Allergy - GERD Treatment and Rhinosinusitis

Author

GERD Treatment and Rhinosinusitis

2006-08-26, 4:22 pm

There have been various studies linking respiratory diseases such as
rhinitis, sinusitis and asthma to acid reflux (GERD).

I am curious--is there anyone reading who has found that GERD treatment such
as PPIs (Prilosec, Prevacid, Nexium, Protonix, etc.) significantly improved
their respiratory symptoms? If so, what was the dosage and regimen that
helped with those symptoms.

(For the record, I have been treated for GERD for years (first Protonix,
later Nexium), and I doubt that has helped my chronic rhinosinusitis much.
I'm curious about whether some have really found significant respiratory
relief due to GERD treatment.

Steven L.

2006-08-27, 4:26 pm

2006-08-28, 4:25 pm

"Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote in message
news:TGjIg.10856$Qf.3629@newsread2.news.pas.earthlink.net...

> He believes that sinusitis can be aggravated by the physical regurgitation
> of stomach contents and fumes all the way up into the nasopharynx (like a
> reverse post nasal drip). Because it's the physical regurgitation,
> anti-acid medications won't help. Surgical intervention to stop the
> physical refluxing is required.

I thought the medications do stop physical refluxing, and they are by far
the most common treatment for this condition. (I think that surgery is
fairly rare.) But yes, I haven't yet heard of people whose sinusitis has
improved due to the medications. (I wonder if a larger dose might help?)

Perhaps many of us need reflux surgery rather than sinus surgery? Well, that
would be a real surprise.! Has anyone reading had that GERD surgery? Did it
improve respiratory symptoms?

Are there many risks and side effects to that surgery?

dinkmeister

2006-08-28, 9:23 pm

Sorry to troll, but he probably also believes that convincing you
its the only option is going to make his pockets a little bit deeper.
I don't trust a lot of doctors, you might want to get a second opinion.

On Sun, 27 Aug 2006 16:24:19 GMT, Steven L. wrote:

:He believes that sinusitis can be aggravated by the physical
:regurgitation of stomach contents and fumes all the way up into the
:nasopharynx (like a reverse post nasal drip). Because it's the physical
:regurgitation, anti-acid medications won't help. Surgical intervention
:to stop the physical refluxing is required.
:
:
:--
:Steven D. Litvintchouk
:Email: sdlitvin@earthlinkNOSPAM.net
:Remove the NOSPAM before replying to me.

cozzmo1@hotmail.com

2006-08-29, 9:23 pm

cozzmo1@hotmail.com

2006-08-29, 9:23 pm

MS wrote:
> There have been various studies linking respiratory diseases such as
> rhinitis, sinusitis and asthma to acid reflux (GERD).
>
> I am curious--is there anyone reading who has found that GERD treatment such
> as PPIs (Prilosec, Prevacid, Nexium, Protonix, etc.) significantly improved
> their respiratory symptoms? If so, what was the dosage and regimen that
> helped with those symptoms.
>
> (For the record, I have been treated for GERD for years (first Protonix,
> later Nexium), and I doubt that has helped my chronic rhinosinusitis much.
> I'm curious about whether some have really found significant respiratory
> relief due to GERD treatment.

I have had significant reduction of sinusitis since being on nexium
twice a day for LPR (laryngeal pharyngeal reflux or silent reflux). I
used to be unable to smell, constantly blowing and rubbing my nose, and
my eyes were even red and irritated. I was thoroughly allergy tested by
two allergists with absolutely no allergies! I also thought I had dry
eye syndrome.
In addition my vocal cords began to be irritated a lot causing
hoarseness and worst of all breathing difficulties especially on
inspiration were my irritated vocal cords would shut prematurely.

After taking the double dose nexium for about 3 months, symptoms
improved dramatically. I am waiting to see if I get any of the dreaded
repeat sinus infections that tend to plague me starting in October (flu
season). I am considering the Nissen Fundoplication procedure because I
don't know if I should be on double dose nexium for existence as I am
only 44 years old. It may also have long term usage effects as it's in
a fairly new class of drugs.

Anyway, I am absolutely sure that my long standing sinus issures were
reflux related; I haven't breathed this clear through my nose as far
back as I can remember.

Tricia

Steven L.

2006-08-29, 9:23 pm

dinkmeister wrote:
> Sorry to troll, but he probably also believes that convincing you
> its the only option is going to make his pockets a little bit deeper.
> I don't trust a lot of doctors, you might want to get a second opinion.

How would it make his pockets deeper? He doesn't do stomach surgery. I
would need to find a gastroenterologist for that.

--
Steven D. Litvintchouk
Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

Steven L.

2006-08-29, 9:23 pm

MS wrote:
> "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote in message
> news:TGjIg.10856$Qf.3629@newsread2.news.pas.earthlink.net...
>
>
> I thought the medications do stop physical refluxing, and they are by far
> the most common treatment for this condition.

Of course they don't.
They just stop the secretion of stomach acid. True, excess stomach acid
can cause stomach gas, which can cause burping and more reflux. But you
can get reflux for other reasons, most notably a weak esophageal
sphincter. And that's a physical problem that can only be corrected
surgically.

> Perhaps many of us need reflux surgery rather than sinus surgery? Well, that
> would be a real surprise.! Has anyone reading had that GERD surgery? Did it
> improve respiratory symptoms?

I recall we had a couple of people on this NG long ago who said that the
Nissen funduplication helped them a lot. It's still a controversial
theory among gastroenterologists, though. Good luck trying to find a
gastroenterologist who will operate on your esophagus just because your
sinuses are bothering you. :-)

>
> Are there many risks and side effects to that surgery?

Yep.

--
Steven D. Litvintchouk
Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

guajeo

2006-08-30, 4:26 pm

<cozzmo1@hotmail.com> wrote in message
news:1156887774.052221.239640@p79g2000cwp.googlegroups.com...

> After taking the double dose nexium for about 3 months, symptoms
> improved dramatically. I am waiting to see if I get any of the dreaded
> repeat sinus infections that tend to plague me starting in October (flu
> season). I am considering the Nissen Fundoplication procedure because I
> don't know if I should be on double dose nexium for existence as I am
> only 44 years old. It may also have long term usage effects as it's in
> a fairly new class of drugs.
>
> Anyway, I am absolutely sure that my long standing sinus issures were
> reflux related; I haven't breathed this clear through my nose as far
> back as I can remember.
>
> Tricia

Glad it has helped you.

Did it take three months before you felt any improvement in symptoms? Did
you earlier take once a day? Any improvement on that?

As said, I'm taking Nexium once per day, and don't feel it is helping my
sinus problems. I have sometimes tried taking two per day, and also have not
felt improvement for that. However, without getting it prescribed for 2x
daily, I wouldn't have enough to do that every day for three months. Perhaps
I should try to see if I can get a doc to prescribe that.

With the med helping you as it does, I wouldn't suggest you have surgery.
Complications from surgery can be much worse than side effects from meds. I
haven't heard of any major negative effects from PPIs. Have you had negative
side effects from Nexium?

cozzmo1@hotmail.com

2006-08-30, 4:26 pm

guajeo wrote:

> Glad it has helped you.
>
> Did it take three months before you felt any improvement in symptoms? Did
> you earlier take once a day? Any improvement on that?
>
> As said, I'm taking Nexium once per day, and don't feel it is helping my
> sinus problems. I have sometimes tried taking two per day, and also have not
> felt improvement for that. However, without getting it prescribed for 2x
> daily, I wouldn't have enough to do that every day for three months. Perhaps
> I should try to see if I can get a doc to prescribe that.
>
> With the med helping you as it does, I wouldn't suggest you have surgery.
> Complications from surgery can be much worse than side effects from meds. I
> haven't heard of any major negative effects from PPIs. Have you had negative
> side effects from Nexium?

Hello,

Yes, it took at least 3 months before I felt improvement and definitely
had to take the double dose nexium. I was on single dose nex, and also
tried protonix and prilosec before that. When I tried to taper back off
the double dose after two weeks of the one pill a day, I was back to my
original symptoms.

Although the sinuses have stayed clear and it's been wonderful to
breathe, smell and not have sinus infections; the GERD\LPR does come
back in cycles on the double dose even. Whenever I feel stress it
starts up as I can feel the pressure in mid sternum and breathing seems
to get heavy. So, I am actually scheduled to see a doctor who is going
to do a ph study. I have the appt. tomm.

I hear so many horror stories now about allowing GERD\LPR to be out of
control, from breathing problems to cancer. I just don't want to risk
any of that, so I am considering the nissen.

As far as negative side effects from the nexium, not anything major, I
think maybe it makes my colon a little touchy sometime but I take a
probiotic pill whenever I feel that and it seems to be fine.

Look up LPR and you will find a lot of info and other sufferers telling
their stories. If you have LPR, it can take up to 6 months of double
dosing to get it under control, ugh!
You may need to educate your doctor(s) as I had to mine.

BTW, do you have other symptoms from reflux besides sinus? I agree that
it would be hard to get a doctor to prescribe the double dose without
other symptoms and further study.

I wish you the best of luck with it, let me know what you do.

Tricia

kathywb2001@yahoo.com

2006-08-30, 9:26 pm

>From what I understand the test for this is a double pH proble that
detects laryngeopharyngeal reflux that the standard probe does not pick
up. I don't know very many places that do this, but there is a doctor
at Wake Forest that does.
MS wrote:
> There have been various studies linking respiratory diseases such as
> rhinitis, sinusitis and asthma to acid reflux (GERD).
>
> I am curious--is there anyone reading who has found that GERD treatment such
> as PPIs (Prilosec, Prevacid, Nexium, Protonix, etc.) significantly improved
> their respiratory symptoms? If so, what was the dosage and regimen that
> helped with those symptoms.
>
> (For the record, I have been treated for GERD for years (first Protonix,
> later Nexium), and I doubt that has helped my chronic rhinosinusitis much.
> I'm curious about whether some have really found significant respiratory
> relief due to GERD treatment.

2006-08-30, 9:26 pm

<cozzmo1@hotmail.com> wrote in message
news:1156969911.828736.37220@b28g2000cwb.googlegroups.com...

> Look up LPR and you will find a lot of info and other sufferers telling
> their stories. If you have LPR, it can take up to 6 months of double
> dosing to get it under control, ugh!
> You may need to educate your doctor(s) as I had to mine.
>
> BTW, do you have other symptoms from reflux besides sinus? I agree that
> it would be hard to get a doctor to prescribe the double dose without
> other symptoms and further study.
>
> I wish you the best of luck with it, let me know what you do.
>

Tricia

In my case, in a upper endoscopy a few years ago, I was diagnosed with
erosive esophagitis. That's when I was put on protonix. I don't have
heartburn, and rarely have digestive problems. So there is a diagnosis of
GERD. (If not, I wouldn't have been prescribed PPI med once per day.)

Yet, since the dosage is normally once per day, I don't know if I can
convince a doc to prescribe it for 2x daily, which AFAIK is not a common
dosage. I'll try though.

By "look up LPR", do you mean you just put that acronym in the search
engine, or the whole name?

Also, I'm curious, what times do you take the two dosages. I assume the
first one is when you first waken, at least a half hour before eating. Are
you supposed to take the second one exactly 12 hours later, or right before
bed, or what?

2006-08-30, 9:26 pm

<cozzmo1@hotmail.com> wrote in message
news:1156969911.828736.37220@b28g2000cwb.googlegroups.com...

> Look up LPR and you will find a lot of info and other sufferers telling
> their stories. If you have LPR, it can take up to 6 months of double
> dosing to get it under control, ugh!
> You may need to educate your doctor(s) as I had to mine.

I've just started to search some articles on the Internet.

The following article is interesting:

http://www.medscape.com/viewarticle/530551

In that article, however, the author says that studies show that PPIs do not
help LPR. Of course, your experience is certainly different than that
conclusion.

2006-08-30, 9:26 pm

The following article, however, concludes that such surgery is not useful
for these symptoms:

http://www.medscape.com/viewarticle/540210_2

"Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote in message
news:TGjIg.10856$Qf.3629@newsread2.news.pas.earthlink.net...
> MS wrote:
>
> My ENT claims that he has seen dramatic improvement with some sinusitis
> patients, after they have had Nissen funduplication surgery to tighten
> their esophageal sphincter muscles. (The ENTs at the Cleveland Clinic are
> gradually coming around to the same conclusion.)
>
> He believes that sinusitis can be aggravated by the physical regurgitation
> of stomach contents and fumes all the way up into the nasopharynx (like a
> reverse post nasal drip). Because it's the physical regurgitation,
> anti-acid medications won't help. Surgical intervention to stop the
> physical refluxing is required.
>
>
> --
> Steven D. Litvintchouk
> Email: sdlitvin@earthlinkNOSPAM.net
> Remove the NOSPAM before replying to me.

tdonline

2006-08-30, 9:26 pm

ENT diagnosed me with LPR last year, but an endoscopy and double Ph
probe test didn't confirm her diagnosis. According to the tests, my
esophageal muscle was "normal" and my Ph results were also "normal" but
I did get some acid into my throat when I burped...During the 7 months
or so, I was first on single dose of Nexium/Protonix 40mg and then
upped it to twice daily dosages.

All I can say is my sinus problem and constant sore throat never really
went away. Plus, I felt terrible on the acid blockers. The "cure" was
worse than the disease. In preparation for the Ph test, I had to go
off Protonix for 10 days and I never went back on it. The other day, I
found a bottle of Protonix and chucked in the waste bin. I still have
ups and downs with my sinuses and sore throat, but I feel much better
otherwise and I don't have to pay for the Protonix anymore.

2006-08-31, 4:28 pm

"tdonline" <trinhd90@gmail.com> wrote in message
news:1156988417.432416.24340@h48g2000cwc.googlegroups.com...

> All I can say is my sinus problem and constant sore throat never really
> went away. Plus, I felt terrible on the acid blockers. The "cure" was
> worse than the disease. In preparation for the Ph test, I had to go
> off Protonix for 10 days and I never went back on it. The other day, I
> found a bottle of Protonix and chucked in the waste bin. I still have
> ups and downs with my sinuses and sore throat, but I feel much better
> otherwise and I don't have to pay for the Protonix anymore.

What negative effects did you have from the acid blockers? I didn't think
they had much in the way of negative effects.

How long did you try the twice per day protonix? Someone reported here that
she only started to feel relief after taking Nexium twice per day for three
months.

tdonline

2006-08-31, 9:27 pm

MS wrote:

> What negative effects did you have from the acid blockers? I didn't think
> they had much in the way of negative effects.
>
> How long did you try the twice per day protonix? Someone reported here that
> she only started to feel relief after taking Nexium twice per day for three
> months.

Yeah, the ENT told me to try Nexium and that if her diagnosis was
wrong, it would be no big deal because it didn't have any side
effects...right. Right off the bat, I was incredibly constipated and
had painful bloody bowel movements which necessitated a colonoscopy. I
also went through weeks and weeks of frightening chest pains which also
led to cardio tests...mo' money out of my school loans. After a month,
I was switched to Protonix and though I got better, I still had weird
abdominal pains and felt bloated all the time and occassionally had
very painful gassiness. I also went through a period after I upped my
dosage where I would get a very nasty taste in my throat every late
afternoon/evening. I basically felt as if my bowels had moved up my
body. I was on a single dose daily for about 3 months and double doses
for another 3 months.

And through all that, my pnd and sore throat with occassional nasty
sulphur-like breath never went away. I started nasal irrigation a
month before I started the acid blockers.