How To Fix LPR (Silent Reflux) - LPR Diet that Stops Reflux

Summary

In this video, Norm Roblot, founder of the Digestive Health Institute, explains how to address Laryngopharyngeal Reflux (LPR), also known as silent reflux. He discusses the ineffective role of common treatments like proton pump inhibitors (PPIs), emphasizing the importance of controlling reflux itself rather than just reducing stomach acid. Roblot introduces the Fast Track Diet, a system designed to reduce gas-producing carbohydrates that contribute to reflux. By focusing on gut-friendly practices and symptom tracking, the diet helps prevent reflux, offering a long-term solution for LPR sufferers.

Takeaways

• 😀 LPR (Laryngopharyngeal Reflux) is a condition where stomach contents, including acid and pepsin, travel up into the throat and respiratory system, causing irritation without common reflux symptoms like heartburn.
• 😀 Common LPR symptoms include hoarseness, sore throat, throat clearing, coughing, difficulty swallowing, wheezing, post-nasal drip, and asthma-like symptoms.
• 😀 Acid-reducing medications like PPIs and H2 blockers are often ineffective for treating LPR, as they only target stomach acid and don't address other reflux components like pepsin and bile.
• 😀 Studies show that PPIs offer no better symptom relief for LPR than a placebo, and they can even worsen conditions like small intestinal bacterial overgrowth (SIBO).
• 😀 The American Gastroenterological Association recommends against using acid suppression therapies for LPR-related symptoms such as laryngitis and asthma.
• 😀 Surgical procedures like fundoplication, which stop reflux by tightening the LES, can significantly improve LPR symptoms but are not recommended as first-line treatments due to associated risks.
• 😀 The traditional approach of eliminating trigger foods or focusing solely on low-acid diets doesn't fully address the root cause of LPR, which is reflux itself.
• 😀 A key cause of reflux is the poor digestion of carbohydrates, which feed gut bacteria that produce gas, increasing intragastric pressure and triggering reflux.
• 😀 The Fast Track Diet is designed to manage LPR by limiting fermentable carbohydrates that fuel gut bacteria, thus reducing reflux episodes.
• 😀 The Fast Track Diet app provides a convenient way for users to track food intake, fermentation potential (FP) points, and symptoms, helping to manage LPR effectively.
• 😀 Healing from LPR takes time—symptoms may persist for weeks or months even after controlling reflux, so patience and consistency are essential for recovery.

Q & A

What is LPR and how is it different from GERD?

LPR, or laryngopharyngeal reflux, is a form of reflux where stomach contents, including acid, pepsin, bile, and other substances, travel up the esophagus and reach the throat, larynx, sinuses, and even the lungs. Unlike GERD (gastroesophageal reflux disease), which typically presents with heartburn, LPR is often referred to as 'silent reflux' because it lacks classic symptoms like heartburn. Instead, it can cause symptoms like hoarseness, sore throat, difficulty swallowing, and wheezing.

Why is LPR sometimes called 'silent reflux'?

LPR is called 'silent reflux' because it doesn't always present with the common symptoms of acid reflux, such as heartburn. Instead, it often manifests in more subtle symptoms like throat clearing, a bitter taste in the mouth, difficulty swallowing, or a sensation of a lump in the throat.

What are the main symptoms of LPR?

The symptoms of LPR can include hoarseness, sore or burning throat, throat clearing, a bitter taste in the mouth, difficulty swallowing, wheezing, breathing problems, asthma-like symptoms, post-nasal drip, and bloating. While heartburn may also be present, it is not always a common symptom.

How do proton pump inhibitors (PPIs) fare in treating LPR?

Proton pump inhibitors (PPIs) are commonly used to treat acid reflux, but studies show that they are no more effective than a placebo in alleviating the symptoms of LPR. PPIs only reduce stomach acid, which doesn't address other components of reflux, such as pepsin, bile salts, or bacteria, which may be more damaging.

Why might PPIs not work well for LPR?

PPIs focus on reducing stomach acid but do not address other potential components of reflux, such as pepsin, bile salts, bacteria, or pancreatic enzymes. These elements may be more harmful than stomach acid and contribute significantly to LPR symptoms. Additionally, PPIs can contribute to small intestinal bacterial overgrowth (SIBO), which may exacerbate reflux.

What surgical options are available for treating LPR?

Surgical options like fundoplication, which tightens the lower esophageal sphincter (LES) to prevent reflux, have been shown to improve LPR symptoms such as hoarseness, chronic cough, sore throat, and even asthma-like symptoms. However, surgery is not recommended as a first-line therapy due to potential risks and side effects.

How can diet play a role in managing LPR?

Diet can significantly impact LPR management. While trigger food diets and low-acid diets are often recommended, they have limitations. A low-acid diet may help reduce inflammation from pepsin but doesn't address the root cause of reflux itself. A more effective approach is to limit carbohydrates that are hard to digest and may lead to bacterial overgrowth, which contributes to reflux.

What is the Fast Tract Diet and how does it help LPR?

The Fast Tract Diet is a diet specifically designed to reduce the fermentation potential (FP) of foods. It limits hard-to-digest, fermentable carbohydrates like lactose, fructose, and certain fibers that feed gas-producing bacteria in the gut. By reducing the gas pressure in the stomach, the diet aims to prevent the reflux that causes LPR symptoms.

How does gas pressure in the stomach contribute to reflux?

When undigested carbohydrates remain in the intestines, they feed gas-producing bacteria. This can lead to the production of large amounts of gas, which increases intra-gastric pressure. This pressure can force the lower esophageal sphincter (LES) to open at the wrong time, allowing stomach contents to reflux into the esophagus and cause symptoms of LPR.

How does the Fast Tract Diet help identify and manage LPR?

The Fast Tract Diet helps manage LPR by reducing the fermentation of carbohydrates that contribute to bacterial overgrowth and gas production. The diet uses a point system to rate foods based on their fermentation potential (FP), allowing individuals to track their food intake and symptoms. The accompanying mobile app helps users monitor their meals, FP points, and symptoms, aiding in the identification of triggers and ensuring the diet is followed effectively.