Returning to diving after LPR related Laryngospasm

[MMWat]

I’ve looked through previous threads but hoping someone can give me a more specific answer. I quit scuba diving about five years ago due to a Laryngospasm of unknown cause. I’ve had about 5 total spasms in about five years lasting about 30seconds mostly awake (one asleep) shortly after meals. Since the last one over a year ago I’ve taken it more seriously going to ENT’s, specialists, etc. they believe it’s caused by silent reflux, or LPR, I’ve lost 60lbs, taken my diet very seriously, also take sodium alginate at nights.

Since the changes I’ve not had dry coughs associated with LPR or Laryngospasms, but since it happened so rarely it’s hard to know if/when it will return.

Can anyone give me thoughts on when/if I should feel comfortable returning to diving, or where to contact a doctor that would have more specific knowledge? My GP basically just shrugged when asked.

 

[Duke Dive Medicine]

Diving can increase the severity of reflux by changing the pressure differential between the stomach and esophagus, so if yours is sufficient to cause coughing and laryngospasm on the surface, it's likely that diving will aggravate it. How was the reflux initially diagnosed? Did you have any studies like endoscopy or a pH probe? If the weight loss improved it, I would circle back with your GI specialist to see if additional studies are indicated. It probably goes without saying that, even if the chances are low, a laryngospasm while diving could be catastrophic.

Also, DM sent re diving medical specialist in the area.

Best regards,
DDM

 

[MMWat]

Diving can increase the severity of reflux by changing the pressure differential between the stomach and esophagus, so if yours is sufficient to cause coughing and laryngospasm on the surface, it's likely that diving will aggravate it. How was the reflux initially diagnosed? Did you have any studies like endoscopy or a pH probe? If the weight loss improved it, I would circle back with your GI specialist to see if additional studies are indicated. It probably goes without saying that, even if the chances are low, a laryngospasm while diving could be catastrophic.

Also, DM sent re diving medical specialist in the area.

Best regards,
DDM

Thanks for the information. Diagnosed with LPR based on symptoms (dry cough, post nasal drip, burping, Laryngospasm). ENT did laryngoscopy, and went onto speech therapy. Recommended treatment was dietary changes and sodium alginate therapy, if symptoms continued PPI, then later referral to GI. I haven't moved beyond the initial phase because it seems to be under control.

I have my next appointment with my GP in September, I’m going to request referral to a GI and also see if he would be willing to order a check for hiatal hernia. I’ll also reach out to the medical specialists you recommended, but maybe focus on a firmer diagnosis first?

 

[Green Frog]

I would check with DAN for a GI expert who has specific experience in your condition as it relates to diving. I would be very hesitant to do any serious (or even casual) diving with any complications in my breathing, but if I could get clearance from a knowledgeable expert I would start easy (and shallow) and wor up (or down) to deeper dives to greater external pressures. Most importantly, I would consult an expert in the field and follow their directions. Your life might depend on it.

 

[Duke Dive Medicine]

I would check with DAN for a GI expert who has specific experience in your condition as it relates to diving. I would be very hesitant to do any serious (or even casual) diving with any complications in my breathing, but if I could get clearance from a knowledgeable expert I would start easy (and shallow) and wor up (or down) to deeper dives to greater external pressures. Most importantly, I would consult an expert in the field and follow their directions. Your life might depend on it.

It's not so much the total pressure as it is the pressure differential between the stomach and the esophagus. There's some evidence that an upright posture in the water could aggravate reflux. In severe cases, gravity could aggravate reflux in a head-down position in the water.

Best regards,
DDM