I may have fallen down the proverbial rabbit hole in Alice in Wonderland.

There is, or there will be, a happy ending for me; but I am quickly discovering I am in a crowd of countless millions – many of whom are suffering under misdiagnosis and missed treatments as their suffering continues.

Looking back at friends and family members in the past, I remember how I dismissed their incessant throat clearing and their coughing as bad habits. 

A tiny light went off when a fellow choral member and I were commiserating about our struggles to sing notes clearly. She said it had to do with reflux.

What? 

I was chomping down on Tums quite regularly at the time – probably from the stress of being a caregiver.

But wait … now I am the one who is clearing my throat all day long – and especially at night!

Oh, and allergies! That postnasal drip seemed to never turn off! Every morning upon waking, I had to hunk out phlegm from my throat. TMI, sorry.

Gross to listen to and embarrassing.

Time for more Tums; then a Pepcid here or there; then Pepcid every night; then twice a day.

I had to do something, so I went on Omeprazole (Prilosec) which is a (PPI) Proton Pump Inhibitor designed to reduce stomach acid. 

The benefits were almost instantaneous. I could sleep flat in bed again, the throat clearing was almost gone, and I could sing for the first time in several years.

But …

There are side effects. 

I was reading articles linking PPIs with dementia, osteoporosis, skin issues, and muscle spasms – to name a few.

I was just starting on month three, when the morning spasms in my feet would wake me and my skin was irritated.

Okay, that’s it! 

I weaned off the PPI over two weeks. There were side effects from that, too, like bladder irritation. 

But, ahem! I’m clearing my throat again!

Eventually spicy foods, tomato-based sauces, chocolate, mint, and alcohol are identified as my common reflux triggers – along with stress and body position.

Then I saw articles about another kind of reflux – a ‘silent’ kind which often happens in the stealth of night.

The more I read, the more boxes I was checking off – not for GERD (Gastro Esophageal Reflux), the kind with the classic heartburn – but for LPR (Laryngopharyngeal Reflux).

To quote Dr. Jamie Koufman: “When you have an acid reflux event, up comes acid and pepsin, the later being the main digestive enzyme of the stomach. Next, the pepsin binds to the surface of tissues in its path (e.g., esophagus and respiratory tract). Then, the pepsin can attack, penetrate, and damage tissue. It’s pepsin (not acid) that wreaks havoc from acid reflux; it causes inflammation and reflux-related disease.” 

I am in week two of taking an alginate gel called Reflux Gourmet. Alginate forms a physical blocking layer that traps pepsin in the stomach and also deactivates it on contact during a reflux event. In the throat and esophagus, it coats and protects delicate tissues from pepsin.

Alginate is taken after meals, but especially after dinner and before bed.

Along with stress control, smaller portions, an earlier dinner, a lower-acid diet, little or no alcohol, alkaline water, strolling after meals, and elevating the head of my bed, I’m seeing significant improvement. 

A simple tracking chart for both my habits and symptoms—especially throat clearing and hoarseness—has been tremendously helpful for staying on track and recognizing patterns.

The rabbit hole is that so many people with an assortment of upper and lower respiratory issues apparently might really be suffering from the effects of LPR – which Dr. Koufman prefers to call respiratory reflux.

I’m not being an alarmist saying LPR is a single cause to all physical problems, but it’s certainly worth a deeper look – especially if your reflux or respiratory issues are not getting better.

Treating reflux and maintaining reflux control is a lifetime commitment to health through awareness and due diligence.

In health – 

Deidre