“Somewhere, something incredible is waiting to be known.”—Sharon Begley.
Deconditioning Works
The upper gut symptoms officially began on January 15, 2007. The loss of multiple cycles of phase III of the migrating motor complex caused the whole GI tract to backup, to prevent the stomach from emptying at all. At the same time, the aerophagia is pumping gargantuan volumes of air into the stomach. So the stomach bloats. Here’s an example image after I dry-heaved 9 times.
The GI tract is being knocked out of homeostasis as a result of two disease states. It can’t fix the aerophagia and it can’t get the phase IIIs to not skip, but it wants to get the air out of the stomach, so what does it do?
Open the lower esophageal sphincter. This started happening in August 2008, about 18 months after the start of the reflux. Unfortunately, this fails to achieve its goal. It actually doesn’t let any air out of stomach (or at least it doesn’t trigger the belching reflex). But it does allow gastric juice into the esophagus and beyond, particularly into throat. This resulted in my developing the symptoms of laryngopharyngeal reflux (LPR).
There is no good treatment for LPR. PPIs are useless because they don’t prevent the reflux itself, and despite raising the pH of the gastric juice, it’s acidic enough, and it contains gastric enzymes to still irritate the throat tissues. (Baclofen does suppress LPR, but it has a short half-life and isn’t practical. Iberogast may help with LPR, but during the time I had the LPR, I never tried it.)
ENTs have a scoring system to measure the degrees of reflux called Reflux Finding Score. It ranges from 0–26 and mine peaked at 19.
The burning throat started several years after the reflux begun, but it is not caused by the reflux per se. Burning throat is not a symptom known to medical science and based on what I have seen on the English-speaking Internet, only a handful of people worldwide have experienced it.
Anyway, with the PEG in place and bloating essentially eliminated, keeping an open lower esophageal sphincter serves no physiological purpose.
My theory was that the body would “realize” this and slowly extinguish the physiological adaptation and tighten up the sphincter.
Well, 18 months after the PEG was implanted, this is indeed what happened. The sphincter pressure returned to normal and my Reflux Finding Score reverted back to zero. The LPR went away.
Of course, the burning throat, which is a separate pathology, was unchanged.