I'm not sure where to go with this. It's complicated. So I'll try as best I can to be brief.
Wife has history of "IBS", severe GERD, and now Autonomic Dysfunction or Dysautonomia after Complete Full Fundoplication 360 Surgery.
This was complicated during recent years with depression and anxiety over daughter's diagnosis at age 12 with severe systemic lupus. My wife went slowly downhill from there. The results have been multiple problems after several years of stress. Two specialists evaluating Colonoscopy results suggestive she has Celiac Sprue differ in opinions. One says she does have Celiac, the other says No.
The fundoplication surgery, was radical total fundoplication to relieve severe stomach acidity with reflux finally causing aspiration pneumonia. Thus the surgeon elected total fundoplication (stomach wrap around surgery to decrease opening of the esophageal sphincter into the stomach, thereby decreasing any more acid reflux into the esophagus.)
Within 4 weeks of this surgery, she had pain that finally was diagnosed as a very large kidney stone. Thus she underwent full anesthesia again for a stent on a Sunday to relieve the pain. A week later, a 3rd anesthesia for the lithotripsy was done. Each time, the anesthesiologist said she had "precipitous" BP drop with a heart rate drop to 40 bpm. Thus she started the multiple problems with what was later diagnosed to be Neurally Mediated Syncope, or Dysautonomia, with Syncope and Bradycardia on each syncope event.
3 cardiology work ups had 2 of one opinion possibly, and a 3rd electrophysiology cardiologist opinion after tilt table study of NO pacemaker as recommended at first by the other cardiologists. So who do we believe??
The other problem is, while GERD seems much relieved, my wife has constant incontinence, a dropped or prolapsed bladder, and a rectocele that cannot be corrected because of the NMS, or neurally medicated syncope. Putting her under again is potentially dangerous with this syncope problem. SOOOOO, she is now home after all this over the past 7 months, and lethargic, but no more syncope at this point. The other point is, this previously energetic woman has to live a sedentary life style. She cannot do much. It was apparent, according to the last cardiologist, that she cannot have any more surgery until this current Autonomic problem is or is not resolved. There seems to be no treatment other than already- tried Florinef, switch from Effexor and Remeron briefly when Prozac seemed to be of no benefit. The side effects were so negative with all these meds, that my wife had to get off of them. She was put back on Prozac.
NOW, my question? Anybody have such problems? Also her gall bladder was removed 2-3 years ago. It is very likely that she has decreased absorption due to decreased stomach volume. Her IBS is worse than ever, with incontinence due to prolapsed bladder, and also the constant problems of some diarrhea plus oozing fecal stickiness with no complete stool formation. Thus she is miserable. The last gastroentoerologist felt Questran could be of help, but she cannot tolerant this grainy med as a powder and liquid form.
So, is Questran or possibly a capsule of similar bile effect called Cholesevelam going to be of any help in anybody's opinion? Any thoughts on vagal nerve damage from the radical stomach surgery to correct the GERD damage? I'm lost. Goliad