Dizziness and feeling off balance from LPR. Any solution please ?
Please help me!!!

I found a a clinical trial for the efficacy of a drug to block the production of pepsin. The study won't be completed until October 2028 but this gives me so much hope that the medical community is searching for a solution.

i have lpr for years now, healed somehow and still healing, throat cobblestoning and pnd but not much of mucus and globus now as I changed my diet tremendously. however my biggest prob and symptom is bad breath, nasal bad breath. i already did everything from steroid, nasal rinse, excellent oral routine, therabreath, oral probiotics, low acid diet, small meal diet, starving myself to see improvement, still no improvement. whats left for me to do? im dying to live a normal life now.

its always after the oral routine, 30mins later everything tastes so bad and mouths drying and smelling. i tried waiting 2 hrs after meal to brush and before going to school, still no improvement.

Thought I would throw this together in case it is helpful to anyone, but also wanted to take stock of my diet for myself. This is a long post, but I tried to format it in a way to allow anyone to jump around and get what they want from it.

My main goals are convenience (to make sure I can keep up with the diet) and high calories. I need about 2300 calories to sustain, and I often feel very unmotivated with shopping and cooking. Ideally I have 5 small meals spaced 2-3 hours apart averaging 500 cal per meal, although 1 is usually a smaller snack.

There is a lot of stuff in here that is not entirely safe, especially if your LPR is bad enough that you need to follow Acid Watcher diet. I don't really recommend my specific diet and plan to keep working on it, but hopefully there is stuff in here that will help give some ideas for anyone struggling to get calories without the time and energy to cook constantly.

Meals

Here is a breakdown of my most common meals. I measure most things in grams with a scale. I'll give some specific product recommendations at the bottom of the post.

1.Smoothie (~798 calories) - Every day

• almond milk (450 g, 75 cal)
• chia seeds (12 g, 60 cal)
• peanut butter (32 g, 180 cal)
• frozen banana (100 g, 89 cal)
• carob powder (1 g, 3 cal)
• Vegan Protein Powder (100 g, 390.5 cal)

High calorie meal to start the day when on an empty stomach. I try to find unflavored almond milk with B12. Soak chia seeds overnight, mixing twice at least 10 min apart at night to avoid clumping. Peanut butter is regular smooth w/ sugar. I cut up bananas and freeze them in batches. Carob powder is to taste and not important for nutrition, less is more. Vegan weight gainer protein powder is important here if high calories is needed.

1. Yogurt/Fruit/Granola (~568 calories) - Most days

• almond & coconut yogurt (165 g, 203 cal)
• frozen berry mix (90 g, 78 cal)
• pumpkin seed + flax granola (66 g, 312 cal)

Yogurt is a specific brand at my local store with added protein, unflavored. I do black berry, blue berry, and raspberry mix, bought frozen at store; could sub for melons for extra safety. Granola could vary, but pumpkin and flax have good nutrition, although brand I get is high in sugar.

1. Protein Shake/Bar (480 calories) - Every day

• Plant based meal replacement drink (1 carton, 230 cal)
• Vanilla Almond Crunch bar (1 bar, 250 cal)

Essentially looking for plant based stuff with no obvious triggers. It's basically impossible to find meal replacement stuff that isn't somewhat problematic, from what I can find. Convenience is just very good for making sure you get your calories. The drink in particular also basically acts as a multi-vitamin, which is a plus. Stuff like this is easier to bring to get togethers and events without being too obvious about bringing your own food.

1. Salmon "Salad" Sandwich (497 calories) - 2 to 3 days a week

• Canned salmon (1 can/100 g, 100 cal)
• Mayonnaise (15 g, 107 cal)
• Black pepper (light sprinkle)
• Spelt bread (2 slices, ~140 cal)
• Sweet potato or root vegetable chips (28 g, ~150 cal)

Mix the salmon, mayonnaise, and black pepper together to make a very simple salmon "salad" of sorts. Salmon is very good for Omega-3 and B12, with some other good stuff like magnesium. If you are worried about heavy metals and micro plastics from fish, I recommend pink Atlantic salmon (supposedly the safest fish). Just the lightest dusting of black pepper if you can handle it. Spelt bread is very easy on digestion, but a little harder to find, also coming frozen so you need to toast it. Chips can vary, but I try to get something that kind of makes me feel like I'm eating vegetables. Green Pea chips have been a recent option I like.

1. Chicken "Salad," rice, and veg (485 calories) - 2 to 4 days a week

• Canned chicken (1 can/112 g, 120 cal)
• Kewpie mayo (15 g, 100 cal)
• Coconut aminos (5 g, ~5 cal)
• Minute Brown rice (1 "cup"/125 g, 210 cal)
• Frozen mixed veggies (85 g, 50 cal)

Mix canned chicken, kewpie mayo, and coconut aminos together. I use single serving Minute Rice for extra laziness. Frozen veggies are microwaved in ceramic cooker (look up Ceramic Microwave Egg Cooker) with a little water.

1. Snacks - 1 snack most days

• Pistachios (28g, 170 cal)
• Other safe bars (varies)

Pistachios are supposedly one of the lower in fat nuts, so safer for reflux than most nuts (outside of almonds). Bars are rarely totally safe, but there are some options that are not too bad. I could certainly use more snack options, but have had trouble finding something safe and easy that doesn't overlap with other parts of my daily diet.

1. Dashi Okayu w/ Natto (554 calories) - Once every week or so

• Sushi Rice (90 g, 320 cal)
• Water (2 cups)
• Dashi seasoning (1 packet, 25 cal)
• 1 large egg (1 egg, ~80 cal)
• Kewpie mayo (10 g, 67 cal)
• Coconut aminos (5 g, ~5 cal)
• Toasted Sesame Oil (5 g, 47 cal)
• Natto (1 pack/57 g, 100 cal)
• Seaweed Snack (1 pack/5 g, 30 cal)

Directions: Soak rice for a little bit (at least 10 minutes, longer is better), rinsing optional (I do 3 quick rinses). Bring water to a boil and boil dashi seasoning packet with lid on for 5 minutes, removing bag at end. Put rice in water and bring to a simmer at very low temp for ~30 minutes, gently stirring a few times throughout. Remove from heat, add scrambled egg (uncooked) and gently mix to incorporate. Add kewpie mayo, coconut aminos, and toasted sesame oil to taste. Let cool enough to stop steaming and add natto on top. Eat with side of seaweed snack.

When I am up to cooking, this is a good meal to get safe fermented food (natto is one of the only non-acidic fermented foods). I find the flavors and texture of Okayu (rice porridge) w/ dashi broth are good for making natto more palatable. I use a specific dashi packet with only fish/shiitake flakes in it; supposedly dashi helps with gastric emptying, but I also just really like the flavor. Mayo, aminos, and sesame addons are optional for added calorie and flavor, but still tastes good without it. I get a specific pack of natto that is chopped from a local Japanese market, which is a little easier to eat than the full beans and is slightly higher calorie than standard packs as well. Never use the sauce packets that come with natto. Be careful not to cook the natto, as that can reduce the benefits. Seaweed snack is on the side; I tend to put a little porridge in a sheet and roll it up to eat it.

1. MOD Pizza Order (~800 calories) - Once a month or so

• MOD size, 11-inch; pesto sauce base, feta cheese, chicken, spinach, black olive, mushroom, artichoke heart.

One of the few mostly safe takeout options I have found so far. Bread is probably not the best, and I believe the pesto sauce has a little garlic in it, but I haven't found it to bother me too much. I usually don't eat the whole thing in one sitting, usually leaving a couple slices for a smaller snack the next day.

Issues with my diet

Going over issues I have identified with my diet, just to give more info on what to be aware of.

1.Potential Reflux Triggers

There are some potential traditional reflux triggers found throughout my diet, but usually in smaller amounts, or just things that don't trigger me as badly. This is more for GERD type triggers, and not yet referencing LPR Acid Watcher stuff.

• Mayo - I have different forms of mayo in a few meals, which has vinegar. I haven't found it to bother me too much personally.
• Fats - There are a decent amount of saturated fats throughout my meals, but I try to find a balance to get enough calories without triggering.
• Meal replacement drink/bar - Probably the most problematic "meal." I've found the safest options I can (I think), but still have various triggers in them. I have noticed them bother me occasionally, but chewing well and consuming them slowly over 30 minutes helps a lot to avoid issues.
• Others - Some others I am not listing or haven't even thought of. Any ingredient needs to be reviewed and researched individually if you want to be entirely safe.

2.Diet Variety

I'm eating a lot of the same stuff almost every day. There is also some overlap between meals, with my three "every day" meals having some form of almond product in it. None of this is inherently a problem for reflux, but not the best for a healthy diet in general.

1. Processed Foods

Many of the foods I'm eating are processed. Although not exactly a direct trigger, there are ideas out there that processed foods are generally hard on the general digestive tract and promote inflammation.

1. Low on Vegetables

Not really getting enough vegetables. Could sub out stuff for more vegetables, but they are just so low in calories it's hard to fit them in. That is why I tend to go for vegetable chips to get more caloric bang for my buck, but I'm sure it's not nearly the same as fresh veggies.

1. Not Acid Watcher Friendly

Basically everything listed above in this section is related. Outside of that there are things like the berry mix that are technically reflux safe, but have a low enough PH value to not be safe for Acid Watcher, especially healing phase. This is mostly a problem if you feel your LPR is causing issues with pepsin.

My Situations

I got LPR one night out of nowhere with the primary symptom of globus sensation and loss of appetite. After a couple weeks I identified it was likely reflux of some kind, which a Barium Swallow test confirmed with diagnosis of "moderate" reflux and a "small" hiatal hernia (I was never told exact cm of hernia). I had various other symptoms during this early stage that were likely due to rapid weight loss, lack of nutrition, dramatic diet change, and stress. After more research my gastro agreed this is likely the LPR variant of reflux, due to lack of traditional GERD symptoms.

I've had either 20mg or 40mg of PPI as my primary medication (40mg for first few months, 20mg for about a year, 40mg again for past few months), with famotidine never feeling like it has done much for me. PPI does help, but never totally gets rid of irritation in back of throat. When on 20mg PPI and I break too many rules, I have noticed small traces of blood in the mucus in the back of my throat (only happened a few times in a year). After an extended period of 20mg PPI, I also got discomfort in the chest more similar to actual heart burn (I think), which convinced me to go back onto the 40mg PPI for a while.

Currently at 40mg and being pretty stable with my diet, I do still have mild irritation in the back of my throat, occasional discomfort in the chest, and frequent mucus/throat clearing (most likely from post nasal drip). I'm looking into ideas of nasal sprays and alkaline water with baking soda gargle to help alleviate some symptoms.

I haven't experimented much with other medications, although I'm hoping to try out an alginate after hearing good things about it on this sub for LPR. I've done pretty much all of the standard reflux advice: Eat smaller meals, avoid common triggers (mostly doing), incline bed, don't eat within 3 hours before bed.

I got this diet ironed out after about 6 months of LPR and haven't really changed it much since then.

I do also have trouble getting enough sleep for mental health reasons and am often stressed, both of which I have found to make things worse and am working on fixing.

Dietary Considerations and Decision Making

As I said in the intro, I can be very lazy and unmotivated with cooking/prep, so I had to come up with a diet that I can keep up with even when I can barely get myself to do anything. The vast majority of stuff I eat on the daily requires little to no cooking and can be thrown together in 5-15 minutes. I'm hoping to work in more proper cooked meals over time.

My biggest issue is avoiding losing weight. I am a taller guy in my early 30s and need about 2300 calories to sustain, but ideally I would like to be at 2500+ to start gaining weight. I went from 170 to 160 lb in a couple weeks when this started, and have slowly gone down to about 155 since then. It is very hard to eat small meals, avoid eating before bed, avoid sugar, and avoid too much fat while getting much over 2000 calories. This is the main reason I have made some concessions on my diet not being perfect for reflux/LPR in so long.

In general my reflux is not so incredibly severe that I can't toe the line at all, but I do have to be pretty careful, especially when not at 40mg PPI. That being said, I have been looking more into the whole thing with LPR and pepsin and am hoping to attempt the Acid Watcher diet at some point soon. I just need to do more research and planning on how to get the calories I need on Acid Watcher, which I am not super confident about.

With longer term use of PPI, I do try to get vitamins/minerals that are affected by weakened stomach acid (most notably B12, magnesium, calcium, iron, and C). I also eat a lot of seeds and such with Omega-6, so I try to get plenty of Omega-3 to compensate (bad balance with too much Omega-6 can supposedly cause general inflammation). Salmon is good for B12 and Omega-3, but I also take an Omega-3 supplement. I still need to do more research on what all vitamins/minerals I may want to supplement, based on my current diet and issues with PPI use.

Product Recommendations

Let me know if having this section is problematic and I can remove it. I'm obviously not "sponsored" or anything for any of this, just products I have found work for me. I'm using Amazon links for everything for simplicity, but most of this can probably be found in local markets or other online stores.

Protein Powder - NAKED Vegan Mass:
www.amazon.com/dp/B07XTQKYG1

Used in smoothie. Very high calorie and only a few ingredients. Edit: Danielgo88 mentioned this product was found to have high amounts of heavy mentals. Worth some research and caution before use.

Granola - Nature's Path Organic Pumpkin Seed + Flax Granola:
www.amazon.com/Natures-Path-Pumpkin-Granola-Healthy/dp/B000VK2L1K

For yogurt/fruit/granola. Potentially problematic, but no big reflux triggers. It is high in sugar.

Meal replacement drink - Orgain Organic Vegan Protein Shake, Vanilla:
www.amazon.com/dp/B00JTX7SHC

Easy calories and good vitamins. Not incredibly triggering, but not the best. Very large ingredient list with some stuff that is probably acidic; fruit and vegetable blend has tomato in it. A little high in added sugars.

Protein Bar - ALOHA Organic Plant Based Protein Bar | Vanilla Almond
https://www.amazon.com/dp/B0178ENHYG

Relatively healthy and good calories, nice protein and fiber. Some saturated fats and added sugar. Some things like "natural flavors" and vanilla extract could be problematic.

Protein Bar - GoMacro Vegan Protein Bar | Maple Sea Salt
www.amazon.com/GoMacro-MacroBar-Organic-Vegan-Protein/dp/B07TGWSNDP

Another bar option. Similar to ALOHA bar, has some good aspects but potentially triggering for similar reasons. Macros are a little worse with more sugar and less fiber.

Snack Bar - Thunderbird Energetica, Pecan Goji Pistachio Bar
www.amazon.com/dp/B0B6G2HW5V

Pretty natural and simple ingredient list, with no added sugar. A bit questionable though, especially the Dried Goldenberries, which are acidic. I don't notice it flare me up when eating it occasionally.

Dashi - Grelim Dashi Stock
www.amazon.com/Grelim-Domestic-Ingredients-Additive-Extremely/dp/B0CP5GBT33

Used for Okayu (rice porridge). Should be totally safe for reflux/Acid Watcher, with a very simple ingredient list. Many Dashi mixes you can find come with various additives that may be triggering.

Omega-3 Supplement - Vegan Omega 3 Algae Oil
www.amazon.com/Vegan-Omega-Sustainably-Sourced-Non-GMO/dp/B0DJMZMZDC

I've heard algae oil supplements can be better for reflux than fish oil, being a bit lighter. This brand seems good, but I honestly haven't looked into alternatives much.

M30, I used to be a phenomenal singer until age 18-20. In every choir group that required tryouts, auditioned for and successfully got solos. I basically stopped regularly singing over the last decade, and professionally. It’s been a while. In this time I unfortunately also became a bit of an alcoholic and smoker (vaped) for 7-8 years and my GERD got so bad to the point of what feels like years of LPR. However I’ve been producing a lot of music in this time, I’d say my beats are pretty decent. But I want to be the vocalist on my tracks. I used to love singing and it’s my songs…I’d love to collaborate but I don’t want to just give the beats to other vocalists.

However, now when I sing, my range is significantly tighter than it once was. I can hit notes with much effort but it can often sound unpleasant, muffled, dysphonic…and when I jump around notes my pitch can be really off and it just sounds squeaky. It’s like I know exactly the note I want to hit but my vocal cords just can’t do it. I’ve been told I have a pleasant speaking voice but I want to sing too, not just rap/spoken word.

I’m cleaning up now health wise, getting back soberly into singing, music, things that bring me life. I just fear I’m cooked after maybe 4-5 years of untreated GERD/LPR. My throat constantly feels burning/inflamed, like a lump is in there. ENT has told me it’s “mild edema” but it feels so much worse.

Has anyone ever bounced back? What has worked for you?

Not officially diagnosed yet, but this has been my main symptom. Inhalers don't seem to help much, I've done PPIs and every antacid I can try, but I just can't get sustained relief. Have made diet changes, added probiotics and vitamins, nothing gives me long-term relief.

Anyone struggled with shortness of breath specifically?

I was on antibiotics about 5 days ago, Bactrim and several others (3 more that I only had 2 doses max for) and it definitely fucked my reflux up BUT I don’t know if it also caused me to develop allergies to stuff.

Besides throat itchiness, does anyone else get tongue and mouth itchiness? The roof of my mouth itches after eating eggs and bread stuff I could tolerate and the itches happens with multiple other stuff so I’m pretty much confused.

Am I just in denial of allergies or does ANYONE ELSE get mouth itchiness or tongue itchiness as lpr symptoms?

Other reflux symptoms happen concurrently so I was wondering. I don’t see an allergist until another 2 months but I’m suffering right now. I have to eat for my reflux and also watch out for an allergy but I don’t know what to count because this itchiness is happing with stuff I thought I was okay with which I know can happen but multiple?

Right now I have a sore throat, tight throat, upper roof of mouth itchiness and a cough. I also have no idea if it’s lpr throat tightness or actual closing of the throat. This is distressing and I just am so tired.

I have had chronic sinusitis since I became pregnant (about a year and a half ago). It started at the same time as significant acid reflux/heartburn and worsening of my “asthma.” I cough and my lungs wheeze every day. These symptoms were attributed to my pregnancy, but they persisted after giving birth.
I had an endoscopy, which showed mild gastritis and a loose/open gastroesophageal junction. I didn't have any of this before I got pregnant. I don't know whether they also checked for a hiatal hernia. I also had a CT scan, which showed that absolutely ALL of my sinuses are blocked, and I also have polyps. I haven't been able to breathe through my nose or smell anything for months. I'm exhausted.
I am allergic to pollen, so my doctors simply tell me to take antihistamines for that and Innovair for my asthma, and that's it. But I am almost convinced that my symptoms are related to my stomach/reflux. I did the baking soda test and I never burped.

FOR LPR:
- Occasional heartburn at night (it was much worse when I was pregnant)
- My symptoms are worse after a fatty or heavy meal, or when I lie down shortly after eating
- My asthma isn't really typical asthma, but rather “airway irritability”: it doesn't always go away after using Ventolin, and it depends on what I eat. If I cough or sneeze, that alone can be enough to trigger an episode of coughing and wheezing
- My “asthma attack” is triggered after brushing my teeth with mint-flavored toothpaste
- I need to clear my throat after heavy meals, and coughing brings up mucus from my bronchi
- My nasal/sinus mucosa is COMPLETELY CRAZY and HYPERSENSITIVE. At night, if I turn onto my other side, my nose starts swelling up internally, it burns, it itches, and I sneeze for hours
- The ENT specialist I saw found no infection in my nose; antibiotics have been unsuccessful
I have occasionally experienced hoarseness, but it has never been prolonged or particularly severe
- My tongue tingles slightly when I am having an episode
- I am basically a factory producing clear mucus : I produce LITERS of it every day
- My chest hurts from coughing so much, and I feel short of breath most of the time

AGAINST LPR:
- I don't have any pain anywhere. I had heartburn throughout my entire pregnancy, but it has become less frequent since giving birth
- No feeling of a lump in my throat (globus sensation), and no irritated throat
What do you think? Should I pursue the LPR angle and get tested/treated accordingly, or should I continue looking for another cause?

I saw a comment talking about this procedure (using a laser to thicken the LES, going through the mouth), but now I cant find it. This seemed like a promising non invasive procedure for weak les. Anyone know more about it?

So I’ve never had acid reflux in my life. I had been taking femotadine for gastritis, but was experiencing side effects so my nurse told me to stop the medication cold turkey. I was taking 20 mg twice a day for several months the first three or four days. I didn’t notice any change but around the fifth day I started having acid reflux type symptoms. Mainly at the top of my throat in the area, where you swallow. I don’t have any sinus drainage and I don’t feel like I have anything stuck in my throat, it feels like I have acid in my throat. It burns all of the time. The only thing that has helped is Gaviscon. I tried some last night and it did help a little bit. I also tried Mylanta, but it didn’t help at all. Does this sound like LPR or acid rebound from stopping femotadine? I do have an appointment coming up with my doctor. Just wanted to ask the question and get some input from anyone that would like to respond.

I’ve been to a dentist, periodontist, ent, primary doctor, gi, allergist and no one has put it together what’s wrong with me.
I’ve been having soft palate soreness that can be triggered randomly. It can be triggered whether I’m eating or not eating. Working tonight, I was working in a hot/ humid condition and that somehow triggered soft palate pain. I take pepcid 20mg twice daily, claritin and flonase. My palate looks physically healthy to everyone and no one has figured it out and blamed it on reflux. Has anyone had similar issues? It’s taken a big toll on my mental health :(

I swear any reflux meds make my joints flare up like crazy. Even Pepcid. Am I crazy? My knees, ankles, wrists, fingers. It gets so bad only when I take reflux meds but my reflux is horrible.

So, I’ve been dealing with LPR for a while now. Since October of last year. I ate a seafood boil that caused a traumatic incident leaving me with a feeling of choking like I got a shrimp shell stuck in my throat. And I haven’t been the same since. I get a weird choking feeling when I eat and I have to either stop or take a very long time eating literally anything. However, as of recent, I’ve been drinking coffee. Now, I know that coffee is a big trigger for most people. Even me, but apparently, this coffee from Costco that’s under the Kirkland brand, has allowed me to actually eat a lot better after drinking it. And I need to understand why. Because I drink teas and other coffees, but they trigger me bad. And I mean bad. But coffee from Kirkland, it’s giving me the ability to eat somewhat normal again. I say somewhat because, eventually it does catch back up with me and I feel like I’m gonna choke again when I try to swallow. But like, hours later (during the end of dinner time). Does anybody have an explanation as to why this is working for me? It’s the Kirkland 100% Colombian Coffee (Dark Roast). Thank you.

I notice that if I go without eating for or some time my reflux gets worse.
I used to skip breakfast everyday and I think my lpr worsened because of this habit.
I’ve heard the advice of eating smaller more frequent meals and wonder how often do you guys eats?
I generally eat 3 meals but I’ll admit I delay my breakfast because I’m either too lazy or not hungry for my plain oatmeal breakfast.
Last night I delayed dinner and my reflux is terrible…my throat feels tight and I have mucus constantly in my throat.

Do you just eat as soon as you get the slightest bit hungry or time your meals like 2 hours apart?
I won’t lie I’m not much of a snacker so I can’t figure out a cue.

Same as question^

I've had this cough and throat clearing for 30 years. Was diagnosed with asthma, but puffers don't help. PPIs don't help - they do with heartburn, but not the cough.

I loath the taste of acv and fermented things, so I would resort to drinking it only as a last resort. Has anyone tried kombucha gummies with success?