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What Causes Regurgitation And Heartburn When Diagnosed With Laryngopharyngeal Reflux Disease?

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Posted on Wed, 24 May 2017
Question: Hello,

I am currently diagnosed with LPR, with chronic throat problems. I am following a strict XXXXXXX Kauffman diet and finish eating at 6pm. Last night I had chicken and potatoes for dinner and found myself waking up to refluxing at 5am! What would be the reason for this, if all digestion is supposed to be done after 4 hours? What would I be refluxing if there was no food left in my stomach? Confused...
doctor
Answered by Dr. Ramesh Kumar (2 hours later)
Brief Answer:
Digestion is a complex process and is not done in just 4 hours.

Detailed Answer:
Hello,
Thank you for choosing HealthcareMagic for your query.
Firstly its a wrong information that that all digestion is done in 4 hours after taking food.
Let me initially give you a small briefing about the complexity of digestion.
Let see how food is digested and what really is digestion.It will help you to understand your problem easily.I ma writing things in lay mans language so that you can understand things easily.

The mouth is the beginning of the digestive tract.In fact, digestion starts here as soon as you take the first bite of food. Chewing breaks the food into pieces that are more easily digested, while saliva mixes with food to begin the process of breaking it down into a form your body can absorb and use.Then the food moves to stomach.The stomach in addition to holding the food, it's also a mixer and grinder. The stomach secretes acid and powerful enzymes that continue the process of breaking down the food. When it leaves the stomach, food is the consistency of a liquid or paste. From there the food moves to the small intestine.Small intestine is made up of three segments, the duodenum, jejunum, and ileum, the small intestine is a long tube loosely coiled in the abdomen the small intestine continues the process of breaking down food by using enzymes released by the pancreas and bile from the liver. Bile is a compound that aids in the digestion of fat and eliminates waste products from the blood. Peristalsis (contractions) is also at work in this organ, moving food through and mixing it up with digestive secretions. The duodenum is largely responsible for continuing the process of breaking down food, with the jejunum and ileum being mainly responsible for the absorption of nutrients into the bloodstream.Stool, or waste left over from the digestive process, is passed through the colon by means of peristalsis (contractions), first in a liquid state and ultimately in solid form as the water is removed from the stool. A stool is stored in the sigmoid colon until a "mass movement" empties it into the rectum once or twice a day.


When we eat, food, liquids, and saliva moves down the esophagus toward the stomach. The lower esophageal sphincter (LES), located at the junction of the esophagus and stomach, opens to allow all this to pass into the stomach. The XXXXXXX then constricts to restore the barrier between stomach and esophagus. In all persons, a small amount of stomach contents may be refluxed back up into the esophagus, then recede HOWEVER in some patiernts like you the amount of acid refluxed is more hence symptoms are caused.So as per your query it does not depend on food etc.Rather no one can predict all these things.The same food is tolerated well by some patient while causes reflux in others.It not the food left in stomach rather the acid which is produced by oxyntic cell in stomach which causes problem.Therefore food which inhibits acid secretion is adviced.


This usually doesn't cause any side-effects in the majority of people. It's when different mechanisms of this portion of the digestive process don't work properly that acid reflux can occur. Besides causing the major symptom of gastro reflux, heartburn, these episodes may also lead to esophageal injury.


It normally takes about 36 hours for stool to get through the colon.
The stool itself is mostly food debris and bacteria. These bacteria perform several useful functions, such as synthesizing various vitamins, processing waste products and food particles, and protecting against harmful bacteria. When the descending colon becomes full of stool, or feces, it empties its contents into the rectum to begin the process of elimination.

So in a nut shell after you eat, it takes about thirty to forty hours for food to pass through your stomach and intestines.Overall it takes almost 30-40 hours for complete digestion and elimination of food.

So digestion is a series of complex procedures and is not a 4 hour procedure.


Secondly you are suffering from chronic acid reflux disease.
Life style modification and dietary changes are often helpful in patients in long term. However it does not mean that if you are following a restricted diet then reflux can not reoccur. Every body is different and response of body to life style changes and even medications is different.

A proper way to start is that take medications along with life style changes initially and as you start getting better taper of the medicines.


Some suggestion though not asked-
Start taking a proton pump inhibitor like Nexium 40 mg twice daily empty stomach.It is superior to other PPI's in treating reflux disorders.Nexium would provide you with immediate symptomatic relief from reflux symptoms.However if not relieved doses can be increased to upto 80mg twice daily.Please make sure to take PPI's empty stomach with just a sip of water.Don't eat any think for atleast 30 minutes after taking PPI's.
2)Ask your primary to prescribe you with Domperidone(Motilium) 30 mg slow release tablet once a day.It is a prokinetic drug hence inhibits acid reflux directly.If used correctly in combination with PPI's like Rabeprazole it can play wonders.
3) Start taking an antacid containing combination of (Aluminium hydroxide and Magnesium hydroxide) with a topical local anaesthetic (Oxethazaine),It will provide you with relief from reflux symptoms.

Along with these medicines follow XXXXXXX Kauffman diet pattern. AThough there is no documented medical literature about this diets yet if you feel relieved follow it.

My advice is -
Take two glasses of cold milk daily.Its an alkaline media and neutralizes acid.
Avoid all beverages,smoking and alcohol.
Take lots of probiotic rich food like yoghurt.
If possible try detox raw vegans diet.
Take simple home coked easily digestible food.
Avoid egg,Meat and Dairy.
Don't drink citrus juices like orange etc.

"Plain and simple, meat is one of the hardest things for the stomach to digest. In general, meat that is lower in fat (fish, lean chicken, turkey) creates less acid. Its less acid but yes it cause acidity."
So i would suggest you to follow a the diet pattern recommended and documented in standard texts. Follow what i instructed and tell me how you are feeling aftyer 1 week.
Remain motivated it takes time but will definitely help.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Ramesh Kumar (4 hours later)
Thank you for your advice...

I have recently cut out caffeine which nearly killed me, and now I am removing cheese and meat. I'm not sure what's left to eat, but I will try this for relief!

doctor
Answered by Dr. Ramesh Kumar (23 minutes later)
Brief Answer:
Follow up.

Detailed Answer:
Hi dear,
Life style and food modification is the most difficult thing one can follow in life.Though it sounds easy but is very difficult to follow.
However in case you feel its difficult to stick to the changed diet then you can start taking the medicines suggested above.Along with medicines you can treat your tastebuds sometimes.
However first try to follow the restrictions as much as possible.
Wish you great health.
Regards.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2913 Questions

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What Causes Regurgitation And Heartburn When Diagnosed With Laryngopharyngeal Reflux Disease?

Brief Answer: Digestion is a complex process and is not done in just 4 hours. Detailed Answer: Hello, Thank you for choosing HealthcareMagic for your query. Firstly its a wrong information that that all digestion is done in 4 hours after taking food. Let me initially give you a small briefing about the complexity of digestion. Let see how food is digested and what really is digestion.It will help you to understand your problem easily.I ma writing things in lay mans language so that you can understand things easily. The mouth is the beginning of the digestive tract.In fact, digestion starts here as soon as you take the first bite of food. Chewing breaks the food into pieces that are more easily digested, while saliva mixes with food to begin the process of breaking it down into a form your body can absorb and use.Then the food moves to stomach.The stomach in addition to holding the food, it's also a mixer and grinder. The stomach secretes acid and powerful enzymes that continue the process of breaking down the food. When it leaves the stomach, food is the consistency of a liquid or paste. From there the food moves to the small intestine.Small intestine is made up of three segments, the duodenum, jejunum, and ileum, the small intestine is a long tube loosely coiled in the abdomen the small intestine continues the process of breaking down food by using enzymes released by the pancreas and bile from the liver. Bile is a compound that aids in the digestion of fat and eliminates waste products from the blood. Peristalsis (contractions) is also at work in this organ, moving food through and mixing it up with digestive secretions. The duodenum is largely responsible for continuing the process of breaking down food, with the jejunum and ileum being mainly responsible for the absorption of nutrients into the bloodstream.Stool, or waste left over from the digestive process, is passed through the colon by means of peristalsis (contractions), first in a liquid state and ultimately in solid form as the water is removed from the stool. A stool is stored in the sigmoid colon until a "mass movement" empties it into the rectum once or twice a day. When we eat, food, liquids, and saliva moves down the esophagus toward the stomach. The lower esophageal sphincter (LES), located at the junction of the esophagus and stomach, opens to allow all this to pass into the stomach. The XXXXXXX then constricts to restore the barrier between stomach and esophagus. In all persons, a small amount of stomach contents may be refluxed back up into the esophagus, then recede HOWEVER in some patiernts like you the amount of acid refluxed is more hence symptoms are caused.So as per your query it does not depend on food etc.Rather no one can predict all these things.The same food is tolerated well by some patient while causes reflux in others.It not the food left in stomach rather the acid which is produced by oxyntic cell in stomach which causes problem.Therefore food which inhibits acid secretion is adviced. This usually doesn't cause any side-effects in the majority of people. It's when different mechanisms of this portion of the digestive process don't work properly that acid reflux can occur. Besides causing the major symptom of gastro reflux, heartburn, these episodes may also lead to esophageal injury. It normally takes about 36 hours for stool to get through the colon. The stool itself is mostly food debris and bacteria. These bacteria perform several useful functions, such as synthesizing various vitamins, processing waste products and food particles, and protecting against harmful bacteria. When the descending colon becomes full of stool, or feces, it empties its contents into the rectum to begin the process of elimination. So in a nut shell after you eat, it takes about thirty to forty hours for food to pass through your stomach and intestines.Overall it takes almost 30-40 hours for complete digestion and elimination of food. So digestion is a series of complex procedures and is not a 4 hour procedure. Secondly you are suffering from chronic acid reflux disease. Life style modification and dietary changes are often helpful in patients in long term. However it does not mean that if you are following a restricted diet then reflux can not reoccur. Every body is different and response of body to life style changes and even medications is different. A proper way to start is that take medications along with life style changes initially and as you start getting better taper of the medicines. Some suggestion though not asked- Start taking a proton pump inhibitor like Nexium 40 mg twice daily empty stomach.It is superior to other PPI's in treating reflux disorders.Nexium would provide you with immediate symptomatic relief from reflux symptoms.However if not relieved doses can be increased to upto 80mg twice daily.Please make sure to take PPI's empty stomach with just a sip of water.Don't eat any think for atleast 30 minutes after taking PPI's. 2)Ask your primary to prescribe you with Domperidone(Motilium) 30 mg slow release tablet once a day.It is a prokinetic drug hence inhibits acid reflux directly.If used correctly in combination with PPI's like Rabeprazole it can play wonders. 3) Start taking an antacid containing combination of (Aluminium hydroxide and Magnesium hydroxide) with a topical local anaesthetic (Oxethazaine),It will provide you with relief from reflux symptoms. Along with these medicines follow XXXXXXX Kauffman diet pattern. AThough there is no documented medical literature about this diets yet if you feel relieved follow it. My advice is - Take two glasses of cold milk daily.Its an alkaline media and neutralizes acid. Avoid all beverages,smoking and alcohol. Take lots of probiotic rich food like yoghurt. If possible try detox raw vegans diet. Take simple home coked easily digestible food. Avoid egg,Meat and Dairy. Don't drink citrus juices like orange etc. "Plain and simple, meat is one of the hardest things for the stomach to digest. In general, meat that is lower in fat (fish, lean chicken, turkey) creates less acid. Its less acid but yes it cause acidity." So i would suggest you to follow a the diet pattern recommended and documented in standard texts. Follow what i instructed and tell me how you are feeling aftyer 1 week. Remain motivated it takes time but will definitely help.