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tonytap01
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Quote tonytap01 Replybullet Topic: Taking esomeprazole
    Posted: 24 Sep 2017 at 11:02pm
Hi all,
Been following this excellent site since Barratt's diagnosis nearly 4 years ago. It's been so helpful, but I've finally hit something I can't find the answer to. Had my 1st follow up gastroscopy at beginning of year, all good and virtually identical to initial diagnosis. Since then, have begun to notice globus, mucus and some throat burning, esp. at night. Thought possibly LPR from 'Down with Acid' link, saw my GP 2 weeks ago. He's not sold on LPR yet, and moved me from 60mg Lansoprazole to 40mg Esomeprazole to see what that does. Symptoms seem at least the same if not a bit worse. However, not sure I'm taking it at the right time. Instructions say on 'empty stomach before meal or with meal. With meal seems go against my understanding of how PPI's work, so I've been taking med 30-60 mins before breakfast (as with Lansop). Is this correct, or should it be immediately before eating or some other time completely? Sorry for long first post, any thoughts appreciated.
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chrisrob
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Quote chrisrob Replybullet Posted: 27 Sep 2017 at 11:22am
Hi Tony,

Timing of PPIs is not actually critical. They are best taken half an hour before food as they are not intended to dissolve until they reach the duodenum. Following them with food ensures they have been pushed there.

"LPR" is not necessarily a recognised term by many doctors. It describes reflux that has continued past the top of the oesophagus which is why it's properly called Extra-Oesophageal reflux. (Jamie Kaufman, a voice specialist in US initially coined the phrase along with her theories that it's caused by pepsin in the throat which can be treated with alkaline water (when she was a director of the company that sold water ionisers)!
The existence of pepsin in the throat is actually proof of reflux as it can only originate in the stomach.

PPIs like lansoprazole and esomeprazole are all as effective as each other when taken in equivalent dose to reduce acid. They do not reduce reflux.

Earlier this year, I carried out a survey into the effectiveness of PPIs at reducing reflux.
It concluded, "Two thirds of patients on Acid Suppressant Medication still suffered with symptoms of Extra Oesophageal Reflux whilst Anti Reflux Surgery reduced symptoms by 57%."


To reduce reflux, see the "Natural remedies" page of the Reflux section of Down With Acid.
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tonytap01
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Quote tonytap01 Replybullet Posted: 27 Sep 2017 at 6:12pm
Thanks, Chris. Interestingly, my GP recognised LPR, but didn't know 'extra oesophageal'! I may have made a mistake in saying I'd read about extra oesophageal on the website, I think he thought I'd been on Dr Google looking to self diagnose. Hopefully I can clarify when we eview the med change in a few weeks. He definitely doesn't like fundo, very much to be avoided. I'm going to have my work cut out!
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