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Hi All – pepsin is suppose to be the culprit with LPR, either splashed up in a forceful type of reflux or in vapors. The mainstream medical doctors and the LPR “experts” treatment for this is to put you on PPI’s and other acid block medicines and a diet of foods that (as Norm’s research shows) causes gut bacteria fermentation (so made my LPR much worse – I had no heartburn, only very inflamed larynx/pharynx/sinuses). Pepsin is supposed to be the culprit, but what is the cause of it? I think Norm has the answer. Thanks to FTD, probiotics, fermented foods, etc. I am 99% LPR-free, and back to eating almost anything (but sticking to majority of FTD foods, not counting points anymore though). At beginning of healing I did use alkaline water & DGL to help neutralize throat. Hang in there, LPR takes a lot longer to heal due to the pepsin and the more delicate nature of throat tissues (no protection or tolerance to stomach acid or pepsin). My journey to 99% normal (100% unless I really overdo it on trigger foods) took 5-6 months.