[Dysphagia] laryngospasm

[LLORTEAU at sbgh.mb.ca (Lindsey Lorteau)]

Thanks Irene

This lady does do as much of the lifestyle management as she can.  She pretty bad rheumatoid arthritis so is somewhat dependent on those limitations re:  positioning.  She has taken 40 mg of omeprazole (20 mg BID) before but rather likes the once-daily dose of 40 mg of Nexium better.  She's on LOTS of meds and in addition to the Nexium (this management suggested by GI) she is also taking Maxeran.  GI reported "chronic GERD with stricturing".  

Anyway she is now having some difficulty with swallowing as well as the laryngospasm and a family member is an MD......thought maybe speech therapy could do something.  I've requested the ENT report whom she saw in the community.

Lindsey

Lindsey J M Lorteau, MS, CCC-SLP
Speech-Language Pathologist/Orthophoniste
l'h?pital g?n?ral St Boniface General Hospital

>>> Irene Campbell-Taylor <eripley@yahoo.com> 12/20/04 10:39am >>>
There is a common misperception about PPIs - they do not treat reflux. They merely inhibit the production of gastric acid to allow healing of esophageal erosions and are not meant to be used for long periods.Only about half of patients tested actually experience inhibition og acid production and about 30% get breakthrough production during sleep.  The only reliable treatment for reflux is life style change: avoiding caffeine, alcohol, fats, large meals, drinking more water, never lying flat, sleeping on the left side etc. etc. Reglan is widely used as a motility modifier but can have some very bad side effects. Domperidone (not available in the US) isn't quite so bad but recent literature states that it must not be regarded as a substitute for cisapride as it can and does cross the blood brain barrier in many. What is not widely understood is that cisapride, probably the best motility modifier ever made, is still available. The physician has to contact the special office at Janssen
 Pharmaceuticals and fill in forms describing the patient and verifiying that he/she does not have the cardiac arrythmias that caused the patient deaths. Also that they are not taking and will be warned not to take the antibiotics to be avoided. Many who were on cisapride before it was controlled are still taking it.

Lindsey Lorteau <LLORTEAU@sbgh.mb.ca> wrote:

Hi all

As far as I can tell from a quick search, laryngospasm is primarily treated by treating the reflux which tends to cause it. Is there anything else other than PPI treatment that is recommended?

Thanks and happy holidays!
Lindsey

Lindsey J M Lorteau, MS, CCC-SLP
Speech-Language Pathologist/Orthophoniste
l'h?pital g?n?ral St Boniface General Hospital



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This email and/or any documents in this transmission is intended for the address(s) only and may contain legally privileged or confidential information.  Any unauthorized use, disclosure, distribution, copying or dissemination is strictly prohibited.  If you receive this transmission in error, please notify the sender immediately and return the original.

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