Have you had a problem with
GastroEsophageal Reflux Disease?
John Haedtler, New Mexico, USA - 2001
Only one comment! York Peppermint Patties.
Those got me through finding the right GERDS meds! Which was Prilosec OTC.
Just over 10 years now and I still keep them in my house!
Dave Ross, FL - 2005
Ahh yes, GERD, one of my favorite subjects!
In early 2001 my GP surmised (I use the word “surmised” because he performed no tests or examinations to substantiate his “diagnosis”) that I was hoarse because I had GERD and he, without further ado, put me on a daily regimen of Prilosec. Fortunately, just a few short weeks later I had my four year follow up visit with my surgeon who had removed my right upper lobe to rid my lungs of a malignant tumor. When I said “hello Doc” he asked why I was hoarse and I told him what my GP had surmised. He said that because of my history he had to “prove that I did not again have cancer” and immediately scheduled me for a bronchoscope which revealed the tumor on my right vocal cord and the biopsy which showed it to be the Big C. The following radiation seemed to work but in 2005 it was back and resulted in my total laryngectomy.
Having been a two pack a day smoker for fifty years, no one ever suggested that some other factors may have also been a player in the loss of my voice box. But as I have had the time to speculate I have come to realize that my use of tobacco may not have been the only culprit!! Consider:
1) In my thirties I developed a “self-extinguishing” fiber glass resin formula during which time I repeatedly inhaled smoke that I later was advised had been found to be carcinogenic;
2) in my teens and twenties I did a considerable amount of automotive maintenance/repair which frequently involved brake work and can recall thinking nothing of breathing in the asbestos dust therefrom;
3) All of my adult life I often had irregular work hours, frequently would eat a large late night dinner and immediately retire for the night; 4) I often had “heartburn”, or as it was sometimes referred to “indigestion”, but in those days that just seemed to be part of life -- no big deal.
Now I wonder -- was it no big deal?? I am, and have been for the past twelve years, on a regimen of two Prilosec caps daily without which I will suffer nightly GERD.
I am now convinced that GERD may have been as much a factor in my Laryngeal cancer as tobacco. Oh, or was it the asbestos -- or the FRP resin additives?
Oh, I also forgot to mention my regular daily consumption of rum and coke which also added to the GERD factor. I could go on and on, but I love greasy foods, have always eaten more than I should so I’ll just say that in my case GERD is likely a major player!!!
Len A.Hynds, The Speechless Poet of AShford, Kent, England - 2004
The first time I realised how different my life would be, with regard to eating and drinking, was immediately after my first valve change. I was so pleased at no longer leaking, that I took a long draught of cooling liquid, marvelling at the sheer joy at the feeling it gave, descending towards the stomach. Quite like old times I told myself. Almost immediately I could feel and sense a build-up, as if my oesophagus was violently rejecting it, and as it rose up, with what it seemed the speed of a bullet, I closed my mouth tightly, only to find the whole glass of liquid pouring out of both nostrils, much to my disgust and the shock of my wife.
I soon realised that with the re-plumbing, my gullet was so much smaller, taking me ages to chew food smaller before swallowing, and I had no epiglottis. If I ate too quickly, that would push the acids into the oesophagus (those very essential acids which break-up our body intake), upwards into the back of the throat, causing a terrible burning to the soft tissues. So the answer was, eat and drink slowly.You soon learn not to lay in the prone position just after drinking anything.
That was in 2004, but I had already slept on my own for the previous ten years, as in 1994, I had fitted American Self-Cleaning Heart Valves, and for quite a few years their night time ticking (terribly loud) was disturbing the wife. I have had them in for 19 years, and never a days trouble. Thank-you America!
Terry Duga, Indianapolis, IN - 1995
I have been taking an acid blocker for a number of years. I was put on Prilosec after my partial laryngectomy in 1993. I kept on it until Prilosec went generic and insurance stopped paying for it. I now take Zantac.
Linda Palucci, FL - 2002
I take 1 omeprazole in the morning and the heartburn problem is eliminated.
Marlene Haynes - 1996
I was diagnosed with acid reflux after my laryngectomy. They were testing me for swallowing problems after my surgery and I was prescribed Gavascon, four per day, two in the am and two in the evening. That was in 1996 and sometime in between then and now I was prescribed Prilosec (omeprazole). I still take it twice a day every day.
The doctor asked me how long I'd had acid reflux, my answer was I never knew I had it until now.... Everytime they give me the swallow test the stuff backs up. I've never been told why, hope I can learn about this here. I try to stay away from acid foods and keep taking my medicine.
Lynn Foti, Akron, OH - 2009
I never had acid reflux prior to losing my larynx and esophagus. After I was allowed to eat again, my ENT said I had acid reflux and would have to take medicine for it, probably for the rest of my life. I always thought it was because he had to construct a new esophagus for me from my inner forearm, but now I see most larys have it too.
It really doesn't bother me a lot except when I eat spicy food (which I love, since I am Sicilian). I am so grateful to be here and able to enjoy my son and friends and family, it is, like a lot of other things.... a small price to pay. In the greater scheme of things we larys deal with, it isn't too much. I am sometimes frustrated by coughing up mucus in a crowded place and the constant runny nose, but all those things can be tolerated. Am so enjoying my garden; have tomatoes and peppers already! My flowers, and just being alive. I know so many things can happen down the road, and I want to be sure to grab every bit of life I can while the grabbing is good.
Thanks to WebWhispers for all the information, comaraderie, and help; I feel like this site has made all the difference.
Bruce Turner, Brisbane Australia - 2004
I have suffered from GORD (Gastro-Oesophageal Reflux Disease) for most of my adult life. I was diagnosed with a rare type of cancer, Chondrosarcoma, in my larynx in early 2004.
I had a lot of trouble with food intake via Nasal Gastro Tube after my total Laryngectomy. I couldn't keep any food down, and lived on milk for three (3) weeks !
I was then diagnosed with Barrett's Oesophagus (without Dysplasia), and had a Laparoscopic Fundoplication operation in 2005. This operation helped a lot to reduce my reflux, but I still take 40 mg Pantoprazole (Somac) of each day .
Carl Strand, Mystic CT - Radiation 1991, Laryngectomy 1993
I was diagnosed with gastric reflux disease and a hiatal hernia years before laryngectomy and have taken Prilosec or the generic equivalent for about twenty five years. I also have to sleep with a wedge or my bed elevated six inches at the head end.
In spite of all this, I have been diagnosed with Barrett's Esophagus, a premalignant change in the lower esophagus caused by acid reflux. I have gone to Prilosec twice daily to keep the reflux under control. My GI doctor is scheduling endoscopic exams annually to monitor the condition.
Frank Watkins, Greenfield Wi - 1985
I been cancer free ever since, thank the Good Lord for that. I had acid reflux almost from the outset of my surgery. Thought it was heartburn and had to live with it. After 3 years of pain and agony I finally mentioned it to my ENT, who casually said I was a fool for not saying anything sooner and he gave me a prescription for Prevacid.
Needless to say that did the trick, and I have been free of acid reflux ever since.
Lesson here, Let your docter know everything that bothers you.
Joe Hilsabeck, Edelstein, IL - 2009
I became a lary in 09 and had reflux for about 2 years, I used omeprazole with sucess. Doctor seemed to think in my case the feeding tube was the cause of some of it. It started to slowly improve over time, I now only use an antiacid occasionally, when I eat certain foods.
The biggest problem I have is if I bend over any time, reflux or bits of food will just run out of my mouth. I have learned to squat instead of bend. However, I didn't have a stomach pullup or a similar operation andmine now can be controlled by diet.
Pat Sanders, Birmingham, AL 1995
I was going to write about my history with acid reflux but I had written about it in 2001 for HeadLines, comparing before lary to after. So this is an update to Then and Now. I sleep on a slanted bed and use a wedge pillow, try not to eat at night... take a Prilosec about an hour before supper (If I miss it, I take it at bedtime)... and here is the story of how I learned about acid reflux:
ACID REFLUX – THEN & NOW by Pat Wertz Sanders
reprinted from Headlines, July 2001
A few days ago, I was preparing to write in to our online support group to continue the discussion about acid reflux and to make comments on what everyone said. Part of what I do in writing, editing HeadLines, and working on our web site information is to gather material and "put it together". I planned to mention again the "silent" reflux that several reported having prior to their throat cancer, when I was suddenly struck by how this affected me personally.
Before my laryngectomy, I had acid reflux - the kind that mostly didn't show and tell. I never had "heartburn". Back then, you didn't see the ads on "acid reflux" on TV telling you what it was and what to do about it. It was called "indigestion" or "heartburn" and they showed a figure with a glowing fire in the chest area. Tums or Rolaids were touted as the cure. And, it was something that everybody had! I never had that fire in the chest.
I would come in from my sales calls at varying times in the afternoon or evening, would check in with the office, make appointment calls, write reports, and then put it all aside until the next day. At that time, I would get comfortable, get my cigarettes out (I didn’t smoke during the day), fix a drink, and either get on the telephone with a friend, check out the news or start cooking supper. I did not realize that smoking, drinking, and eating late suppers, in addition to sleeping flat so gravity didn't help the acid to stay in my stomach, were creating a situation that was not good for me. I had acid washing up through my esophagus and into my throat at night and I didn't know it. I used to say I could eat anything and had a cast iron stomach… but it was sneaking up on me. I often had a sore throat and was hoarse but it would get better, so I blamed that on allergies and drainage or having to talk loudly over shop machinery. One night, I was awakened by a stomach spasm that gushed acid up like a geyser and by the time I jerked upright, it had hit the back of my nasal passages. Burned like hell. I was hoarse and had a sore throat for a week. This time I knew what caused it but I still didn't think about the other sore throats. Should I have gone to a doctor at that point? Yes. Did I? No. I was in denial that I had a problem other than that one time.
I think acid reflux was a contributing factor in my vocal cord cancer. That is my opinion. This is in addition to smoking and drinking, a deadly pair in which the combination is far more dangerous than either one alone. Until recently, very few doctors agreed with reflux being a causative factor, but now some are indicating there might be something to it. Looking at this from another viewpoint says it is not the acid reflux but the smoking and drinking that causes the cancer…along with aggravating acid reflux.
After my laryngectomy, I mentioned the reflux and was put on Prilosec. I took it regularly for a while but gradually cut back to every other day, then a couple of times a week and then, only when I needed it, and I didn't need it very often.
In the last couple of months, I have had an occasional problem with swallowing, not far down but seemingly at the back of my throat. Always in the morning. Synthroid, as small as it is, would stick a little before going down and once the water came up through my nose and the pill stayed in my throat. After I had sipped some coffee, it seemed to open up and I had no problem swallowing at breakfast or the rest of the day. This last week, it happened every morning. I could look in my throat and see swollen and slightly pinker tissues than usual and it felt like it does when you have sinus drainage...but there was nothing there. My throat felt just a little raw but no white patches, no fever. I hadn't a clue.
I was thinking about the acid reflux discussion when the lightbulb lit up over my head. I was having acid reflux at night again, when I didn't know or feel it. The acid was causing swollen tissues. Being upright during the day, gravity helped and it was not a problem although one day I did eat too fast and couldn't get the food down so I was probably having some swelling I couldn't see.
The day I realized what was likely happening, I took a Prilosec before supper and did again the next day. The third day, the morning pill went down easily. I will continue to do this to see if that ends my problem. I will also have an earlier supper...and cut out the ice cream snack right before bedtime so my stomach is not full. My bed is already raised on blocks, but I had been careless about the rest. I had my checkup last month and everything looked clear. But if this doesn't get rid of it totally, I'll see the doc for another look.
Who says we don't continue to learn? Many times has someone written to me to say...I already knew that, I just forgot? This just happened to me. I already knew. I forgot.
A few more comments.....
I received a note from David Arnaud, who said, "Yes, Pat, my Doc at MD listed acid reflux right there with tobacco use as major causes of cancer of vocal chords and voice box."
After the article above, I wrote more about the search for professionals who believed this. It was in this newsletter in 2004. I don't want to copy the entire article because some of the links are no longer working.
LPR - Laryngopharyngeal Reflux
After my laryngectomy, I asked a lot of questions about laryngeal cancer causes other than smoking or drinking. I wanted to know if breathing in acids or alkalis were a problem since I had been in a lot of contact with chemicals. I asked if stomach acid could be a cause and was told that it was a known cause of esophageal cancer but not of laryngeal cancer.
This never made sense to me since I knew I had awakened at night with a rush of acid coming up into my throat and sometimes even up behind and out of my nose. The next day, that whole area would burn, I would be hoarse, having to clear my throat and cough to clear the mucus. This area was a much more tender area than the esophagus. After the surgery, we raised the head of my bed and I took medication so it has been better.
I learned to talk and played with my new computer, installed the day I came in from the hospital, but I did not have a service provider until 6 months later. Even after I got Compuserve (with a limit of 5 hours a month!), there was no big Internet with a Google search engine in 1995. I learned to chase down information on the fairly new World Wide Web, in which you had to find a site that related to what you were looking for and from there try a connected (linked) site. I ran into a lot of dead ends in my searches and particularly so in my search for what happens when stomach acid hits the throat and vocal cords.
During all this time, I had been calling on patients at UAB Hospital and, in addition to teaching them to talk or showing them equipment and answering questions, I would always ask if they had been bothered by heartburn. Almost before I could get the question out, the caregiver would jump in to say, "Oh, Boy, does he ever! He ate TUMS all the time." I would always tell them to be sure the doctor knew about that because there were some one-a-day medicines that could help a lot and they did not want to start having acid come up into the new throat.
Finally, I found the Voice Center at Wake Forest University where there was a great deal of research and their conclusion was: there was a different kind of reflux, one that usually did not cause heartburn, and it did cause throat cancers. Then, I saw a brochure, put out by the drug company AstraZeneca with information developed by The Center For Voice Disorders of Wake Forest University and the Department of Otolaryngology, Bowman Gray School of Medicine. I rejoiced that the word was out.
Next, I found from the American Academy of Otolaryngology:
What is GERD?
Gastroesophageal reflux, often referred to as GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from "refluxing" or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up the esophagus.
When stomach acid touches the sensitive tissue lining the esophagus and throat, it causes a reaction similar to squirting lemon juice in your eye. This is why GERD is often characterized by the burning sensation known as heartburn.
In some cases, reflux can be SILENT, with no symptoms until a problem arises. Almost all individuals have experienced reflux (GER), but the disease (GERD) occurs when reflux happens on a frequent basis often over a long period of time.
What is LPR?
During gastroesophageal reflux, the acidic stomach contents may reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), and into the back of the throat and possibly the back of the nasal airway. This is known as laryngopharyngeal reflux (LPR), which can affect anyone. Adults with LPR often complain that the back of their throat has a bitter taste, a sensation of burning, or something "stuck." Some may have difficulty breathing if the voice box is affected.
At last, GERD and LPR was being recognized...