Seeking otolaryngologist - head and neck surgeon for reflux

[david_je]

Hello,

I have a suspected case of non-acid reflux that may be causing constant throat phlegm and cough, sinus congestion and post-nasal drip, and maybe migraines. I have been to regular ENT doctors without resolution, and have been advised to see an otolaryngologist - head and neck surgeon who has dealt with such cases and can do a thorough check-up.

I'd appreciate hearing from anyone who's seen and can recommend such a specialist in Bangkok for this problem.

Thank you

[JDGRUEN]

I am sure you want just the referral for a otolaryrngologist ... but I hope you have had a thorough work up for allergies, parasites, and a round of antibiotics... Also - your weight ... some of us are plagued with a big belly ... and it can contribute greatly to the esophageal valve not functioning correctly which can be involved in aggravating a hiatal hernia. The lack of acid reflux is a bit of a mystery...

Sincere good luck in finding that specialist...

[JDGRUEN]

Also David... has your doctor prescribed something like Budesonide is a glucocorticoid steroid or other kind of steroid use for nasal and sinus problems? If not please consider talking with the doctor about it ... Such a medication can provide dramatic relief. You might want to talk about using this type of medication accompanied with antibiotics.

If it were me - I would treat myself as these medications along with a wide range of antibiotics are available at many pharmacies. But what you do is course up to you.

About two months ago, I met a fellow at a long stay hotel in Bang Plii. He was suffering from a bad sinus situation along with some of the symptoms you speak of... He was on a respirator at night - the kind with a mask. He complained that the nightly treatment had stopped providing relief. I took him over to the local pharmacy and bought him some RhinoCort Aqua - Budesonide. I suggested he try a spray about every one to two hours for 3 times total in about a 6 to 8 hour time frame ... Then go to the recommended dosage on the package. In about six hours time he was breathing quite well - first time in a week or more. And didn't have to use the nightly respirator.

My experience with it is similar. In the U.S. - in the fall - winter months - I often get much of the same set of problems you describe. And a steroid based nasal spray ... sometimes with antibiotics fixes the problem in a few days.

As they say in Thailand... Up to you...

I am not a doctor but have significant education and experience in the health/medical field...

Good Luck on getting this aggravation done with...

[arjunadawn]

I am curious what you mean by non acid reflux. Your complaints sound very much pulmonary. Reflux nearly always considers a deficiency in the cardiac sphincter (Not heart), or the flap at the lower esophagus/stomach juncture. What you describe is upper respiratory, excepting the cough. This guy JDGruen offered you some sound advice and food for thought.

Please remember this little phrase: "Don't look for zebras when everyone is riding horses." In medicine, the easiest explanation is usually the correct one.