'Let food be thy medicine and medicine be thy food.' - Hippocrates of Kos, 460-370BC, Greek physician
There have been a few changes in my world lately. For one thing, I seem to be getting to the bottom of my health issues. Friends and regular readers may be aware that I've been unwell for a couple of years, going back to when I was diagnosed with two strains of atypical pneumonia and glandular fever. At the time, the doctors also found that my calcium levels were too high, my Vitamin D levels were too low, there were indications of lupus, thyroid problems and osteopenia. A specialist also found a hiatus hernia, reflux or GERD and oesophagitis. To my huge disappointment, it seemed that my entire system had virtually crapped itself. Regretfully, I had to take months off work from a job that I absolutely loved... and this was not a great lead into my planned retirement!
While Peter's mother, Joan, was visiting recently, my persistent cough worsened to the point that it was uncontrollable. It was during this time that Joan mentioned that, like myself, she takes medication for reflux and noted that she also has a cough that won't go away.
The penny dropped!
You see, we'd treated Joan to high tea and all kinds of other culinary outings, and my cough seemed to get unbearably worse after I'd consumed certain foods and beverages. In fact, while talking on the phone with a friend, I noticed that I hadn't been coughing at all until after I'd eaten two chocolate wheaten biscuits.
I booked an appointment with my GP and, in the meantime, consulted a couple of medical books, and also jumped online to do a little research. To my amazement, I learned that some people with reflux and hiatus hernia can have laryngopharyngeal reflux (LPR) or 'silent reflux', the symptoms of which include hoarseness, chronic throat clearing, chronic coughing, difficulty swallowing and breathing, a constant 'lump in the throat', unexplained vomiting and chest pain, among other things. As I understand it, these issues are caused by acidic juices backing up from the stomach into the oesophagus and throat, thus causing irritation from the digestive enzyme known as pepsin.
On reflection, I was reminded that in 2013, the specialist gastroenterologist had advised me not to eat too many red capsicums and suggested I look at the FODMAP eating plan, but he didn't really elaborate and at the time I didn't make too many drastic changes to my diet.
LPR is referred to as 'silent reflux', because it can be present without any feelings of heartburn or with only very mild symptoms. In a small number of cases, the condition may be more severe and can cause major complications, such as pneumonia (!!). More alarmingly, it can also lead to cancer.
A lengthy consultation with my GP confirmed my suspicions and, thankfully, I've now been referred to an ENT specialist. I discussed an 'acid-free', low fat elimination eating plan with my doctor and he agreed that it was a sensible approach. My daily dose of Nexium has also been slightly increased for the time being (and he mentioned the possibility of surgery - ugh). My preference is to manage and calm my symptoms through a revised diet, if possible. This won't be the first time that I've adopted lifestyle and dietary changes to improve my health and wellbeing.
As such, I'm eating smaller meals, and don't eat anything for three hours before bedtime, as this is when my symptoms are worse. Indeed, it explains me waking up with a sore throat and chest, and 'flu-like' symptoms for so many, many months. Using this list as a basic guide, I'm avoiding all caffeine, alcohol, chocolate, citrus, mint, carbonated drinks, and gluten; as well as all fatty, highly acidic and overly spicy foods.
Some of my favourite things are to be eliminated, at least for now. To help monitor my progress, I'm keeping a food diary. Frankly, I miss eating fruit, and drinking fizzy water and wine. Fortunately, I can tolerate pears and watermelon, and there are plenty of other foods that I can enjoy. Peter is voicing his disappointment at the fact that I'm avoiding so many of the foods that I love. But if I'm to get well, I simply must do this. Of course, he is not missing out, as I will happily prepare individual meals for the both of us... e.g. chillies for him, none for me. Things won't change too much here, on this little journal, but I do plan to keep you posted, particularly those who are interested.
Two weeks into it and I'm already seeing results. The cough has all but stopped and I have much more energy. There's a distinct pattern forming, in that if I consume even small amounts of food or drink that I should be avoiding, the hoarseness and phlegmy throat clearing returns. Given that my GP confirmed the specialist's findings from 2013, I feel assured in the knowledge that none of this is psychosomatic and so I will continue with the revised eating program.
Some might wonder why I am sharing this information here on a web site that celebrates food. My response is that sometimes too much of a good thing can be bad for us. I'm living proof of that. Also, for far too long I've been under the impression that the symptoms I've been experiencing are due to viruses or bacterial infections. Case in point, when I mentioned the chronic cough to a GP I saw about a rash on my face a couple of months ago (not my usual doctor), he did not look into my medical history. Instead, he suggested an old fashioned cough remedy from the pharmacy. And this wasn't the only time the diagnosis may have been overlooked. If this can happen to me, it can happen to others.
I am keen to get back to the good health and vitality that I've enjoyed for most of my life, slowly but surely and under medical supervision. If that means eliminating foods that may be 'harmful' to my condition, then so be it.
This article details my own personal experience with silent reflux. It has been shared for informational and educational purposes only. The information should not been seen or taken as medical advice under any circumstances. It goes without saying that you must consult your own physician or medical practitioner if you have any concerns about your health.
Hello. I'm Liz, a writer, cook and traveller based in Canberra, Australia.
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NB: I use Australian standard measuring cups and spoons in my recipes.