Gastrointestinal Reflux as Dysautonomia

Pyrrhus

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Gastrointestinal Reflux as Dysautonomia

Within the esophagus and gastrointestinal system there are actually four different types of reflux, each associated with four different valves (sphincters) in the digestive system. All four valves (sphincters) in the digestive system are controlled by the autonomic nervous system, so dysfunction of these valves can be a form of dysautonomia. It is apparently common to have multiple types of reflux at the same time.

What does this mean for eating and digestive problems in ME/cfs?

  1. Gastro-esophageal reflux is when the lower esophageal sphincter fails to close, allowing the contents of the stomach, such as acidic enzymes, to flow back up into the esophagus. This often results in heartburn.
  2. Laryngo-pharyngeal reflux is when the upper esophageal sphincter fails to close, allowing contents in the esophagus to flow back up into the back of the throat and then down into the lungs. This often results in coughing fits and a feeling of "nasal drip" on the back of the throat.
  3. Duodeno-gastric reflux is when the pyloric sphincter fails to close, allowing contents in the small intestine, such as bile, to flow back up into the stomach and allowing stomach acid to continuously leak into the duodenum. Symptoms may include pain, nausea or vomiting. Vomit may have the dark brown color of bile. One patient describes it here: https://forums.phoenixrising.me/thr...y-disorder-duodenum-and-gaping-pylorus.79344/
  4. Ileo-cecal reflux is when the ileocecal sphincter fails to close, allowing food and bacteria in the large intestine to flow backwards into the small intestine. Although it is normal to have bacteria in the large intestine, bacteria are mostly absent from the small intestine.

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hapl808

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My reflux is mostly of the LPR type I believe, although sometimes the LES type may be involved as well. In general, I think dysautonomia describes a lot of my symptom clusters - reflux, tachycardia, muscle weakness, etc.

What are the treatments for dysautonomia. The only things I've tried are stuff like more fluids, more salt or electrolytes, changing diet, various supplements. Unfortunately online they always mention stuff like physical therapy, but that's pretty hard when you're housebound and relatively severe.
 

GreenMachineX

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My reflux is mostly of the LPR type I believe, although sometimes the LES type may be involved as well. In general, I think dysautonomia describes a lot of my symptom clusters - reflux, tachycardia, muscle weakness, etc.

What are the treatments for dysautonomia. The only things I've tried are stuff like more fluids, more salt or electrolytes, changing diet, various supplements. Unfortunately online they always mention stuff like physical therapy, but that's pretty hard when you're housebound and relatively severe.
I have this lpr too, and maybe dysautonomia but I'd need to research that more. Muscle weakness, bizarre heart rate at strange times, and lpr for sure though.
 

GreenMachineX

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Gastrointestinal Reflux as Dysautonomia

Within the esophagus and gastrointestinal system there are actually four different types of reflux, each associated with four different valves (sphincters) in the digestive system. All four valves (sphincters) in the digestive system are controlled by the autonomic nervous system, so dysfunction of these valves can be a form of dysautonomia. It is apparently common to have multiple types of reflux at the same time.

What does this mean for eating and digestive problems in ME/cfs?

  1. Gastro-esophageal reflux is when the lower esophageal sphincter fails to close, allowing the contents of the stomach, such as acidic enzymes, to flow back up into the esophagus. This often results in heartburn.
  2. Laryngo-pharyngeal reflux is when the upper esophageal sphincter fails to close, allowing contents in the esophagus to flow back up into the back of the throat and then back down into the lungs. This often results in coughing fits and a feeling of "nasal drip" on the back of the throat.
  3. Duodeno-gastric reflux is when the pyloric sphincter fails to close, allowing contents in the small intestine, such as bile, to flow back up into the stomach and allowing stomach acid to continuously leak into the duodenum. Symptoms may include pain, nausea or vomiting. Vomit may have the dark brown color of bile. One patient describes it here: https://forums.phoenixrising.me/thr...y-disorder-duodenum-and-gaping-pylorus.79344/
  4. Ileo-cecal reflux is when the ileocecal sphincter fails to close, allowing food and bacteria in the large intestine to flow backwards into the small intestine. Although it is normal to have bacteria in the large intestine, bacteria are mostly absent from the small intestine.

View attachment 46357


My lpr feels like a scab in the back of my throat which makes me cough or gag too. Most people I've read say it feels like a pill, but mine feels sharper and I have to position myself in different ways when it hits (like can't lay on my back flat). I also get the globus sensation and tight throat feeling. I think I said this elsewhere, that for a condition as benign as reflux, it sure feels dangerous.
 

Pyrrhus

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With this type of reflux, is there a big risk of pneumonia? I was just diagnosed with it. What have you found to help it or is it chronic?
The only thing I have found to be helpful is taking a basic calcium antacid at the first sign of laryngopharygeal reflux (LPR). This de-activates the gastric enzyme particles that are landing in the lungs, reducing lung irritation. After about 30-45 minutes, the excess mucus production slows down and I stop coughing. I don't think you have to worry about pneumonia.

My lpr feels like a scab in the back of my throat [...] I also get the globus sensation
Very interesting. That could also be herpangina. Even a small herpangina blister can feel like a lump. When the herpangina blister breaks open, it feels like an ulcer...
 

GreenMachineX

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The only thing I have found to be helpful is taking a basic calcium antacid at the first sign of laryngopharygeal reflux (LPR). This de-activates the gastric enzyme particles that are landing in the lungs, reducing lung irritation. After about 30-45 minutes, the excess mucus production slows down and I stop coughing. I don't think you have to worry about pneumonia.



Very interesting. That could also be herpangina. Even a small herpangina blister can feel like a lump. When the herpangina blister breaks open, it feels like an ulcer...
So you don't see this LPR as dangerous?

Regarding herpangina, an ENT scoped me several times to the area I have it and saw no abnormality which is good, but also frustrating because now I feel crazy.
 

Pyrrhus

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Most of the time I get it in the night just before falling into sleep, but also when eating special kinds of fast foods or by drinking orange juice.
I often experience the effects of laryngo-pharyngeal-reflux (LPR) when I eat something that triggers gastric acid production, such as amino acid supplements.

This doesn't mean that the gastric acid causes LPR. It just means that the gastric acid activates the gastric enzymes such as pepsin. Then, when a micro-particle of activated pepsin is ejected from the stomach and lands in the lungs, it triggers lung irritation, lung mucus production, and constantly clearing the throat.

But the underlying cause of LPR is dysautonomia. If the autonomic nervous system were working correctly, then the esophageal sphincters would be closed and no particles from the stomach could enter the esophagus or lungs.

I hope this helps.
 

kewia

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Then, when a micro-particle of activated pepsin is ejected from the stomach and lands in the lungs, it triggers lung irritation, lung mucus production, and constantly clearing the throat.
Did you have similar problems when drinking directly pepsin wine?

I often experience the effects of laryngo-pharyngeal-reflux (LPR) when I eat something that triggers gastric acid production, such as amino acid supplements.
This is indeed very interesting. Did you have a special amino acid in mind?

But the underlying cause of LPR is dysautonomia. If the autonomic nervous system were working correctly, then the esophageal sphincters would be closed and no particles from the stomach could enter the esophagus or lungs.
Probably yes, but in my case I think it's a kind of detoxification. I've the feeling my body tries to transport out mucus where it doesn't belong to.
Why there is at all mucus and why it can't be detoxified naturally is still unclear to me. However, I've a lymphatic issue. So because detoxification doesn't work over the lymphatic pathway as expected, my body chooses another way, just an assumption.
I wish I had it more often as it gives me some kind of relief despite stressing other people around me with it.
 

GreenMachineX

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I often experience the effects of laryngo-pharyngeal-reflux (LPR) when I eat something that triggers gastric acid production, such as amino acid supplements.

This doesn't mean that the gastric acid causes LPR. It just means that the gastric acid activates the gastric enzymes such as pepsin. Then, when a micro-particle of activated pepsin is ejected from the stomach and lands in the lungs, it triggers lung irritation, lung mucus production, and constantly clearing the throat.

But the underlying cause of LPR is dysautonomia. If the autonomic nervous system were working correctly, then the esophageal sphincters would be closed and no particles from the stomach could enter the esophagus or lungs.

I hope this helps.
I've been looking into dysautonomia and see the correlation to worsened lpr symptoms. I'm still figuring it out, but quite sure b12/folate imbalance in my case worsens all of that.