Anyone with "silent reflux"?

That’s when you’ve got gastroesophageal reflux, but without the traditional symptoms of heartburn. It’s one of many things that can “mimic” asthma (other common ones being sinusitus / nasal allergies and untreated apnea, as well as a lot of much scarier things). Reflux (GERD) traditionally presents with heartburn but the ‘silent’ kind can be sneakier.

If so (known or suspected):
What made you (or your doctor) suspect this was going on?
Is it being treated successfully?
If so, how?
If not, what things have you tried?
How was it diagnosed? History, tests, etc.?
If tests, what kind?

Back story: Increasing hoarseness and a sensation that my asthma isn’t well controlled. Other likely causes are in the process of being ruled out, but it’s conceivable that known GERD isn’t as well-controlled as we’d thought. So that one’s next to be explored (sigh).

Because I rarely experienced anything I would call heartburn, I was extremely skeptical when my ENT said the vocal cord polyp I had several years ago was due to reflux. But treating the reflux has prevented it from coming back, so what do I know?

What made you (or your doctor) suspect this was going on?
A couple of rounds of antibiotics did nothing for my hoarse voice originally diagnosed as bronchitis (IIRC), so I was sent by my GP to an ENT who found a polyp on my vocal cord. Voice rest for a month only gave it a month to grow to the point of jeopardizing my airway, so I went under the knife. It started coming back despite several non-pharmaceutical attempts to treat the reflux, so I went first on Prilosec and ultimately on Protonix.

Is it being treated successfully? If so, how?
Yes. Once we got the Protonix dosage right, I’ve had no polyp recurrence. I also take antacid before bed and am supposed to be taking some other preventive measures.

How was it diagnosed? History, tests, etc.? If tests, what kind?
Laryngoscope first, upper endoscopy later (to check that I wasn’t doing long-term damage to my esophagus).

I also never experience heartburn but my ENT diagnosed me with GERD.

Primary symptoms were hoarseness and constant feeling of a lump in my throat.

I had a laryngoscope and a barium swallow.

I was put on Zegerid and then Protonix and neither had any effect whatsoever. Still not resolved and I’m learning to just live with it.

My dad has severe reflux. He often wakes up in the middle of the night gasping for air; he says it feels like he’s drowning and can’t get any air in. He’s had to go to the ER plenty of times for it during the wee hours.
He has hoarseness, clears his throat often, etc. Other than that he doesn’t have the typical heartburn symptoms.

Thanks!

KneadToKnow: “jeapordizing airway” = :eek:. I had no idea polyps grew that much that fast. Do you use your voice a lot more than an average person (like, you’re a teacher or singer or something)? And how rough was the surgery?

I Like Pie: What if anything are the doctor(s) doing for your dad? is he on medication? is surgery an option?

I don’t know if my gastro will redo the endoscopy or not. I had one 3 years ago (long story involving a medication side effect that mimicked GERD) and that found no esophageal damage from years of true GERD - i.e. my Prilosec was generally doing the job. I suppose manometry/PH probe/barium swallow might happen, or I may ask about treating it as if silent GERD had been confirmed, without the invasive te$t$.

Yes, my polyp was (according to a post here I found recently when searching) the size of a whole pecan. They can get quite big.

I’m a librarian, so one would think I use it less than most. :slight_smile:

Actually, while I was on voice rest (for over a year), the thing I got sickest of hearing was how great it was that I was a librarian, like that meant I didn’t talk to people or something. No, I only answer questions all day for a living, that’s all.

Some of this I describe may not be very pleasant, so I wouldn’t read it while eating.

I was diagnosed with GERD some 33 years ago. I’m 54 now. Never heard of it called silent reflux before. But 20% of GERD sufferers don’t experience heartburn. That is true of me too; it’s just something I don’t experience. And I sleep great too. After refluxing 1-2 times a month on average during meals for nearly all of that time, and on medication (prevacid 30 mg capsules), my reflux went into remission a little over a year ago.

During my time of suffering, there were probably only perhaps 20 different months (just guessing) I may never have refluxed any. And perhaps 1 or 2 weeks a year, I really had a very bad time of reflux, where just about every meal was causing me problems. I remember some days, I would reflux a quart or two and it was violent, sometimes lasting hours. It seems like my stomach was never going to empty. This was usually when I was experimenting and went off the meds completely for a few weeks. Other times, it was over quick, I would lose the whole meal instantly.

Now I would like to know what happened after suffering through it all of those years why it decides to go away after having it for 30 years plus. I’m going to guess what I did last year, may not be related to why it went away, but I’ll tell it, anyway, FWIW.

Both of my elderly parents were down health-wise, and I had to be the full-time health care taker of them 5 days and nights a week for several months. Even longer period than that, I had to stay with them quite a bit before I could come back home.

Two things were different, and I started doing them about the same time. I started eating their foods and drinks. And I also decided since Walmart has the generic form of Prevacid in 15 mg capsules, I would try using those instead of my usual 30 mg dosage that were prescription I had been on for those 30+ years.

As far as my diet that was different, the foods were actually not as healthy as I had been eating, but the drinks were different. I started drinking tea, with no sugar, but the sugar substitute packets. I would generally add with lemon juice too. I didn’t think anything of it.

Anyway, wasn’t paying too much attention, until about two months later, I started realizing, I only had one very light reflux during that time, maybe two, don’t recall exactly. But another month passes, and no reflux. Then another month goes by, and no reflux. Before I know it, the year passes, and I can only recall maybe three very light reflux episodes. I kept thinking either the tea or lemon, or both may have helped, as well as possibly reducing the medication dosages in half. It’s hard to know if it did, or the thing just went into remission on its own.

For this year, I wanted to keep an accurate data sheet of exactly how many times I’m going to reflux that I’m going to mark on my calendar. Thus far, it’s still at zero. I think I went the last nine months of last year, with one very, light episode of reflux sometime before Thanksgiving. There are occasions, where I will experience a little bit of hiccupping, but I stop eating for about a half a minute and it goes away. Nothing really discomforting. I still take the 15 mg dosage, but for right now, it’s only 3 days in a row, and four days off a week. I started doing that about three weeks ago, and still doing great. I don’t think it has completely left; I’m kind of leery of changing things up much more when I’m doing so good now, but will continue to proceed with caution. In another few months, I’m thinking about dropping all medicine for it and seeing how it goes, but staying with the occasional tea and lemon juice.

What’s crazy about reflux, is what foods and drinks the doctors tell you that you should avoid. Everybody has seen the list. Basically, there was hardly anything you could eat. There were times during my most violent episodes, I would even reflux water, but that was kind of when I was already in my reflux state. Others tell me, they think I should have taken a test to see if my body wasn’t making enough acid, instead of taking these acid blockers. It seems like everybody says to avoid jalapeno peppers (I eat a lot of those every day), lemons, oranges, and other acidy foods, along with tea and milk which was also supposed to make it worse. But with me there really wasn’t a specific food or drink that matters, although I’m kind of leery of eating certain BBQ foods, and their sauces.

Sometimes I wonder if my doctor misdiagnosed me, but he seemed very thorough. The diagnosis I got was GERD. I had the barium test, x-rays, scope down my throat, and it was supposed to show I had a hiatal hernia, and esophagitis. I had my throat stretched once some 25 year ago.

There’s yet another operation out nowadays that goes in and repairs the flap that is supposed to be better than other methods in the past, and this is supposed to fix a high number of acid reflux sufferers. I understand great results have come about from it all.

I just hope my luck continues. I came out of it without any erosion to my teeth or throat that I’m aware of. Wish all of you the best of luck too, on whatever the hell works.

I just noticed, I’m off on all of my figures by ten years, other than my age. It started when I was around 31, not 21. I had my throat stretched closer to 15 years ago, not 25. And was on my prescription medicine for 20+ years, not 30+. Damn, it’s a wonder I got my age right. Geeze, I’m getting old when I let simple figures go right by me like that without catching it.

A quick update: saw the gastro today and he strongly recommends doing an endoscopy now so he can get a better feel for what’s going on. Based on symptoms there’s a fair chance that something is going on.

Apparently when hoarseness is a symptom, there can be far less acid involved - i.e. not enough to cause burning pain.

The endoscopy will let him suggest the appropriate course of treatment, and also double-check to make sure the long-term Prilosec hasn’t caused other stomach issues.

I don’t know how your insurance coverage works, Mama Zappa, but investigate going with a scrip like Protonix. I can get 3 months of that for $10 vs. like $20 for a couple of weeks worth of OTC like Prilosec.

Wow, I reflux hard from water <even too much ice in a drink will do it> but nothing else. And it certainly doesn’t feel like asthma or affect my breathing, yikes. My mom and sister also have problems drinking water, same reflux; we joke that our bodies are so acidic that the acid flees at the sight of water, lol. (Currently refluxing from drinking diet lemonade today, but taking antacids and hoping I eventually get used to it.)

What made you (or your doctor) suspect this was going on?
…Perpetual cough and clearing my throat

Is it being treated successfully?
…yes

If so, how?
…Drastic weight loss (bariatric surgery) and a med, can’t recall the name but it’s the common GERD med (omeprezole) with added sodium bicarbonate…Ahhh, found it! Zegerid

How was it diagnosed? History, tests, etc.?
…Simple look at the top of the esophagus “Say Ahhh” and he could see inflammation.

That may be what happens. In fact, to my surprise, my insurance covers prescription omeprazole (generic Prilosec), at the same dose as the OTC stuff, which is bizarre - and it’s something like 12 dollars for 3 months (my copay, the total is 50ish, which is less than the OTC stuff would be).

But the doctor wants to make sure what’s going on first; for example I might have “bile reflux” (which is rare but slightly more common among people who’ve had gallbladder surgery). The treatment for that is quite different, e.g. Prilosec / Protonix won’t help at all.

Ruby: I knew “Zegerid” from your description even before I got to where you’d found the name. That one makes me snicker; it’s cheap omeprazole, with even cheaper baking soda, and they charge a premium price because nobody else has a patent on that combination. A few years back when something else was misdiagnosed as GERD, my internist wanted me to try it. I priced it out and my insurance didn’t cover it at all, so it would have been like 500 dollars a month. Can you say “price gouging”?

Yes – chronic cough, post-nasal yuckiness and tonsiloliths. No heartburn or reflux (except occasionally after heavy late night meals.) GP suggested reflux but I argued. Months later I was prescribed three meds for idiopathic hives, one of which was ranitidine. Because of drowsiness I dropped two but stayed on the ranitidine (300 mgs at bedtime) and was symptom free. When the prescription ran out symptoms immediately returned. I admitted to the GP that she was right and remain on ranitidine.

For a while I couldn’t afford the medication so I was making my own at home. I purchased OTC Omeprazole at the same dosage as the Rx and swallowed it with water mixed with baking soda. IANADoctor or anything else for that matter so DON’T DO THIS NO MATTER WHAT ELSE I SAY but it worked for me.

Update: got scoped yesterday (in fact am still a little “out of it” from the sedation - that stuff hits me harder than most).

I’d actually been feeling quite a bit worse lately, so was glad to get the procedure out of the way: a sensation of lump in the throat, and much more frequent awareness of actual refluxing.

Good news overall: no bile reflux, no hiatal hernia, no signs of Barrett’s which is the one that was really worrying me. Just… worsening esophagitis despite being on omeprazole.

So insurance-willing (it’s non-formulary and requires approval), I’ll be taking Dexilant for a bit. That’s the “right-handed” version of Prevacid (lansoprazole) but has a dual-release formulation, so may work better for me.

I presume that at some point, fundoplication might still be an option, but for numerous reasons I’m in no hurry for that!!

Good news, indeed, Mama Zappa.

Hey, did your refrigerator happen to die while you were recovering from your scope? That happened to me. Still feeling very dopey, I went downstairs to get something to drink and was standing in a puddle trying to figure out what was wrong with this picture before I finally got my head around it.