Solving Silent Reflux LPR, or Silent Reflux, is a very common cause of chronic throat symptoms (‘post nasal rip”, lump in the throat, cough, throat clearing, hoarseness) without the pain of heartbum. Follow these strategies to control your problem and improve your symptoms. ‘You will probably fee! no different for the first 7-10 days, but don't get frustrated. ..you will get better! 1. Avoid eating 2 or 3 hours before lying down or going to bed. 2. Elevate the head of your bed 2 inches with blocks/bricks under the legs, or pillows/foam under the mattress: = = Pad extra pillows under your head don't help! 3. Don't skip breakfast, no matter how rushed you feel. 4. Try to eat 4 or 5 small meals a day, instead of 1 or 2 huge meals a day. 5. Reduce these foods if they affect you: whole milk and dairy products, caffeine, chocolate, alcohol, tomato sauces/tomatoes, onions, spicy foods, oranges, grapefruits, and peppermints. 6. Take your proton pump inhibitor (omeprazole, Aciphex, Nexium, Prevacid, Prilosec, Protonix) 30 minutes before dinner, if a second dose is prescribed, take it before 7. Take other reflux medicines (Zantac, Pepcid, Carafate) at bedtime. 8. Stop vitamin C. Reduce Motrin, Advil and excessive aspirin. Tylenol and a baby aspirin are fine. 9. Ifyou smoke, STOP. We cannot stress the importance of this enough! 10. Do your best to lose weight. Even 2 - 5 pounds is helpful! 11. Reduce stomach compression (tight belts or clothes, crunches and abdominal exercises while lying down, straining). 12. Use baking soda toothpaste (Arm & Hammer or Tom's). 13. Gargle 1 tablespoon baking soda in 1 cup warm water, several times a day. 14. For more information, check out a You Tube video entitled “Understanding LPR". 15. Additional notes: When you fee! better, share these ideas with your friends and family, many of whom have the same problem and don't even know it! ‘Saba Aftab MD, FACS Scott R. Schaffer MD, FACS.