things you can't eat your drink.  Can you only drink water, lovely when its cold outside. 

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Carol, you say you usually refrain from anti acids...because they affect your IBS and cause constipation...omeprazole....is an "anti acid"...and you have stated 5 day improvements. You say you have silent refulx...was this diagnosed via your gastroentrologist? The one med you were taking was not for IBS but for gastroparesis. If anti acids help your mucus control but affect constipation,is it lack of hydration with the anti acids? The gold standard for us aging folks that deal with constipation is psyllium husk powder with plenty of water. Many prefer "stool softeners" vs PHP because either they are too fussy or merely want a simple pill to solve their discomfort...PSP has qualities that can promote good intestinal bacteria, thus could also help with IBS..

I would re examine the 4th and 5th day of each and everything I put in my mouth to evaluate if any could have began a mucus producing process...crisps? Because you responded the morning after..maybe a trigger or cause...Do you take meds for your inflammatory condition?

Face one ugly fact....any remedy will take time...discipline as ines has said is difficult but with some devotion, it gets more easy over time.

Last..found the nutation and the inhibitor...but not available nor approved...yet...and I doubt you have this mutation its rare...super rare.

Claudio

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Hi there,

Gaviscon Advance (the UK version) isn't an antacid it's an alginate - made out of seaweed which react with the acid in your stomach to form a raft on top of stomach contents, this means the only thing coming up is gaviscon, if that makes sense. There have been some studies on it and it's the most effective thing to stop non acid reflux, as this may still be causing some of your symptoms. Google it and have a look. The gaviscon dual action is an antacid and I would steer clear as you aren't supposed to take antacids with ppis. Ask your gp for a prescription. Both my gastro and ENT consultants have prescribed it for me, and it really helps. I'm on ppis too but it helps mop up any excess stuff that wants to make it's way up my throat.

I cut down for a couple of weeks and have ended up with horrendous burning mouth and throat. I upped my gaviscon today and already feel better. Just to reiterate, it's the alginate, not the antacid smile x

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Thank you for clearing that up Stella.

All the best.

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No worries. Feel better soon smile x

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Hello again, With regard to IBS this has been going on for 4 years,

Gp diagnosed.  I also suffer with anxiety.  Although always a worrier, I think it started around the time daughter and family moved away.  The IBS is ok at the moment.  I tend to get constipation and cramps if I take antibiotics, and have not taken them for ages.  I meant antacids like the one labelled heartburn and indigestion mixture etc.   Don't they contain

ingredients that can cause both constipation and diarreah.  At the time

I started the IBS I remember having heartburn and taking some mixture

which cured it, but the next day I was doubled up with cramps and constipation, this was around 2010.  Now I know Omeprazole is an anti acid and can cause side effects.  I was taking ranitidine for slight indigestion problem, but my gp said I needed something stronger, hence the omeprazole.  I have not been referred to the hospital as yet.  Having to go on 25th for knee arthritis but that is another story, have it in knees neck and spine.  What did you mean by am I taking any meds for my inflammatory condition?  I take mebervine before meals for IBS, Levothyroxine, amlodipine for blood pressure (I have long thought that this might be the cause of the extra mucus in the body and my gp has said that she might change it something else) I take celluvisc drops for dry eyes, as I have blepharitis and have also had 2 cataract ops in the last 2 years, which have not helped, although it is settling down now.

I have asthma and take symbicort, and salbutamol when required which is not very often.  I do know to drink plenty of water to avoid constipation

and so far, although only 6 days on the ppi I am fine there.  I don't like taking all these pills but there you go.  I only take paracetamol or use pernaton gel for arthritis pain, which was very bad during August. I tried

ibuprofen gel as I cannot take the tablets.  Not using now wonder if this is the cause of my problems, even though the side effects are less than tablets.  When I was at the consultants last year for my other leg they gave me codeine and dycodamol both of which caused side effects.

When you have so much going on it is hard to know what is causing what.  I appreciate that any remedy takes time.  I still think the route of a lot of my problems in anxiety.  I am seeing a councillor for this.  It is so hard to deal with anxiety when you have all these health problems to deal with.  Sorry to moan on but feel like theres not much to look forward to at this rate.

Carol

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Hi I have yearly blood tests but I don't suppose they automatically test for vitamin and mineral defiencies.  I take Vit D3 as I was found to be low in that.  Will mention to doctor when I see her .  Thank you for the information.  Best wishes