The Silent Kind

I wish this wasn’t the case but, the longer I live, the more I learn about new medical issues, and much of the time I had never heard of them until a loved one or I experience them.

After several primary office visits and months of coughing – along with a handful of other symptoms that some might think are TMI to share – I landed in the office of an ENT at my doctor’s suggestion to unravel what had become the million-dollar question: Do I have Allergies? Reflux? Something else?  

The ENT and I discussed the situation and even though I had been dreading the diagnostic laryngoscopy procedure (that was to be done right there in the office) for no reason other than because I am a big baby, I was excited when she said that I’ll know if I have reflux before I leave the office.   

The scope took under 2 minutes, if that, and wasn’t nearly as unpleasant as I had anticipated. Fewer than 10 seconds later, she said “This is ‘Silent Reflux.’” I knew of reflux, but silent? Who knew there was such a thing?

Silent reflux or “LPR” for laryngopharyngeal reflux differs from the more common reflux known as GERD (gastroesophageal reflux) because traditional reflux symptoms such as heartburn and indigestion are NOT present, thereby making LPR a bit tricky to figure out.

With LPR, stomach acid travels up the esophagus and spills into the throat or voice box (pharynx/larynx). It is when these acids make contact with the food pipe and vocal cords that the irritation/discomfort/burning can occur. With GERD, on the other hand, the acid settles into the esophagus and poses different problems.

This is my understanding of Silent Reflux 101. I still have a lot to learn, but first...How do I pronounce what the L in LPR stands for...laryngopharyngeal?

lə-ˌriŋ-gō-ˌfar-ən-ˈjē-əl, -fə-ˈrin-j(ē-)əl – according to the Miriam-Webster dictionary.

Given this diagnosis, experts advise a change in dietary habits which includes the restriction of spicy, fried and fatty foods (NBD - no big deal); citrus fruits (NBD); tomatoes (ugh); chocolate (double ugh ☹); peppermint (NBD); cheese and garlic (ugh); and caffeinated and carbonated beverages are best taken off the table. In addition, I’ll be trying out a PPI (proton pump inhibitor) that will hopefully work as expected.

So where does this leave my obsession with Trader Joe’s dark chocolate covered almonds? And my love for tomatoes eaten right off the vine that David grows in our back yard? And cheese for my omelets? And that scrumptious hot green tea?

I’ve sure enjoyed all this stuff over the years, but I realize that as we get older, our bodies don’t work the way they used to. This unfortunately leads to new ailments that impact us in one way or another, requiring us to act. With this LPR finding, I realize I’ll have to make some changes but, all things considered, it could be worse.  

Like everything else – and the title for a recent blog post – it’s all relative.