Question:
x-posted to alt.support.asthma – Hide quoted text — Show quoted text – I have been experiencing very thick secretions down near my vocal cords for approximately six years. The problems are exacerbated by eating and drinking, and cause me to have the urge to constantly clear my throat. If I don’t, my voice becomes garbled due to the mucous. I have been diagnosed with asthma and have had allergy tests which show that I am allergic to most everything (dust, mites, trees, grasses, mold etc.). I have been on shots for over one year, and don’t notice any appreciable improvement. I have also tried just about every conceivable Rx including Claritin, Zyrtec, Provental, many steriod nasal sprays, and a mucous thinner. Nothing seems to help. My sinuses are clear on the CT scan (although I do have a severly deviated septum on one side). The ENT doc wants to operate to correct this problem and thinks that it may help alleviate some of my problem, but I am skeptical. Does anyone out there experience these symptoms, and if so, what helps??
Since you mention it’s worse with food or drink, has GE reflux been considered. GE reflux can trigger or worsen asthma due to reflux being aspirated into lungs. Treatment includes elevating head of bed 6-8" with wood blocks, no meals near bedtime, drugs like omeprazole and H2 blockers. A gastroenterologist can diagnose GERD. Your ENT seems to think it’s postnasal drip? This would tend to indicate sinusitis or rhinitis. These can worsen asthma due to postnasal drip getting into lungs. Not sure how effective an operation for deviated septum would be. The emphasis should be on controlling any post nasal drip with nasal sprays, saline wash, etc. Links: http://www.ama-assn.org/special/asthma/treatmnt/updates/gerd.htm Asthma and Gastroesophageal Reflux Disease-GERD Nov ‘97 JAMA http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis 11-97 JAMA
Response:
– Hide quoted text — Show quoted text – x-posted to alt.support.asthma I have been experiencing very thick secretions down near my vocal cords for approximately six years. The problems are exacerbated by eating and drinking, and cause me to have the urge to constantly clear my throat. If I don’t, my voice becomes garbled due to the mucous. I have been diagnosed with asthma and have had allergy tests which show that I am allergic to most everything (dust, mites, trees, grasses, mold etc.). I have been on shots for over one year, and don’t notice any appreciable improvement. I have also tried just about every conceivable Rx including Claritin, Zyrtec, Provental, many steriod nasal sprays, and a mucous thinner. Nothing seems to help. My sinuses are clear on the CT scan (although I do have a severly deviated septum on one side). The ENT doc wants to operate to correct this problem and thinks that it may help alleviate some of my problem, but I am skeptical. Does anyone out there experience these symptoms, and if so, what helps?? Since you mention it’s worse with food or drink, has GE reflux been considered. GE reflux can trigger or worsen asthma due to reflux being aspirated into lungs. Treatment includes elevating head of bed 6-8" with wood blocks, no meals near bedtime, drugs like omeprazole and H2 blockers. A gastroenterologist can diagnose GERD. Your ENT seems to think it’s postnasal drip? This would tend to indicate sinusitis or rhinitis. These can worsen asthma due to postnasal drip getting into lungs. Not sure how effective an operation for deviated septum would be. The emphasis should be on controlling any post nasal drip with nasal sprays, saline wash, etc. Links: http://www.ama-assn.org/special/asthma/treatmnt/updates/gerd.htm Asthma and Gastroesophageal Reflux Disease-GERD Nov ‘97 JAMA http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis 11-97 JAMA
Ellis: Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. Before you buy.
Response:
– Hide quoted text — Show quoted text – x-posted to alt.support.asthma I have been experiencing very thick secretions down near my vocal cords for approximately six years. The problems are exacerbated by eating and drinking, and cause me to have the urge to constantly clear my throat. If I don’t, my voice becomes garbled due to the mucous. I have been diagnosed with asthma and have had allergy tests which show that I am allergic to most everything (dust, mites, trees, grasses, mold etc.). I have been on shots for over one year, and don’t notice any appreciable improvement. I have also tried just about every conceivable Rx including Claritin, Zyrtec, Provental, many steriod nasal sprays, and a mucous thinner. Nothing seems to help. My sinuses are clear on the CT scan (although I do have a severly deviated septum on one side). The ENT doc wants to operate to correct this problem and thinks that it may help alleviate some of my problem, but I am skeptical. Does anyone out there experience these symptoms, and if so, what helps?? Since you mention it’s worse with food or drink, has GE reflux been considered. GE reflux can trigger or worsen asthma due to reflux being aspirated into lungs. Treatment includes elevating head of bed 6-8" with wood blocks, no meals near bedtime, drugs like omeprazole and H2 blockers. A gastroenterologist can diagnose GERD. Your ENT seems to think it’s postnasal drip? This would tend to indicate sinusitis or rhinitis. These can worsen asthma due to postnasal drip getting into lungs. Not sure how effective an operation for deviated septum would be. The emphasis should be on controlling any post nasal drip with nasal sprays, saline wash, etc. Links: http://www.ama-assn.org/special/asthma/treatmnt/updates/gerd.htm Asthma and Gastroesophageal Reflux Disease-GERD Nov ‘97 JAMA http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis 11-97 JAMA Ellis:
Thanks for your post and the links to JAMA. I neglected to mention that my allergist has attempted to treat possible GERD by prescribing Prilosec. I took it for about one week and did not see any difference. That is what is so frustrating about my symptoms, nothing seems to relieve them. Frankly, I can live with the asthma, but the mucous in my throat is driving me CRAZY. Before you buy.
Response:
Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed.
How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA
Response:
- Hide quoted text — Show quoted text – Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA
Intriguing point, Larry. I had a well qualified allergist last year put me on Prilosec for a month for exactly that reason, to see whether I had GERD based upon my level of spirometer improvement after the Prilosec. She concluded that I did not have GERD. Fortunately a subsequent pulmonary physician ordered a barium swallow which showed a lovely hiatal hernia and significant GERD. Back on Prilosec and much happier; I wonder whether there is a train of thought in the medical community that thinks as the allergist does. pavane
Response:
– Hide quoted text — Show quoted text – Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA Intriguing point, Larry. I had a well qualified allergist last year put me on Prilosec for a month for exactly that reason, to see whether I had GERD based upon my level of spirometer improvement after the Prilosec. She concluded that I did not have GERD. Fortunately a subsequent pulmonary physician ordered a barium swallow which showed a lovely hiatal hernia and significant GERD. Back on Prilosec and much happier; I wonder whether there is a train of thought in the medical community that thinks as the allergist does. pavane
Prilosec, as a drug that lowers gastric acid secretion, may well ameliorate the symptoms of heartburn that accompany GER, but that is not the prime consideration when we are talking about pulmonary problems: there, the mechanism has to do with aspiration of stomach contents that have refluxed into the esophagus, usually while you are recumbent. It makes no difference whether you have acid reflux symptoms, and the absence (or presence) of these does not tell whether GER might be contributing to asthma. I am pleased that you feel better now, with a good diagnosis and Prilosec. I wonder if you are carrying out any other anti-GER measures. — Larry Preuss Ann Arbor, MI USA
Response:
- Hide quoted text — Show quoted text – Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA Intriguing point, Larry. I had a well qualified allergist last year put me on Prilosec for a month for exactly that reason, to see whether I had GERD based upon my level of spirometer improvement after the Prilosec. She concluded that I did not have GERD. Fortunately a subsequent pulmonary physician ordered a barium swallow which showed a lovely hiatal hernia and significant GERD. Back on Prilosec and much happier; I wonder whether there is a train of thought in the medical community that thinks as the allergist does. pavane Prilosec, as a drug that lowers gastric acid secretion, may well ameliorate the symptoms of heartburn that accompany GER, but that is not the prime consideration when we are talking about pulmonary problems: there, the mechanism has to do with aspiration of stomach contents that have refluxed into the esophagus, usually while you are recumbent. It makes no difference whether you have acid reflux symptoms, and the absence (or presence) of these does not tell whether GER might be contributing to asthma. I am pleased that you feel better now, with a good diagnosis and Prilosec. I wonder if you are carrying out any other anti-GER measures. — Larry Preuss Ann Arbor, MI USA
No, the only other measure that I am aware of is the raising of the head of the bed but to do that I would have to scrap a quite lovely existing combination bedframe/side table combination that is both very heavy and quite nice. Are there other things that can be done other than the bed raising? Thanks… pavane
Response:
In most patients with GERD, a therapeutic trial of a proton pump inhibitor (Prevacid or Prilosec) can help establish whether symptoms are a result of GERD. To do this though you need relief of symptoms with the medicine and return of symptoms when the medicine is discontinued. Other measures certainly help GERD but usually not with the effectiveness of the medicines. The patients still reflux but they don’t reflux acid which is the cause of most symptoms discussed here (alt.support.asthma). Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER.
– Don Elton Columbia, SC http://www.midcarolina.org
Response:
Try getting several large pillows to sleep on to raise your upper body an eqivalent amount Tim
– Hide quoted text — Show quoted text – Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA Intriguing point, Larry. I had a well qualified allergist last year put me on Prilosec for a month for exactly that reason, to see whether I had GERD based upon my level of spirometer improvement after the Prilosec. She concluded that I did not have GERD. Fortunately a subsequent pulmonary physician ordered a barium swallow which showed a lovely hiatal hernia and significant GERD. Back on Prilosec and much happier; I wonder whether there is a train of thought in the medical community that thinks as the allergist does. pavane Prilosec, as a drug that lowers gastric acid secretion, may well ameliorate the symptoms of heartburn that accompany GER, but that is not the prime consideration when we are talking about pulmonary problems: there, the mechanism has to do with aspiration of stomach contents that have refluxed into the esophagus, usually while you are recumbent. It makes no difference whether you have acid reflux symptoms, and the absence (or presence) of these does not tell whether GER might be contributing to asthma. I am pleased that you feel better now, with a good diagnosis and Prilosec. I wonder if you are carrying out any other anti-GER measures. — Larry Preuss Ann Arbor, MI USA No, the only other measure that I am aware of is the raising of the head of the bed but to do that I would have to scrap a quite lovely existing combination bedframe/side table combination that is both very heavy and quite nice. Are there other things that can be done other than the bed raising? Thanks… pavane
Response:
- Hide quoted text — Show quoted text – I have been experiencing very thick secretions down near my vocal cords for approximately six years. The problems are exacerbated by eating and drinking, and cause me to have the urge to constantly clear my throat. If I don’t, my voice becomes garbled due to the mucous. I have been diagnosed with asthma and have had allergy tests which show that I am allergic to most everything (dust, mites, trees, grasses, mold etc.). I have been on shots for over one year, and don’t notice any appreciable improvement. I have also tried just about every conceivable Rx including Claritin, Zyrtec, Provental, many steriod nasal sprays, and a mucous thinner. Nothing seems to help. —cut—– Since you mention it’s worse with food or drink, has GE reflux been considered. GE reflux can trigger or worsen asthma due to reflux being aspirated into lungs. Treatment includes elevating head of bed 6-8" with wood blocks, no meals near bedtime, drugs like omeprazole and H2 blockers. A gastroenterologist can diagnose GERD. Your ENT seems to think it’s postnasal drip? This would tend to indicate sinusitis or rhinitis. These can worsen asthma due to postnasal drip getting into lungs. Not sure how effective an operation for deviated septum would be. The emphasis should be on controlling any post nasal drip with nasal sprays, saline wash, etc. Links: http://www.ama-assn.org/special/asthma/treatmnt/updates/gerd.htm Asthma and Gastroesophageal Reflux Disease-GERD Nov ‘97 JAMA http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis 11-97 JAMA Ellis: Thanks for your post and the links to JAMA. I neglected to mention that my allergist has attempted to treat possible GERD by prescribing Prilosec. I took it for about one week and did not see any difference. That is what is so frustrating about my symptoms, nothing seems to relieve them. Frankly, I can live with the asthma, but the mucous in my throat is driving me CRAZY.
One week on Prilosec is not sufficient treatment to rule out GERD. The following link from AMA indicates 12 week therapy needed. Somtimes surgery is needed. More links: http://www.vh.org/Providers/ClinGuide/AsthmaIM/comp2/Control.html#Gas… Reflux "Medical management of gastroesophageal reflux should be instituted for any patients with asthma complaining of frequent heartburn or pyrosis, particularly those with frequent episodes of nocturnal asthma. Medical management of gastroesophageal reflux includes: Avoiding food and drink within 3 hours of retiring (Nelson 1984) Elevating the head of the bed on 6- to 8-inch blocks (Nelson 1984) Using appropriate pharmacologic therapy (Hixson et al. 1992) For patients who have persistent symptoms following optimal therapy, further evaluation is indicated. For patients with poorly controlled asthma, particularly with a nocturnal component, investigation for gastroesophageal reflux may be warranted even in the absence of suggestive symptoms (Irwin et al. 1989). The symptoms of gastroesophageal reflux are common in both children and adults with asthma (Nelson 1984). Reflux during sleep can contribute to nocturnal asthma (Martin et al. 1982; Davis et al. 1983). Both medical (Ekstrom et al. 1989) and surgical (Perrin-Fayolle et al. 1989) therapy of gastroesophageal reflux have been reported to reduce the symptoms of asthma. " http://www.njc.org/MFhtml/GER_MF.html Gastroesophageal Reflux 1994., NJC http://www.ama-assn.org/special/asthma/library/readroom/40894.htm Gastroesophageal Reflux Disease and Asthma Diagnosis and Management JAMA Excerpt: "Summary Gastroesophageal reflux occurs commonly in asthmatics and, in selected patients, appears to contribute to the state of bronchospasm. The contribution of GER to the inflammatory state associated with asthma remains to be adequately evaluated. The mechanism by which GER potentiates bronchoconstriction is likely multifactorial, with the asthma itself worsening reflux, leading to a vicious cycle. Association of reflux with asthma should be sought in patients who describe reflux-associated respiratory symptoms, a worsening of asthma after meals or reclining, nocturnal asthma, asthma worsened by bronchodilator therapy, or after the new development of intrinsic asthma in an adult. Ambulatory pH monitoring allows documentation of GER and correlation with respiratory symptoms and is the diagnostic test of choice. Furthermore, repeated monitoring allows confirmation of the efficacy of medical therapy. If suspicion remains high despite a negative pH study result, endoscopy or barium studies may be indicated. A trial of medical antireflux therapy requires an adequate dose of acid-suppressive therapy (omeprazole or H2RA) taken for at least 12 weeks. If asthma improves with the treatment of GER, and the patient is a suitable candidate, antireflux surgery should be considered. " Ellis
Response:
Does an upper GI or barium swallow always show GERD if it is present? I have many symptoms of GERD, but had an upper GI in 1997 that did not indicate reflux. Patrice
– Hide quoted text — Show quoted text – Thanks for the post and the links. I neglected to mention that my allergist has explored the possibility of GERD by prescribing Prilosec. I took the medication for about one week and didn’t notice any improvement. I have not tried to elevate the head of the bed. How would Prilosec establish the presence or absence of gastro-esophageal reflux? If you have not elevated the bed you have not investigated the possibility of GER. — Larry Preuss Ann Arbor, MI USA Intriguing point, Larry. I had a well qualified allergist last year put me on Prilosec for a month for exactly that reason, to see whether I had GERD based upon my level of spirometer improvement after the Prilosec. She concluded that I did not have GERD. Fortunately a subsequent pulmonary physician ordered a barium swallow which showed a lovely hiatal hernia and significant GERD. Back on Prilosec and much happier; I wonder whether there is a train of thought in the medical community that thinks as the allergist does. pavane
Response:
My ENT says secretions are less annoying when they are thinned down by drinking lots of water, eliminating substances with a diuretic effect (caffeine, coffee, tea, lemon, etc.) and avoiding medication like antihistamines which dry you up. It’s a very simple and basic therapy which worked for me. I am prone to sinus infections and found the increased water, combined with a regimen aimed at getting my sinuses to drain (expectorant, decongestant, steroid spray) works very well for me. I take antihistamines now only when my allergy symptoms go beyond stuffy head stuff. Good Luck! Adelle Stavis – Hide quoted text — Show quoted text – x-posted to alt.support.asthma I have been experiencing very thick secretions down near my vocal cords for approximately six years. The problems are exacerbated by eating and drinking, and cause me to have the urge to constantly clear my throat. If I don’t, my voice becomes garbled due to the mucous. I have been diagnosed with asthma and have had allergy tests which show that I am allergic to most everything (dust, mites, trees, grasses, mold etc.). I have been on shots for over one year, and don’t notice any appreciable improvement. I have also tried just about every conceivable Rx including Claritin, Zyrtec, Provental, many steriod nasal sprays, and a mucous thinner. Nothing seems to help. My sinuses are clear on the CT scan (although I do have a severly deviated septum on one side). The ENT doc wants to operate to correct this problem and thinks that it may help alleviate some of my problem, but I am skeptical. Does anyone out there experience these symptoms, and if so, what helps?? Since you mention it’s worse with food or drink, has GE reflux been considered. GE reflux can trigger or worsen asthma due to reflux being aspirated into lungs. Treatment includes elevating head of bed 6-8" with wood blocks, no meals near bedtime, drugs like omeprazole and H2 blockers. A gastroenterologist can diagnose GERD. Your ENT seems to think it’s postnasal drip? This would tend to indicate sinusitis or rhinitis. These can worsen asthma due to postnasal drip getting into lungs. Not sure how effective an operation for deviated septum would be. The emphasis should be on controlling any post nasal drip with nasal sprays, saline wash, etc. Links: http://www.ama-assn.org/special/asthma/treatmnt/updates/gerd.htm Asthma and Gastroesophageal Reflux Disease-GERD Nov ‘97 JAMA http://www.ama-assn.org/special/asthma/treatmnt/updates/sinus.htm Asthma and Sinusitis 11-97 JAMA Ellis: Thanks for your post and the links to JAMA. I neglected to mention that my allergist has attempted to treat possible GERD by prescribing Prilosec. I took it for about one week and did not see any difference. That is what is so frustrating about my symptoms, nothing seems to relieve them. Frankly, I can live with the asthma, but the mucous in my throat is driving me CRAZY. Before you buy.
Response: