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Silent reflux or laryngopharyngeal reflux (LPR)?


Sionevar

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I came off Ciprelex completely near the end of March 2018.

 

A week or so later, I caught the cold that was then doing the rounds at my office. It was a HORRIBLE cold - a week of aches and chills, then a week of sinus and chest congestion. The cold eventually went away, but the sinus congestion didn't, and I'm STILL dealing with horrendous post-nasal drip.

 

While I was on Ciprelex, I would occasionally wake up during the night feeling like my throat was clogged up. I would have to swallow several times to clear the block, or in bad cases, get up to take a drink of water. This didn't happen very often - maybe once every couple of months, and I don't recall it ever happening before I started taking the medication.

 

I just found out about something called silent reflux or LPR, where post-nasal drip isn't due to what's coming DOWN out of your sinuses, but what's coming UP out of your stomach. 

 

I know I probably sound like I'm grasping at straws here, but is it possible being on / coming off Ciprelex has triggered silent reflux? 

 

All the medical sources I've read say that if the PND starts out of the blue when you have a cold, instead of being a slow-developing thing, it's probably a sinus problem. But none of the sinus treatments I've taken so far have worked, and it was actually only this week that I remembered having the throat clogging moments. Were those throat clogging moments actually the early stage of silent reflux, and coming off Ciprelex somehow made it worse?

 

If anyone has any input to offer, I'd love to hear it. I'm at the end of my tether with the PND.

2016 = 5mg Ciprelex per day
2017 = 2.5mg per day for 4m, 2.5mg every 2nd day for 4m, 2.5mg every 3rd for 4m
2018 = 2.5mg every 4th day for 3m, stopped drugs in March 

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It is definitly possible. I think I am dealing with this. I thought it was histamine issues but from what I can tell I too had the clagging throat thing. It was quite scary and I often feel dyspepsia which is another symptom of reflux, usual culprits make it worse, dairy, caffeine, etc. Try fasting and having a bland diet. I try not to eat too close to bed time either. I also have the post nasal drip thing which isnt related to a particular food but gets worse with dairy. 

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  • Altostrata changed the title to Silent reflux or laryngopharyngeal reflux (LPR)?
  • 1 year later...

Not sure if there’s a topic on this specific symptom already but I couldn’t find one. I’ve been dealing with what I thought was just a lump in the throat but now I believe it might be silent reflux. I have pretty much all the of symptoms of silent reflux and it has been awful. My appetite has been decreased, I feel like I have to constantly clear my throat, I feel nauseous, and also have trouble swallowing. I started this topic hoping to see if others have dealt or are dealing with this

Adepsique: January 2016 - July 2016 (took half a pill in the mornings for 6 months) the dosage was 5 mg of amitriptyline, 1.5 mg of diazepam, and 1 mg of perphenazine 

 

Escitalopram: 10 mg: July 2016 - April 2018

Olanzapine 2.5mg: July 2016 - October 2017

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Yeah I think I get that, SSRIs seem to make it worse. Or they did when I first started on them, after being on them a while it calmed down. Do you have extra bad something died breath in the morning? A feeling like there's something rotting in your sinuses? I honestly don't know what I did to make it go away, but it's mostly not bothering me now. But maybe it just went from obvious GERD to silent reflux again. I think chewing fennel seeds and ginger did help, as well as sleeping with my head and neck more elevated than normal. And avoiding going to sleep for a few hours after eating. Melatonin might help with esophageal sphincter tone, but it makes me groggy if I take it more than a couple times a week.

2018/7 Started on lamotrigine (12.5 mg) and escitalopram (2.5 mg). Tapered up over the course of a month to 50 mg LTG, 10 mg escit. Kept tapering LTG up to 75 mg by 2018/10. 2018/11 Crosstapered from escitalopram to sertraline. 2018/12 Was still taking both SSRIs (escit. 5 mg, sert. 25 mg) when sert. was discontinued to trial quetiapine. Quet. tapered up to 25 mg, but tapered back down after 3 days on the full dose because side effects. Total time on quetiapine 10 days. Switched back to cross tapering esit. and sert., started tapering LTG up to 100 mg.
 
2019/1 Lamotrigine 100 mg, sertraline 12.5 mg, escitalopram 5 mg. Finally discontinued escit. and on full dosage of sertraline (25 mg) 2019/04.
 
2019/11 About two weeks of sertraline 12.5 mg, but went back up to 25 mg.
2019/12/4 Lamotrigine taper: too fast, down to 25 mg over the course of about 10 days. Also started increase sertraline 37.5 mg during luteal phase of menstrual cycle for PMDD.
 
2020/(early) on 22 mg lamotrigine for a while, maybe a month and a half, maybe longer, then 2020/03 Institutionalized for self harm. I think I was trying to taper the sertraline at the time, don't remember the details. Doses increased: Sertraline 50 mg/lamotrigine 25 mg (current regimen). Supposed to be taking seroquel and abilify (TWO antipsychotics?!) but didn't take any once I was discharged from the institution. (Was on them a few days.)
________________________________________________________
2001(?) Citalopram, don't remember dosage, cold turkey after a couple months and had terrible withdrawals, including what in retrospect was probably PAWS for the next five or so years. (agoraphobia, crippling social anxiety, anhedonia, dp/dr).
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@readyfortheworld @bottlehalffull Not everything is caused by drugs. You might have some other condition, or indigestion or a food sensitivity.

 

Please investigate further with Dr. Google, on specialized forums, or with a gastroenterologist, we can't counsel about general medical conditions here.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I was pretty brain foggy and in pain yesterday so I think I wasn't very clear. I'm not blaming SSRIs for my reflux (and don't think @readyfortheworld is either). I have various digestion problems, not SSRI related. I've been having frequent reflux on and off the past year or two (or fluctuating from none to silent to full burning), but it spiked majorly when I went on lamotrigine and escitalopram, and also spiked when I switched from escitalopram to sertraline. Since then it's calmed a lot, but there are still mornings when I know I did something wrong with my diet or something the day before because of the GERD/LERD symptoms. I'm still on the sertraline. I'm still more sensitive to reflux triggers than before SSRIs. But I can take sertraline on an empty stomach now without feeling the major acid burn I felt when I started it (though it's still not a great idea).

 

@readyfortheworld you can feel free to message me if you want to talk about this gut stuff and it's not considered on topic. For me, it probably isn't caused by being on and off antidepressants, but certainly can be influenced by it. (But from your sig it looks like you're not on any right now?)

 

One of the most important tidbits I have about silent reflux is: it's silent because it's not the stomach acid that's being popped up to the back of the throat/sinus/tonsils, it's enzymes and other stomach juices. Because it's not just acid, all the typical antacid stuff (baking soda, PPIs, etc) don't really do anything.

2018/7 Started on lamotrigine (12.5 mg) and escitalopram (2.5 mg). Tapered up over the course of a month to 50 mg LTG, 10 mg escit. Kept tapering LTG up to 75 mg by 2018/10. 2018/11 Crosstapered from escitalopram to sertraline. 2018/12 Was still taking both SSRIs (escit. 5 mg, sert. 25 mg) when sert. was discontinued to trial quetiapine. Quet. tapered up to 25 mg, but tapered back down after 3 days on the full dose because side effects. Total time on quetiapine 10 days. Switched back to cross tapering esit. and sert., started tapering LTG up to 100 mg.
 
2019/1 Lamotrigine 100 mg, sertraline 12.5 mg, escitalopram 5 mg. Finally discontinued escit. and on full dosage of sertraline (25 mg) 2019/04.
 
2019/11 About two weeks of sertraline 12.5 mg, but went back up to 25 mg.
2019/12/4 Lamotrigine taper: too fast, down to 25 mg over the course of about 10 days. Also started increase sertraline 37.5 mg during luteal phase of menstrual cycle for PMDD.
 
2020/(early) on 22 mg lamotrigine for a while, maybe a month and a half, maybe longer, then 2020/03 Institutionalized for self harm. I think I was trying to taper the sertraline at the time, don't remember the details. Doses increased: Sertraline 50 mg/lamotrigine 25 mg (current regimen). Supposed to be taking seroquel and abilify (TWO antipsychotics?!) but didn't take any once I was discharged from the institution. (Was on them a few days.)
________________________________________________________
2001(?) Citalopram, don't remember dosage, cold turkey after a couple months and had terrible withdrawals, including what in retrospect was probably PAWS for the next five or so years. (agoraphobia, crippling social anxiety, anhedonia, dp/dr).
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Hello @bottlehalffull, I actually do wake up with really bad breath in the morning. I don’t know about something rotting in my sinuses but I feel like I have constant mucus in my throat. I also tend to burp a lot. I’m not sure if we can post links on here but I found this website that explains the different symptoms related to silent reflux. https://www.refluxgate.com/lpr-symptoms I deal with most of those symptoms on a daily basis. Anxiety seems to make it worse.  

 

Are you also dealing with stomach issues as well or was the silent reflux separate? Did the silent reflux affect your appetite? 

Adepsique: January 2016 - July 2016 (took half a pill in the mornings for 6 months) the dosage was 5 mg of amitriptyline, 1.5 mg of diazepam, and 1 mg of perphenazine 

 

Escitalopram: 10 mg: July 2016 - April 2018

Olanzapine 2.5mg: July 2016 - October 2017

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I tried to post this after @Altostrata's reply a couple days ago, but for some reason my post is in hidden post limbo.

 

I was pretty brain foggy and in pain yesterday so I think I wasn't very clear. I'm not blaming SSRIs for my reflux (and don't think @readyfortheworld is either). I have various digestion problems, not SSRI related. I've been having frequent reflux on and off the past year or two (or fluctuating from none to silent to full burning), but it spiked majorly when I went on lamotrigine and escitalopram, and also spiked when I switched from escitalopram to sertraline. Since then it's calmed a lot, but there are still mornings when I know I did something wrong with my diet or something the day before because of the GERD/LERD symptoms. I'm still on the sertraline. I'm still more sensitive to reflux triggers than before SSRIs. But I can take sertraline on an empty stomach now without feeling the major acid burn I felt when I started it (though it's still not a great idea).

 

@readyfortheworld you can feel free to message me if you want to talk about this gut stuff and it's not considered on topic. For me, it probably isn't caused by being on and off antidepressants, but certainly can be influenced by it. (But from your sig it looks like you're not on any right now?)

 

One of the most important tidbits I have about silent reflux is: it's silent because it's not the stomach acid that's being popped up to the back of the throat/sinus/tonsils, it's enzymes and other stomach juices. Because it's not just acid, all the typical antacid stuff (baking soda, PPIs, etc) don't really do anything.

 

Reflux, silent or not, does affect appetite. (Any weird feeling in my throat affects my appetite.) Sometimes it's hard to tell the difference between silent reflux and sinus issues/allergies though, since the refluxed digestive enzymes hanging out in your sinuses can actually trigger an allergic type response. The supposed mechanism is gas bubbling up from your stomach propelling enzymes, so burping a lot would sound like it goes right along with it.

 

When I feel like it's bothering me a lot, I do saline nasal rinses before bed (or sometimes multiple times a day) and do all the anti reflux not going to bed until a few hours after eating, sleeping with my head propped up, etc. It takes a while to start noticing a difference, because the throat/sinus tissues have to heal. The goal is to keep the digestive enzymes from digesting my throat. Oh, also chewing gum after meals can help, since it makes you make saliva that you're constantly swallowing and rinse the esophagus with. NOT mint gum though, mint relaxes the esophageal sphincter. I go for fruit or "bubble gum" flavored gum. I think chewing fennel seeds does the same thing, but I guess the flavor and texture of fennel seeds aren't for everyone. (And they might also affect a sensitive brain unpredictably.)

2018/7 Started on lamotrigine (12.5 mg) and escitalopram (2.5 mg). Tapered up over the course of a month to 50 mg LTG, 10 mg escit. Kept tapering LTG up to 75 mg by 2018/10. 2018/11 Crosstapered from escitalopram to sertraline. 2018/12 Was still taking both SSRIs (escit. 5 mg, sert. 25 mg) when sert. was discontinued to trial quetiapine. Quet. tapered up to 25 mg, but tapered back down after 3 days on the full dose because side effects. Total time on quetiapine 10 days. Switched back to cross tapering esit. and sert., started tapering LTG up to 100 mg.
 
2019/1 Lamotrigine 100 mg, sertraline 12.5 mg, escitalopram 5 mg. Finally discontinued escit. and on full dosage of sertraline (25 mg) 2019/04.
 
2019/11 About two weeks of sertraline 12.5 mg, but went back up to 25 mg.
2019/12/4 Lamotrigine taper: too fast, down to 25 mg over the course of about 10 days. Also started increase sertraline 37.5 mg during luteal phase of menstrual cycle for PMDD.
 
2020/(early) on 22 mg lamotrigine for a while, maybe a month and a half, maybe longer, then 2020/03 Institutionalized for self harm. I think I was trying to taper the sertraline at the time, don't remember the details. Doses increased: Sertraline 50 mg/lamotrigine 25 mg (current regimen). Supposed to be taking seroquel and abilify (TWO antipsychotics?!) but didn't take any once I was discharged from the institution. (Was on them a few days.)
________________________________________________________
2001(?) Citalopram, don't remember dosage, cold turkey after a couple months and had terrible withdrawals, including what in retrospect was probably PAWS for the next five or so years. (agoraphobia, crippling social anxiety, anhedonia, dp/dr).
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Thanks for this post @bottlehalffull. It’s insightful and it showed me things I didn’t even think were related. I’ll message you right now 

Adepsique: January 2016 - July 2016 (took half a pill in the mornings for 6 months) the dosage was 5 mg of amitriptyline, 1.5 mg of diazepam, and 1 mg of perphenazine 

 

Escitalopram: 10 mg: July 2016 - April 2018

Olanzapine 2.5mg: July 2016 - October 2017

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  • 1 month later...
On 12/17/2019 at 9:08 PM, readyfortheworld said:

Hello @bottlehalffull, I actually do wake up with really bad breath in the morning. I don’t know about something rotting in my sinuses but I feel like I have constant mucus in my throat. I also tend to burp a lot. I’m not sure if we can post links on here but I found this website that explains the different symptoms related to silent reflux. https://www.refluxgate.com/lpr-symptoms I deal with most of those symptoms on a daily basis. Anxiety seems to make it worse.  

 

Are you also dealing with stomach issues as well or was the silent reflux separate? Did the silent reflux affect your appetite? 

 

I have all of this too.

 

Mucus throat, constant throat clearing....etc.,

Dose History: 19 Feb 2014 - Escitalopram 10mg daily June 2015 - Started taper, 5mg every other day July 2015 - 5mg every 2 days August 2015 - 5mg every 3 days September 2015 - 5mg every 4 days Sept 14th - Completed tapering, but at 7 weeks "drug free" I suffered serious WD symptoms as a consequence of "incorrect" tapering. Nov 25 2015 - Re-instated Cipralex @ 2.5mg daily. WD symptoms faded. Held at this dose and experienced "windows and waves". 12 Oct 2017 Reduced dose to 1.25mg. 13 Mar 2018 Reduced dose to 0.625mg (approx.). 16 April 2018 0mg. Windows and waves triggered by stress (IBS/reflux, headaches, sinus issues) Aug 2019 Mirena coil fitted 6 Jan 2020 MAJOR Wave hit 19 months following last dose (protracted WD).  Symptoms listed below Mar 2020 Mirena coil removal.

Therapy: Nov 15th 2016 Re-started therapy Jan 19th 2017 Started CBT Dec 2017 Started listening to Hypnotherapy CD (self-esteem). Nov 2019 Started couples therapy.

Supplements: "Bioglan" Biotic Balance Ultimate Flora 10 billion CFU, live Bacteria, Probiotic, suitable for Vegetarians, with Lactobacillus Acidophilus, Lactobacillus Rhamnosus, Bifidobacterium Longum"Pukka" Vitalise a unique blend of 30 energising botanicals.

Diet: 16 April 2018 Detox cleanse / anti-candida for 90 days. Jan 2020 Started "small plate" diet (i.e child size portions).

Exercise: Stretching, Yoga, Pilates, Spinning, Elliptical/upper body workout, walking.

Medical Test Results: 4 Jan 2017 Homeopathic Treatment starts 24 Feb 2017 Started weight loss program 24 Mar 2017 Naturopathic Treatment + anti-Candida diet started due to suspected Candida Related Complex (CRC). DETOXED for 7 weeks to "re-set" gut. April 2017 "Genova Diagnostics" Comprehensive Stool Analysis NEGATIVE; Full Blood Count (Normal) / Blood Cholesterol: 5.6 (Borderline) / Blood Sugar (Normal) / 28 Jun 2017 FSH 8.2 / 14 Nov 2017 FSH 17.7 Dec 2017 Blood Cholesterol: 3.9 (Normal) / Kidney Function (Normal) / Blood Sugar (Normal). December 2017 "Genova Diagnostics" Food panel allergy (bloodwork) analysis - a few "VERY LOW/VL" allergens; Mar 2018 "Genova Diagnostics" SIBO urine analysis: High Level of Yeast/fungal markers found in small intestine but NO SIBO.  April 2018 Thyroid (Normal) / Full Blood Count (Normal) / FSH (Normal). 16 April 2018 Started anti-Candida diet - 3 month protocol.   25 March 2020 All test results "Normal". CRP" 5 mg/L (normal range to 0-5 mg/L).

Symptoms:  Flu-like symptoms, anxiety, anhedonia, sinus headaches right-side (severe), IBS issues/reflux (severe)**, tinnitus, fatigue, inner tremor, nausea, chills/hot flushes, pounding heart, muscular issues including stiff left hip flexor, intense anger, PSSD (ongoing).  **Histhamine intolerance (suspected).

Major Life Events: 

Re-located to UK from Canada: Jan 2016

My father died: 5:05pm, Monday 5 Feb 2018 Last Lexapro dose: 16 April 2018 (its now been over a year since I quit ADs)  Moved house: Friday 23rd February 2018  "Divorced" toxic Mother: Monday 26 March 2018 Starting working again: 19 November 2018  Diagnosed with: 5th August 2021 PTSD/C-PTSD Diagnosed with: March 2022 Interstitial Cystitis (IC)/Painful bladder syndrome

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  • 2 years later...
On 2/19/2020 at 1:48 PM, Junglechicken said:

 

I have all of this too.

 

Mucus throat, constant throat clearing....etc.,

 

has it gone away for you?

April 2022- Only 1 celxa pill 10mg

had an adverse reaction & never took anymore again 

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  • 7 months later...
On 9/2/2018 at 1:35 PM, historygal said:

It is definitly possible. I think I am dealing with this. I thought it was histamine issues but from what I can tell I too had the clagging throat thing. It was quite scary and I often feel dyspepsia which is another symptom of reflux, usual culprits make it worse, dairy, caffeine, etc. Try fasting and having a bland diet. I try not to eat too close to bed time either. I also have the post nasal drip thing which isnt related to a particular food but gets worse with dairy. 


has this gone away for you, the lpr symptoms? @historygal

April 2022- Only 1 celxa pill 10mg

had an adverse reaction & never took anymore again 

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  • 5 months later...
On 2/28/2023 at 7:38 PM, peaceandlove said:


has this gone away for you, the lpr symptoms? @historygal

 

2006-2007 Lexapro (not sure of dose) in 2006

2007 Stopped abruptly. Developed serious wd symptom.Went back after two weeks and  tapered successfully over 3 months

November 2013  started 10 mg of Celexa for hormonal symptoms

early 2014 cutdown Celexa to 5 mg.Attempted to get off it November 2014 and had  

Anxiety increased  every time I used  an OTC or had stress.

April-May Cortisol spike problems 

July 2016 Started taking liquid Celexa 7.5 mg

June 2021 I finished my taper en

Severe anxiety and insomnia

June 2022 symptoms omproved

July 2023 gut issues and sleep issues contnue

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I read this thread with interest. I hace what I thought was hustemin3 sensitivity but seems to be dilent reflux. This only happened as I was tameri g from ADs abd after stopping altogethet. I am pretty sure is related ti wd as I never had anything like 5hus before in my lu

ife before. I came up Positive fir SIBO C and this kind if dysbiosis can cause acid reflux. Interestingly enough I have sleep issues still (caused by AD wd as I never had them before) and this affects my digestion and increases my silent reflux. I am getting ready to try some probiotics (slowly) and possibly HCL. Anyone has any experience with this? @historygal and @peaceandlove and @Junglechicken

2006-2007 Lexapro (not sure of dose) in 2006

2007 Stopped abruptly. Developed serious wd symptom.Went back after two weeks and  tapered successfully over 3 months

November 2013  started 10 mg of Celexa for hormonal symptoms

early 2014 cutdown Celexa to 5 mg.Attempted to get off it November 2014 and had  

Anxiety increased  every time I used  an OTC or had stress.

April-May Cortisol spike problems 

July 2016 Started taking liquid Celexa 7.5 mg

June 2021 I finished my taper en

Severe anxiety and insomnia

June 2022 symptoms omproved

July 2023 gut issues and sleep issues contnue

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  • 10 months later...

,i derinf

On 8/18/2023 at 10:29 PM, gn11 said:

 

 

On 2/28/2023 at 7:38 PM, peaceandlove said:


has this gone away for you, the lpr symptoms? @historygal

It has been awhile since I posted here. Still having LPR. Have you resolved the issue?

2006-2007 Lexapro (not sure of dose) in 2006

2007 Stopped abruptly. Developed serious wd symptom.Went back after two weeks and  tapered successfully over 3 months

November 2013  started 10 mg of Celexa for hormonal symptoms

early 2014 cutdown Celexa to 5 mg.Attempted to get off it November 2014 and had  

Anxiety increased  every time I used  an OTC or had stress.

April-May Cortisol spike problems 

July 2016 Started taking liquid Celexa 7.5 mg

June 2021 I finished my taper en

Severe anxiety and insomnia

June 2022 symptoms omproved

July 2023 gut issues and sleep issues contnue

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