Post Nasal Drip

[camerata]

I've had post-nasal drip after meals for decades. The only symptom is mucus and clearing of the throat after eating, which suggests a food allergy. The problem is it happens after eating almost anything. Does anyone know of a good specialist, preferably at Bumrungrad or Samitivej, for this type of thing?

[awakened]

I've had post-nasal drip after meals for decades. The only symptom is mucus and clearing of the throat after eating, which suggests a food allergy. The problem is it happens after eating almost anything. Does anyone know of a good specialist, preferably at Bumrungrad or Samitivej, for this type of thing?

I had a similar problem for years, in that I had the sniffles after eating most foods and often sneezed when the food was put in front of me. A food allergy test at Bumrungrad was negative.

Found this online... 'The more common and reliable methods of testing for food and environmental sensitivities are the IgG blood test, the Coco Pulse Test, and the elimination/provocation diet. The patch skin tests and RAST blood tests are effective for testing for allergies, but generally ineffective for diagnosing/detecting sensitivities.'

I tried the coco pulse test and gradually removed likely culprits from my diet... grains, nuts, tomatos, red meat, dairy, processed food and the reactions diminished. I rarely react these days.

Some sites claim 'leaky gut' as a possible cause.

[mommysboy]

I've had post-nasal drip after meals for decades. The only symptom is mucus and clearing of the throat after eating, which suggests a food allergy. The problem is it happens after eating almost anything. Does anyone know of a good specialist, preferably at Bumrungrad or Samitivej, for this type of thing?

I had a similar problem for years, in that I had the sniffles after eating most foods and often sneezed when the food was put in front of me. A food allergy test at Bumrungrad was negative.

Found this online... 'The more common and reliable methods of testing for food and environmental sensitivities are the IgG blood test, the Coco Pulse Test, and the elimination/provocation diet. The patch skin tests and RAST blood tests are effective for testing for allergies, but generally ineffective for diagnosing/detecting sensitivities.'

I tried the coco pulse test and gradually removed likely culprits from my diet... grains, nuts, tomatos, red meat, dairy, processed food and the reactions diminished. I rarely react these days.

Some sites claim 'leaky gut' as a possible cause.

A tricky one this. If the tests are neg then they are neg. Possibly you just have sensitive nasal linings?. Could be that when you relax the day's wear and tear including the incredible assault on your nasal linings come to the fore. Could it be a general condition that you just become awareof at certain times?

One common thing is that a perso who has very agitated nasal linings, perhaps caused by hayfever, or similar, sneezes at just about anything thereafter causing one to believe that whatever is present is the cause, could this be true?

I'd reckon you should get your nose properly checked out , just in case you have a recurring infection. or narrowing y

[kat]

Yes, I'm having this experience as well, but it just started this year. Or possibly, it started in Thailand but became chronic this year, I'm not sure. Since I can observe exactly when it became chronic, I can only share my observation and experience. It seems to be related to food allergies. As many of you know, I struggled with that this year. Sinus issues are one of the co-factors of whatever is plaguing me. I have reduced cheese (can't or won't give it up altogether, but I regulate it in my life as well as ice cream), don't do milk. I also cut out wheat, but I think dairy is the biggest culprit for me. I rinse my sinus with mild salt water in a netti pot 2-3 times a week.

I also sneeze and have a variety of reactions to food. The question for me is: is it related to specific food allergies, a specific condition, or is it related to overgrown Candida creating a "leaky" gut, in which food passes straight into your bloodstream?

"Leaky gut syndrome is a diagnosis prevalent in various branches of alternative medicine. Its proponents hypothesize that damage to the bowel lining, caused by antibiotics, toxins, poor diet, parasites or infection (e.g. with the yeast Candida albicans) [1] can lead to increased permeability of the gut wall to toxins, microbes, undigested food, waste or larger than normal macromolecules.[2] Some versions posit that these substances affect the body directly, while others postulate an immune reaction to these substances."

http://www.leakygut.co.uk/Candidiasis.htm

[camerata]

A tricky one this. If the tests are neg then they are neg. Possibly you just have sensitive nasal linings?. Could be that when you relax the day's wear and tear including the incredible assault on your nasal linings come to the fore. Could it be a general condition that you just become awareof at certain times?

Not really. The symptom is a lot of mucus at the back of the throat immediately after eating, and it lasts 30-40 minutes. It doesn't occur at any other time, including when drinking liquids. It's far worse if I eat anything with any kind of sauce that has multiple ingredients. If I eat, say, one fresh apple there's little problem.

[mommysboy]

Yes, I'm having this experience as well, but it just started this year. Or possibly, it started in Thailand but became chronic this year, I'm not sure. Since I can observe exactly when it became chronic, I can only share my observation and experience. It seems to be related to food allergies. As many of you know, I struggled with that this year. Sinus issues are one of the co-factors of whatever is plaguing me. I have reduced cheese (can't or won't give it up altogether, but I regulate it in my life as well as ice cream), don't do milk. I also cut out wheat, but I think dairy is the biggest culprit for me. I rinse my sinus with mild salt water in a netti pot 2-3 times a week.

I also sneeze and have a variety of reactions to food. The question for me is: is it related to specific food allergies, a specific condition, or is it related to overgrown Candida creating a "leaky" gut, in which food passes straight into your bloodstream?

"Leaky gut syndrome is a diagnosis prevalent in various branches of alternative medicine. Its proponents hypothesize that damage to the bowel lining, caused by antibiotics, toxins, poor diet, parasites or infection (e.g. with the yeast Candida albicans) [1] can lead to increased permeability of the gut wall to toxins, microbes, undigested food, waste or larger than normal macromolecules.[2] Some versions posit that these substances affect the body directly, while others postulate an immune reaction to these substances."

http://www.leakygut.co.uk/Candidiasis.htm

wow you throw up the whole works.

To have a post nasal drip, surely it's necessary first to have a badly blocked nose, that probably takes more than an immediate reaction to food, butI'm no doctor.

I'd get the sinusitis and possibly nasal problem sorted and I wouldn't be surprised if this considerably lessens the gastric problems too.

I had all these sorts of probs -not candida though. An effective diagnosis got me the right medicine and near perfect health. It culd be as simple as taking a short course of antibiotics and 2 months on a corticosteroid to cure any nasal/sinus inflammation.

Also discuss the possibility of an anti-inflammatory for your stomach.

There is no substitute for a correct medical diagnosis. IMHO you should not self treat here.

Surely you are experiencing a lot of pain?

[mommysboy]

A tricky one this. If the tests are neg then they are neg. Possibly you just have sensitive nasal linings?. Could be that when you relax the day's wear and tear including the incredible assault on your nasal linings come to the fore. Could it be a general condition that you just become awareof at certain times?

Not really. The symptom is a lot of mucus at the back of the throat immediately after eating, and it lasts 30-40 minutes. It doesn't occur at any other time, including when drinking liquids. It's far worse if I eat anything with any kind of sauce that has multiple ingredients. If I eat, say, one fresh apple there's little problem.

But you said a post nasal drip didn't you????? Maybe you need to observe what's happening. Either way I'm sure it's a minor problem. Possibly minor gastric reflux, or just a generalised reaction of the membranes. I think we all have probs. of this nature.

Chilli is a known irritant to many westerners, it seems to creep in everywhere - I've even found some in my fruit - I mean HECK!!!what can you do ??

[kat]

Thanks for your feedback. I'm not in a lot of pain now, but I was several months ago. I also started experiencing severe memory and cognitive issues, due to malabsorbtion of B-vitamins. I cut out wheat and dairy, but I still sneeze and have reactions to food that should be safe. During the winter, I got terrible pneumonia/bronchitis. This sinus/nasal drip has been with me since, and I believe it is related to the same battle with food allergies. I went on antibiotics this past winter. So, the post/nasal drip arose as another symptom to what was occurring, not as a primary symptom.

I know that many expats in Thailand may have similar issues with over prescribed antibiotics, parasites, microbes, and an overgrowth of bad bacteria in their gut. In my experience, this can cause problems in your whole immune system. I read recently that more than 70% of your immune system is located under the lining of your intestines. Candida and other leaky gut syndromes affect the lining of your intestines and can cause a spectrum of allergies, reactions and food intolerances. One of the symptoms of allergies and food intolerances is post nasal drip. In my case, it is absolutely related to what has been happening in my gut.

Just a thought. Thanks again.

[mommysboy]

Thanks for your feedback. I'm not in a lot of pain now, but I was several months ago. I also started experiencing severe memory and cognitive issues, due to malabsorbtion of B-vitamins. I cut out wheat and dairy, but I still sneeze and have reactions to food that should be safe. During the winter, I got terrible pneumonia/bronchitis. This sinus/nasal drip has been with me since, and I believe it is related to the same battle with food allergies. I went on antibiotics this past winter. So, the post/nasal drip arose as another symptom to what was occurring, not as a primary symptom.

I know that many expats in Thailand may have similar issues with over prescribed antibiotics, parasites, microbes, and an overgrowth of bad bacteria in their gut. In my experience, this can cause problems in your whole immune system. I read recently that more than 70% of your immune system is located under the lining of your intestines. Candida and other leaky gut syndromes affect the lining of your intestines and can cause a spectrum of allergies, reactions and food intolerances. One of the symptoms of allergies and food intolerances is post nasal drip. In my case, it is absolutely related to what has been happening in my gut.

Just a thought. Thanks again.

Thanks for the education. I do hope you have a better winter this year.

Sounds like rest and avoiding pollution is important. The thing I notice about Bangkok is that it doesn't take much exposure to the outside atmos. before problems come to the fore.

As a general rule of thumb, if you have a mild allergy in Farangland it becomes moderate in Bangkok, and so on. I think this stands good.

Regarding your stomach, it may sound a bit eccentric but I'm a great believer in good basic diet, so plenty of greens and starches. Carbs from your own base diet, eg, from UK eat potatoes, Italy eat pasta.

Obviously overuse of antibiotics is an issue, but as far as I aware it has to be considerable use over a protracted period of time, although this might not apply with specific medicines such as clindamycin.

[jfchandler]

I've had very bad sinus problems starting suddenly about 6 years ago when I was in the midst of a very stress-filled, demanding work environment in Los Angeles... Sinus surgeries and all manner of not very effective treatment in the USA followed.

After coming to live here, the problems still continued, though my nose certainly was more open after the various surgeries in the USA. Finally, after very unsatisfactory doctor experiences at Bumrungrad, I went to BNH and found a very good ENT doc -- Dr. Pasakorn Thavornant -- who took the time to listen to my symptoms and history, and was open to different testing and treatment approaches.

He did a variety of testing, and came up with a result positive for fungal infection...something the doctors in the U.S. would never test for despite my requests. He put me on an anti-fungal medication for the past two months, and I'm feeling much better and my symptoms have subsided.

I mention this because, while in the U.S., the ENTs there had me on long and repeated courses of antibiotics in an attempt to resolve my sinus symptoms. While taking the antibiotics, I'd always feel better. But as soon as I stopped them, the symptoms would return. Just before leaving, I went for a comprehensive allergy test and found much to my surprise I had developed multiple allergies (that I hadn't had in prior tests years ago) to a lot of pretty common foods.

So, while the BNH doctor is not an allergist, and I can't recommend any allergist in BKK, I can recommend him as a very good, attentive, knowledgeable sinus doctor. There are a couple BKK hospitals, however, that have dedicated allergy centers.

And second, the above discussion about candida and "leaky gut" syndrome is something I believe to be real, and in my case, a likely contributing cause of my sinus and allergy problems. (When you take a lot of antibiotics over a long period, that kills off the good flora in your intestine and allows Candida fungus to proliferate, causing these kinds of allergy and sinus symptoms).

A very useful, practical and informative book on this subject, which lays out anti-Candida diet and lifestyle recommendations, is "Sinus Survival" by Robert Ivker.

In the case of the OP, and the history he presented, the symptoms he described don't sound like they are related to Candida... But they do sound like something is going on there in the way of food allergies.

The simplest home approach to discern that, other than going for full-blown allergy testing, is by modifying your diet to initially stay with simple, non-allergy producing foods. And then, slowly and one at a time, begin reintroducing other foods into your diet and monitor whether they are triggering allergy symptoms. In that manner, you can begin to isolate what is triggering your symptoms...

Some foods that are particularly prone to triggering allergy symptoms include wheat grain and flours (which are present in so many things), dairy products, peanuts, eggs, soy products, malt barley and sometimes citrus products such as oranges/orange juice.

On the other hand, meats and vegetables, brown rice, melons and most other fruits, tea and water, are considered to be relatively non-allergenic.

[mommysboy]

I've had very bad sinus problems starting suddenly about 6 years ago when I was in the midst of a very stress-filled, demanding work environment in Los Angeles... Sinus surgeries and all manner of not very effective treatment in the USA followed.

After coming to live here, the problems still continued, though my nose certainly was more open after the various surgeries in the USA. Finally, after very unsatisfactory doctor experiences at Bumrungrad, I went to BNH and found a very good ENT doc -- Dr. Pasakorn Thavornant -- who took the time to listen to my symptoms and history, and was open to different testing and treatment approaches.

He did a variety of testing, and came up with a result positive for fungal infection...something the doctors in the U.S. would never test for despite my requests. He put me on an anti-fungal medication for the past two months, and I'm feeling much better and my symptoms have subsided.

I mention this because, while in the U.S., the ENTs there had me on long and repeated courses of antibiotics in an attempt to resolve my sinus symptoms. While taking the antibiotics, I'd always feel better. But as soon as I stopped them, the symptoms would return. Just before leaving, I went for a comprehensive allergy test and found much to my surprise I had developed multiple allergies (that I hadn't had in prior tests years ago) to a lot of pretty common foods.

So, while the BNH doctor is not an allergist, and I can't recommend any allergist in BKK, I can recommend him as a very good, attentive, knowledgeable sinus doctor. There are a couple BKK hospitals, however, that have dedicated allergy centers.

And second, the above discussion about candida and "leaky gut" syndrome is something I believe to be real, and in my case, a likely contributing cause of my sinus and allergy problems. (When you take a lot of antibiotics over a long period, that kills off the good flora in your intestine and allows Candida fungus to proliferate, causing these kinds of allergy and sinus symptoms).

A very useful, practical and informative book on this subject, which lays out anti-Candida diet and lifestyle recommendations, is "Sinus Survival" by Robert Ivker.

In the case of the OP, and the history he presented, the symptoms he described don't sound like they are related to Candida... But they do sound like something is going on there in the way of food allergies.

The simplest home approach to discern that, other than going for full-blown allergy testing, is by modifying your diet to initially stay with simple, non-allergy producing foods. And then, slowly and one at a time, begin reintroducing other foods into your diet and monitor whether they are triggering allergy symptoms. In that manner, you can begin to isolate what is triggering your symptoms...

Some foods that are particularly prone to triggering allergy symptoms include wheat grain and flours (which are present in so many things), dairy products, peanuts, eggs, soy products, malt barley and sometimes citrus products such as oranges/orange juice.

On the other hand, meats and vegetables, brown rice, melons and most other fruits, tea and water, are considered to be relatively non-allergenic.

great posting, and it shows just how important it is to team up with a good doctor., well one that will listen at any rate.

[kat]

I mention this because, while in the U.S., the ENTs there had me on long and repeated courses of antibiotics in an attempt to resolve my sinus symptoms. While taking the antibiotics, I'd always feel better. But as soon as I stopped them, the symptoms would return. Just before leaving, I went for a comprehensive allergy test and found much to my surprise I had developed multiple allergies (that I hadn't had in prior tests years ago) to a lot of pretty common foods.

So, while the BNH doctor is not an allergist, and I can't recommend any allergist in BKK, I can recommend him as a very good, attentive, knowledgeable sinus doctor. There are a couple BKK hospitals, however, that have dedicated allergy centers.

And second, the above discussion about candida and "leaky gut" syndrome is something I believe to be real, and in my case, a likely contributing cause of my sinus and allergy problems. (When you take a lot of antibiotics over a long period, that kills off the good flora in your intestine and allows Candida fungus to proliferate, causing these kinds of allergy and sinus symptoms).

A very useful, practical and informative book on this subject, which lays out anti-Candida diet and lifestyle recommendations, is "Sinus Survival" by Robert Ivker.

On the other hand, meats and vegetables, brown rice, melons and most other fruits, tea and water, are considered to be relatively non-allergenic.

jfchandler:

Thanks so much for the above discussion and recommendations. You have nailed my experience to a tee, and helped further confirm my suspicions of what has been plaguing me. I got sick in Thailand, had the requisite medication and antibiotics, came back to the states with a probable candida overgrowth which probably started presenting more severe reactions after a change to the Western diet, became ill again and thought it was a reoccurrence of parasites, went to a doctor, who prescribed powerful flagyl antibioitcs, which resulted in more illness and a change to the lining of my intestines, and suddenly I am allergic to everything and anything! I understand the issues of self-diagnosis, but I had to fight with a Western doctor just to get an allergy test when he told me I was lactose intolerant. Turns out I had an allergy to milk, which is rare. Now I am noticing a whole list of other things and I now it is probably related to Candida, but how am I going to get treatment from a Western doctor on an ailment that supposedly does not exist?! I have to heal myself. I will look for the book you recommended. Thanks again.

[jfchandler]

Kat, all of the many sinus docs I saw in the U.S., almost without exception, dismissed any notion of fungal or Candida as a cause... But, I'd never had allergic sensitivity to all the many things I tested positive for in the past, when I'd had prior allergy testing... So something changed.... And, when I began taking a prescription antifungal here, I began feeling much better and had much less bothersome symptoms. In fact, at times, I could smell at times what seemed like dying yeast in my nose or from my skin...sort of like a moldy cheese smell... very weird....

The nice thing about the Ivker book, however, is you can accomplish much of it on your own, simply by changing your diet. He also mentions some homeopathic products that can help at killing Candida, though I found them hard to find and haven't used them as yet. There are, then, the prescriptions anti-fungals, but those should be used with caution because of potentially serious side effects... They are obtainable in the U.S., however. And he does say those are the quickest way to begin to remedy the situation.

Ivker's book also contains a list of MD's in the U.S. who are knowledgeable about his program. One of those used to work at UCLA in Los Angeles. But by the time I went looking for her there, she had already departed and I couldn't figure out where she had gone to... If you're back in the U.S., and you want to PM me with your state location/area, I'll check my copy of the book to see if there's any doctor listed nearby....

The other good thing about his approach is, even if your self diagnosis is wrong for some reason, there's nothing bad or harmful in his dietary recommendations just in the overall healthy living sense, i.e, seriously cut down/out sugars, avoid all yeast-bearing products, especially BEER, more lean meat and vegetables, fewer starches and focus on non-gluten grains, etc etc...

[kat]

Thanks Chandler. I have already cut out gluten and dairy and trying to adjust. It will be a big step to change further for Candida, because it excludes a lot, and for many months. I think I would be more successful with the anti-fungals. What are the potential side effects?

I live in D.C.

[jfchandler]

Kat, I responded to your questions via PM....

[camerata]

After googling around a lot I found this mucus-in-the-throat-after-meals problem is very common and there are a number of causes. The main one seems to be Gastroesophageal Reflux Disease (GERD) or laryngopharyngeal reflux (LPR). After eating, acid (or even acid fumes) from the stomach comes up and irritates the throat. I have suffered from heartburn in the past, which is another pointer towards GERD and LPR..

[mommysboy]

After googling around a lot I found this mucus-in-the-throat-after-meals problem is very common and there are a number of causes. The main one seems to be Gastroesophageal Reflux Disease (GERD) or laryngopharyngeal reflux (LPR). After eating, acid (or even acid fumes) from the stomach comes up and irritates the throat. I have suffered from heartburn in the past, which is another pointer towards GERD and LPR..

yes I think it's a common problem.

But I don't understand, you haven't tackled the post nasal drip?

[kat]

After googling around a lot I found this mucus-in-the-throat-after-meals problem is very common and there are a number of causes. The main one seems to be Gastroesophageal Reflux Disease (GERD) or laryngopharyngeal reflux (LPR). After eating, acid (or even acid fumes) from the stomach comes up and irritates the throat. I have suffered from heartburn in the past, which is another pointer towards GERD and LPR..

Yes, but then my question would be: why? Why would your stomach start producing enough acid to cause GERD? For me, it is simply another symptom of underlying issues that need to be diagnosed and treated together. I don't believe in simply focusing on a symptom without questioning the underlying cause. GERD is highly associated with allergies, food intolerances, Celiac Disease and other malabsorption issues. Anyway, I'm sure that my issue originates in the stomach, and is causing multi-system symptoms and new food intolerances.

Good luck on your quest to optimal health. It's not just for the super young.

[mommysboy]

After googling around a lot I found this mucus-in-the-throat-after-meals problem is very common and there are a number of causes. The main one seems to be Gastroesophageal Reflux Disease (GERD) or laryngopharyngeal reflux (LPR). After eating, acid (or even acid fumes) from the stomach comes up and irritates the throat. I have suffered from heartburn in the past, which is another pointer towards GERD and LPR..

Yes, but then my question would be: why? Why would your stomach start producing enough acid to cause GERD? For me, it is simply another symptom of underlying issues that need to be diagnosed and treated together. I don't believe in simply focusing on a symptom without questioning the underlying cause. GERD is highly associated with allergies, food intolerances, Celiac Disease and other malabsorption issues. Anyway, I'm sure that my issue originates in the stomach, and is causing multi-system symptoms and new food intolerances.

Good luck on your quest to optimal health. It's not just for the super young.

I wonder is it not true that we all suffer minor conditions of the nose, stomach, or whatever, mainly as a consequence of modern living ?.

I mean for sure I have rhinitis, and am prone to indigestion and an acid stomach. I got in to a cycle of gastro enteritis too. This got better when I gave up smoking and got to grips with my sinus problem- don't know how?? I just got all round better. I put weight on, nearly 10% for the first time in my life. I'd describe myself as just having an allergy to urban life it's over exposure to fumes, chemicals, noise, air conditioners, hot engines, etc.

It's when minor becomes something more that the problem really starts, and I see more and more of this and wonder whether the underlying condition is toxic irritation.

Cause and effect is important as you point out, and so focusing solely on the symptom is an error.

I believe I read somewhere that GERD and allergies are inter-related, especially with non-allergic conditions such as vasomotor rhinitis, could explain OP's minor affliction.

[wpcoe]

After coming to live here, the problems still continued, though my nose certainly was more open after the various surgeries in the USA. Finally, after very unsatisfactory doctor experiences at Bumrungrad, I went to BNH and found a very good ENT doc -- Dr. Pasakorn Thavornant -- who took the time to listen to my symptoms and history, and was open to different testing and treatment approaches.

He did a variety of testing, and came up with a result positive for fungal infection...something the doctors in the U.S. would never test for despite my requests. He put me on an anti-fungal medication for the past two months, and I'm feeling much better and my symptoms have subsided.

I wholehearted endorse Dr. Pasakorn, as well. Besides being a very attentive and compassionate doctor during my septoplasty, he also was able to "think outside the box" (e.g. not routinely prescribe a bag of antibiotics) when I was sieged with a series of ear infections. I live in Pattaya and had been visiting the ENTs at Bangkok-Hospital Pattaya about once every six weeks and each time, the treatment was a different antibiotic. I was in Bangkok on a day-trip, and decided to see Dr. Pasakorn, and expressed my concern at taking so many antibiotic pills so often. He examined my ears and verified there was an infection, but because I was leaving for Pattaya in a few hours, didn't have time to take a sample and determine the type of infection (which none of the BHP doctors ever did...). He said infections often thrive in the ear canal when it is too alkaline, so prescribed acetic acid (vinegar) to flush the ear canal a few times daily to raise the acidity of the area, and a TOPICAL (not SYSTEMIC) antibiotic to apply directly to the infection. He satisified my concern about systemic antibiotics and successfully treated the infection.

A friend of mine also went to Dr. Pasakorn to diagnose the cause of excessive and constant post nasal drip after having no success with other doctors (here and abroad), and Dr. Pasakorn found, and treated him for, polyps. Amazing that other doctors didn't "notice" the polyps, but my friend is now post nasal drip-free.

[jfchandler]

After coming to live here, the problems still continued, though my nose certainly was more open after the various surgeries in the USA. Finally, after very unsatisfactory doctor experiences at Bumrungrad, I went to BNH and found a very good ENT doc -- Dr. Pasakorn Thavornant -- who took the time to listen to my symptoms and history, and was open to different testing and treatment approaches.

He did a variety of testing, and came up with a result positive for fungal infection...something the doctors in the U.S. would never test for despite my requests. He put me on an anti-fungal medication for the past two months, and I'm feeling much better and my symptoms have subsided.

I wholehearted endorse Dr. Pasakorn, as well. Besides being a very attentive and compassionate doctor during my septoplasty, he also was able to "think outside the box" (e.g. not routinely prescribe a bag of antibiotics) when I was sieged with a series of ear infections. I live in Pattaya and had been visiting the ENTs at Bangkok-Hospital Pattaya about once every six weeks and each time, the treatment was a different antibiotic. I was in Bangkok on a day-trip, and decided to see Dr. Pasakorn, and expressed my concern at taking so many antibiotic pills so often. He examined my ears and verified there was an infection, but because I was leaving for Pattaya in a few hours, didn't have time to take a sample and determine the type of infection (which none of the BHP doctors ever did...). He said infections often thrive in the ear canal when it is too alkaline, so prescribed acetic acid (vinegar) to flush the ear canal a few times daily to raise the acidity of the area, and a TOPICAL (not SYSTEMIC) antibiotic to apply directly to the infection. He satisified my concern about systemic antibiotics and successfully treated the infection.

A friend of mine also went to Dr. Pasakorn to diagnose the cause of excessive and constant post nasal drip after having no success with other doctors (here and abroad), and Dr. Pasakorn found, and treated him for, polyps. Amazing that other doctors didn't "notice" the polyps, but my friend is now post nasal drip-free.

Glad to hear your account above and that he helped you. Equally glad that your experience and that of your friend match mine with this particular doctor. It's very hard to find a really good doctor in any particular specialty... The only real way is thru personal trial and experience. This should be a good indicator to others on TV in need of a good sinus doc....

[jfchandler]

After coming to live here, the problems still continued, though my nose certainly was more open after the various surgeries in the USA. Finally, after very unsatisfactory doctor experiences at Bumrungrad, I went to BNH and found a very good ENT doc -- Dr. Pasakorn Thavornant -- who took the time to listen to my symptoms and history, and was open to different testing and treatment approaches.

He did a variety of testing, and came up with a result positive for fungal infection...something the doctors in the U.S. would never test for despite my requests. He put me on an anti-fungal medication for the past two months, and I'm feeling much better and my symptoms have subsided.

I wholehearted endorse Dr. Pasakorn, as well. Besides being a very attentive and compassionate doctor during my septoplasty, he also was able to "think outside the box" (e.g. not routinely prescribe a bag of antibiotics) when I was sieged with a series of ear infections. I live in Pattaya and had been visiting the ENTs at Bangkok-Hospital Pattaya about once every six weeks and each time, the treatment was a different antibiotic. I was in Bangkok on a day-trip, and decided to see Dr. Pasakorn, and expressed my concern at taking so many antibiotic pills so often. He examined my ears and verified there was an infection, but because I was leaving for Pattaya in a few hours, didn't have time to take a sample and determine the type of infection (which none of the BHP doctors ever did...). He said infections often thrive in the ear canal when it is too alkaline, so prescribed acetic acid (vinegar) to flush the ear canal a few times daily to raise the acidity of the area, and a TOPICAL (not SYSTEMIC) antibiotic to apply directly to the infection. He satisified my concern about systemic antibiotics and successfully treated the infection.

A friend of mine also went to Dr. Pasakorn to diagnose the cause of excessive and constant post nasal drip after having no success with other doctors (here and abroad), and Dr. Pasakorn found, and treated him for, polyps. Amazing that other doctors didn't "notice" the polyps, but my friend is now post nasal drip-free.

Glad to hear your account above and that he helped you. Equally glad that your experience and that of your friend match mine with this particular doctor. It's very hard to find a really good doctor in any particular specialty... The only real way is thru personal trial and experience. This should be a good indicator to others on TV in need of a good sinus doc....

I should have likewise added re wpcoe's comments that the standard, near universal answer most all the sinus docs have to almost everything is to prescribe oral, systemic antibiotics. But, that isn't always such a good thing for you and your health, and more importantly, in sinus cases, it may also treat only the symptoms but not the CAUSE of what's leading to infections. That's why it's so refreshing to find a doctor who's actually interested in getting to the cause of things, and not just treating recurring symptoms...

[Searat7]

I've had post-nasal drip after meals for decades. The only symptom is mucus and clearing of the throat after eating, which suggests a food allergy. The problem is it happens after eating almost anything. Does anyone know of a good specialist, preferably at Bumrungrad or Samitivej, for this type of thing?

Dr. Chanchai (first name) is an excellent ENT physician at BNH Hospital. My sinuses give problems after 2 weeks here and he gives me a treatment (including a steroid shot) which lasts about 5 months. Before I found him I almost moved back to the USA.

[camerata]

But I don't understand, you haven't tackled the post nasal drip?

A combination of fuzzy thinking and laziness, I guess. I assumed it was caused by an allergy to something in most foods, so the thought of giving up a lot of foods for the sake of a bit of throat-clearing didn't seem worth it.

[camerata]

Yes, but then my question would be: why? Why would your stomach start producing enough acid to cause GERD?

As I understand it, the sphincter muscle that is supposed to only open to let food go down is just like other muscles. It can become weak or malfunction due to wear and tear, and then it lets acid go up. Tissue in the oesophagus and larynx has little protection against acid so it gets inflamed. I don't think there has to be a lot of acid for this to happen.

What made me suspicious was that recently I switched to a high-fibre diet and occasionally have just an apple and some dried apricot for lunch. This results in up to two hours of throat-clearing. Since it is wholesome food, the problem seems more likely to be related to acidity (on an empty stomach) than allergens.

[mommysboy]

But I don't understand, you haven't tackled the post nasal drip?

A combination of fuzzy thinking and laziness, I guess. I assumed it was caused by an allergy to something in most foods, so the thought of giving up a lot of foods for the sake of a bit of throat-clearing didn't seem worth it.

Yes I can relate to this and in any case it's difficut to isolate symptoms and match them to specific causes. Indeed true, the cost of good health is often giving up the things we like, and is it worth it? I'm not always sure it is with minor afflictions.

I guess if I searched hard enough I could find a doctor who would diagnose me with GERD, and higher blood pressure, but really I know I just need to cut down on a whole range of things.

generally change when confronted with definite pain.

[mommysboy]

Yes, but then my question would be: why? Why would your stomach start producing enough acid to cause GERD?

As I understand it, the sphincter muscle that is supposed to only open to let food go down is just like other muscles. It can become weak or malfunction due to wear and tear, and then it lets acid go up. Tissue in the oesophagus and larynx has little protection against acid so it gets inflamed. I don't think there has to be a lot of acid for this to happen.

What made me suspicious was that recently I switched to a high-fibre diet and occasionally have just an apple and some dried apricot for lunch. This results in up to two hours of throat-clearing. Since it is wholesome food, the problem seems more likely to be related to acidity (on an empty stomach) than allergens.

My 'gerd' is usually caused by overeating and generally bad eating times. It might be important just to eat a bit less I guess- damned if I can do it though.

[Sheryl]

The stomach is naturally acidic. GERD is caused not by too much acid in the stomach but by the stomach contents flowing up into the lower part of the esophagus due to a weakness in the sphincter that normally prevents this.

Eating very large amounts at one time and lying down on a full stomach both increase the chance of this occurring (basic physics).

It also happens more easily as one ages due to gradual reduction in sphincter tone.

There is some evidence that caffeine affects the sphincter's function as well and m,any people (myself included) find that caffeine n more than small quantities wil seems to set off GERD.

Lastly, some people have a condition called hiatuis hernia whereby part of the stomach slips up into the chest cavity, and this will contribute to GERD.

In addition to discomfort, over time GERD may cause abnormal changes in the cells lining the esophagus and increase the risk of developing esophageal cancer (that's increase the risk, not necessarily cause cancer). Hence it should not be taken too casually, and people with persistent abnormal sensations in the thrat or on swallowing are well advised to see a GI specialist and undergo an endoscopy.

[mommysboy]

The stomach is naturally acidic. GERD is caused not by too much acid in the stomach but by the stomach contents flowing up into the lower part of the esophagus due to a weakness in the sphincter that normally prevents this.

Eating very large amounts at one time and lying down on a full stomach both increase the chance of this occurring (basic physics).

It also happens more easily as one ages due to gradual reduction in sphincter tone.

There is some evidence that caffeine affects the sphincter's function as well and m,any people (myself included) find that caffeine n more than small quantities wil seems to set off GERD.

Lastly, some people have a condition called hiatuis hernia whereby part of the stomach slips up into the chest cavity, and this will contribute to GERD.

In addition to discomfort, over time GERD may cause abnormal changes in the cells lining the esophagus and increase the risk of developing esophageal cancer (that's increase the risk, not necessarily cause cancer). Hence it should not be taken too casually, and people with persistent abnormal sensations in the thrat or on swallowing are well advised to see a GI specialist and undergo an endoscopy.

Oh I see.

I must admit I can relate to much of this except latter part.

But even as a youngster I can remember a bit of indigestion and heartburn, and wouldn't minor viral/ bacterial infections cause their own problems?.

Clearly you have the scientific edge but I still think there is a level of dysfunction we all have to live with.

In my case though, it is borderline. I think I'll at least mention it to the doc. HEY HO, yet more giving up to do I fear.