Silent Reflux & Low-Acid Diet

Hi everyone!

I wanted to share with you a little about what’s going on in my life right now. For about six months now, I’ve been having terrible shortness of breath. It’s completely random, sometimes it will happen in the morning before work, or in the evening when I’m eating dinner, or at night when I’m laying down for bed. It seems to be very stressed induced– when I’m with my family or friends, it rarely happens. When I’m busy at work or on the weekend, it tends to flare up.

I went to the doctor and he did several tests at first– an EKG and a pulmonary function test. The EKG results were normal (meaning nothing was wrong with my heart), but my pulmonary function test showed a moderate restriction in my breathing (duh). 

So, we tried several different asthma inhalers: albuterol (which I had a terrible reaction to and made my heart almost beat out of my chest) and asmanex, plus singulair and dymista for allergies. I took these for about two months, and didn’t see any results.

One of my nurse practitioners at work mentioned to me that perhaps the problem may not be from my lungs. Maybe my shortness of breath was silent reflux. What? I started doing some research.

Silent reflux– officially called laryngopharyngeal reflux (LPR)–  is similar to GERD (gastrointestinal reflux)– that results from the contents of the stomach backing up (reflux), but symptoms are often very different from the typical GERD case.

With LPR, you typically don’t have the classic symptoms of GERD, such as heartburn, so it can be difficult to diagnose. At the end of our esophagus is a ring of muscle (a sphincter). This is supposed to keep the contents of the stomach in the stomach, but with LPR, the sphincter doesn’t work right. Stomach acid backs up into the throat or voice box. This causes inflammation.

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Adults can have the typical heartburn, but more likely to have these symptoms:

• Excessive throat clearing
• Persistent cough
• Hoarseness
• A “lump” in the throat that doesn’t go away with repeated swallowing
• A sensation of postnasal drip or excess throat mucus
• Trouble swallowing
• Trouble breathing: especially during the in breath, not the out breath.
• Sore throat

I was surprised when I saw this list of symptoms. I was having 7/8. Particularly the trouble breathing. I shared this list of symptoms with my doctor, and he started me on omeprazole.

It had been about three weeks of the omeprazole treatment, and I hadn’t seen any improvement yet (although I read that it can take up to a month to heal inflammation). I called my doctor and he added carafate, which coats the esophagus and stomach so the acid can’t do any more damage.

He encouraged me to really follow a low-aciddiet for the next month. This means that I need to avoid:

• Alcohol
• Chocolate
• Citrus such as: oranges, lemons, limes, grapefruit, pineapple
• Carbonated beverages
• Spicy or tomato-based products
• Red wine
• Caffeine
• Chocolate
• Mint or peppermint
• Fatty or spicy foods
• High fat nuts such as walnuts, almonds, cashews
• Avocados, large amounts of olive oil
• Onions and garlic
• Cheese, sour cream, butter
• Potato chips

 
And I need to:

• Stop eating at least three hours before going to bed
• Elevate the head of the bed about 4 to 6 inches
• Take a probiotic
• Eat more fiber
• Eat non-reflux causing foods, such as oatmeal, bananas, melon, chicken and turkey, fish, and roots and greens

 
You’d think being a dietitian would make this easier. Nope. Making changes to one’s diet can be one of the hardest things to do, I see it every day with my clients at work. I am going to really need to concentrate if I’m going to cut out coffee for a WHOLE MONTH. Gah. And red wine. And cheese. And tomatoes.

I’ll need as much support as I can get! I am super highly motivated to start feeling better. Being short of breath all the time is NOT fun. Plus, if I don’t start to feel better, then I’ll have to go get an upper endoscopy to check for a hiatal hernia. Which I am not looking forward to.

Have you ever had to make any large dietary changes? How did YOU stick with it?