Esophagopharyngeal reflux (EPR)

[hali_grl]

I came across this site which is very informative please read and post your responses. Here's in excerpt: http://www.ucdvoice.org/lpr.html

Esophagopharyngeal reflux (EPR) is the regurgitation of esophageal contents back into the larynx and pharynx. Gastroesophageal reflux disease (GERD) is the disorder caused by the regurgitation of GASTRIC contents into the esophagus. The hallmark of GERD is heartburn. LPR is the disorder caused by the regurgitation of GASTRIC contents into the larynx and pharynx. Persons with GERD and LPR usually respond well to medications that reduce the acid content of the refluxed materials (H2-blockers/proton pump inhibitors). Patients with EPR present with symptoms very similar to persons with LPR. They do not, however, respond well to traditional anti-reflux therapy. The problem with EPR is that of bolus transport and esophageal emptying. Most patients with EPR have a disorder of esophageal motility. Some of the ingested food sticks in the esophagus and regurgitates back into the throat causing throat clearing, cough, excessive mucus, etc... Treatments for EPR are similar to treatments for esophageal dysmotility. Treatment for EPR is often less successful than treatmment for LPR or GERD. Medications that reduce the acid content (H2-blockers/PPIs) do not stop static esophageal contents from being regurgitated back into the upper airway. Behavioral modifications are crucial and alginates (Gaviscon) have shown some success in keeping the food contents from regurgitating out of the esophagus. persons with a diagnosis of LPR who fail medical therapy should be considered for a diagnosis of EPR. A dynamic video-fluoroscopic swallow evaluation and ambulatory impedance testing are the only ways to diagnosis EPR.

I've always felt my breath on good days smelled chemically old and hot but on bad days smelt like hot trash of rotten food. One member stated that she could smell the trash can in her home distinctly because its similar to her breath, same here. I wonder if the food sticks to esophagus and throat for too long could it rot. Maybe this is the reason why the ppi's/h2's don't work for some. What do u guys think? I'm usually so busy now a days with school and work i barely have time to visit anymore. But i think gerd/lpr/epr is the reason for bb in alot of us.

[halitosisux]

Although they show no apparent lack of hygiene or obvious medical symptoms, most people with the disorder report having foul body odors, bad breath, or a bad taste in their mouths. Studies in the last few years have shown that trimethylaminuria results from defects in an enzyme that breaks down trimethylamine, a byproduct of protein digestion released by bacteria living in the gut. This small molecule — the compound that gives fish their fishy odor — smells foul or garbage-like at low concentrations and fishy in larger amounts.

People with the disorder can release trimethylamine through breath, sweat, and urine. A few have a strong odor all the time, but most others experience a less severe smell that fluctuates over time. Researchers speculate that the variability of symptoms indicates that a range of genetic mutations can cause the disease and that stress and diet play a role in triggering symptoms

[hali_grl]

Sux
I appreciate the comment i have not been tested for tmau yet. But my symptoms throat clearing, lump in throat, pnd, nasal congestion, burning throat, chest pain, indigestion, etc seems to line up more with epr or lpr. I did the scoring test thats on the link posted and my score was 17 which anything over 10 meant i had a severe case and im almost double that.

[hali_grl]

It amazes me how there's very little information dedicated to EPR most of the info is a after thought or note after discussing LPR.

[cambodian_girl]

hali_grl,

have you tried Zantac yet? If not, why?

[halitosisux]

HG, reflux and associated esophegal problems are quite common and are well known as causes of bad breath in certain cases. I really hope this is true for you and many others on here too and that you manage to get diagnosed soon and find a solution which manages to resolves all your issues.

I'm glad you didn't mind me going off the topic and pasting that bit about TMAU, but it was hard to resist when you mentioned what you did about the smelling of garbage. I wanted to take the opportunity to once again highlight the point that there are many ways in which TMAU can manifest itself, and the important fact many people could be wrongly dismissing TMAU because they don't appear to suffer with the classic symptoms associated with primary TMAU, i.e. smelling strongly of rotting fish and having it coming from every bodily secretion, because the type of TMAU they may have means they do not secrete high concentrations of trimethylamine, so their only symptoms might be bad breath/bad taste which is foul and garbage-like, rather than predominantly strong fishy body odour.

ok, back to the topic, EPR...

[Tibya]

So how do I test myself for tmau?