The summary:
> I shared earlier how my ENT had diagnosed reflux because my vocal cords
were
> inflamed, had tiny nodules and I started the morning sounding like a bass.
> (I'm a soprano.) I also have constant phlegm. I "taste" salt and not
acid...
> I got put onto expensive medication for two months, which did not really
> seem to help...He also wanted me to run around with
> a tube in my nose to measure acidity...
> I needed to see my GP, who suggested...a barium meal (yummy) and a blood
test. Well, there is no
> reflux, no ulcer and no hernia...
> My cords are still inflamed and I still have phlegm.
>
> Could my Irritable Bowel and allergies have something to do with it? The
ENT
> could not see sinusitis as being a huge problem.
>
Reflux is often not seen on the barium meal or upper GI as we call it here.
You go in fasting; reflux is less common fasting. Often the radiology tech
will give you some gas producing crystals to try to cause reflux. So no
reflux on a barium study does not prove it does not exist. It is good to
rule out ulcers however.
Even endoscopy may not see reflux but it can assess the lining of the
stomach and esophagus for signs of it.
The definitive test is a pH probe as was suggested to you. Don't do it
unless you really plan to give it your best shot as the probes cost about
$750 here in the US and it would be a shame to waste one (we don't reuse
them).
I forget the details of prior emails, but are you overweight? If so, you
should really try to lose 5-10 lb. It can often eliminate reflux.
Are you clearing your throat often? This can irritate the vocal apparatus,
although it does not cause the same kind of redness that one sees in reflux
which is usually somewhat characteristic. Allergies alone shouldn't cause
as much trouble as you describe. You may need the pH probe to settle the
issue.
John
John J. Messmer, M.D.
Assistant Professor, Family & Community Medicine
Penn State College of Medicine
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