HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For LPR And GERD

Posted on Mon, 9 Feb 2015

Question: 5 years of GERD, done with nissen fundoplication in Aug 2009. I am having LPR diagonsed by ENT last month. I am a smoker 10 cigarettes a day and i have stopped smoking for last one of the month. i dont have any cough.

I had the following symptoms when i went to the doctor -

Hoarseness, mucus stuck in the throat, morning thick mucus, mucus from roof of the mouth with blood streaks mainly in the morning,

after having PPI's my symptoms are better, but i see fresh streak of blood in the mucus that comes from roof of the mouth. i also see very less blood in my nose when i try touch with my finger. let me know what this could be?

Answered by Dr. Dr. Klerida Shehu (59 minutes later)

Brief Answer:
Following advice on managing LPR...

Detailed Answer:
Hi,

I have gone through your medical history carefully and am sorry for the situation you are in.

The streaks of blood with mucus are consequences of LPR (laryngopharyngeal reflux). The mucosa of upper respiratory tract (mouth, pharynx, laryngx) has become more fragile due to hyperacidity of the stomach giving the clinical symptoms you are experiencing for the moment.

Furthermore, the fundoplication you did sometimes, does not result successful and the problems might relapse giving your actual clinic.

Smoking can paralyse the ciliae of the upper respiratory tract, thus, they won't run their function as normally. Bacterial coinfections are common and are associated with thick mucus.

I advise to:
- continue with PPIs for at least 8 weeks and than follow the symptoms
- continue following the healthy diet and lifestyle regimen
- run culture of the mucus in order to decide for the most susceptible antibiotic.

All the best!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Klerida Shehu (22 minutes later)

Thanks for the response doc,

Do you see any problem with the lungs. My thick mucus is already reduce to the great extent. But why does blood comes only in the morning just once and seems it is very fresh.

Thanks,
XXXX

Answered by Dr. Dr. Klerida Shehu (1 hour later)

Brief Answer:
Not related to lungs,temporary situation,gingivitis to rule out

Detailed Answer:
Hi back XXXXXXX

I do not see anything wrong with your lungs (although I do not hear your lungs with stethoscope) as long as you do not report cough as a complain.

Having fresh blood coming from your mouth is a temporary situation until everything will be settled.

Another reason could be inflammation of gingiva or other dental issues. Further consultation with dentist is advised.

All the best!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Klerida Shehu (16 minutes later)

Doc- I am pretty sure that this clear mucus with blood mixed comes from roof of the mouth or throat. I have started taking antibiotics. I have been on PPI now almost 8 weeks. Still i am not perfectly fine though i am 80% better than before

Thanks
XXXX

Answered by Dr. Dr. Klerida Shehu (49 minutes later)

Brief Answer:
Should continue with PPIs

Detailed Answer:
Hi back,

I am happy that you are feeling better although not 100%.

This is showing that your current treatment is effective but needs time for a complete recover.

As your symptoms persist, you should continue with PPIs. Please bare in mind that duration of treatment with PPIs is depending on the health conditions of the patient.

Wish fast recovery!
Dr.Klerida

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj