Dysphasia two and a half years after Nissen

Hello,
I am wondering if anyone has had a Nissen redone due to dysphasia? I had my Nissen done 2 and 1/2 years ago and about a year ago things started to get stuck again. Not just meats, but also soft foods. I had an esophogram done the 1st of Oct. and the 12 mm tablet stuck at the junction for 20 minutes. My GI decided they needed to dilate the LES. I since have had it dilated 4 times, the last being on 12/22. They have used a 51, 54, and a57 dilator. They say there is only one larger one, but I still have food getting stuck.
A different surgeon believes the wrap could be too tight or overly scarred and my esophagus may also have shortened. I see him again tomorrow since the dilations didn't work. After a year and a half of good results it's really frustrating to deal with this now. Also, the GI Dr's found Barrett's now. What a bummer.
Anyhow, I was just wondering if anyone has had experience with a redo for this?

Thanks,
BIll

Thanks for the welcome.
I saw the surgeon today and he wants me to go to the Mayo Clinic. He says my GI Dr. hasn't given him enough information for a good diagnosis. They just want to rely on 2 1/2 year old tests and keep dilating. So I guess I'm gonna go there and see what happens.

Bill

Saddaze,
I first noticed the "heartburn" probably about 18 years ago. I had a bad habit then (chewing tobacco) and thought that was the cause. Well I quit that habit Jan. 21st 1995 and the problem didn't go away. Then about June of 2000 I started to have food getting stuck and worse "heartburn". I talked with my family Dr. and he set me up with the GI Dr. Followed the normal regime of EGDs, dilations, etc. Finally after about 5 to 6 years of PPI's not working they decided to do a 48 hour PH study. They said mine was the highest they had ever seen and recommend I see a surgeon for a Nissen Fundoplication. I had some dysphagia prior to the surgery, but it would go away for about a year or so when they would dilate the stricture due to GERD. I never was diagnosed with Barrett's before surgery either. Anyhow, I decided to go ahead with surgery in June of '06, had 2 dilations within 2 months of surgery due to it being to tight. The radiologist that did the barium swallow the day after surgery told me it was "really tight". I asked the surgeon about that then and he told me he made it that way due to my very high acid numbers. After bout 3 months things weren't too bad. I had some trouble swallowing certain foods, but could manage with several drinks of water. November of '07 I went back to the GI's and told them I was having worse trouble swallowing and felt like the GERD was back, hadn't had to use PPI's since the surgery. So they did another PH study, Bravo this time. WOW, what an easier way to do it. Anyhow they said the acid levels were in the normal range, but they saw a stricture and dilated it. Things progressively got worse through the winter and spring to the point my stomach would hurt when ever I ate and the horrid taste was back from acid. Went back to see them again in June '08. Did another EGD. This time they found Barrett's, an unusual "Z line" and severe gastritis, and esophagitis. Had to start taking previcid twice a day again. Scheduled a barium swallow test again. This time they said I possibly had Achalasia, took 20 minutes for the 12mm tablet to pass into my stomach. Apparently it should pass in under a minute. So back for another EGD and dilating the wrap/ LES with a 51 dilator with no results. 2 months later they used a 54 dilator then a 57 dilator 2 weeks after that with no results for the dysphagia. That leaves me where i am today, waiting for my surgeon to get my insurance to OK me to go up to the Mayo Clinic in Minnesota.
Sorry this is so long, but sometimes it helps me to vent a little. It's been very frustrating year or so. When the doctors tell you that if the dilation doesn't work they don't know what to do. I, like many people, don't want to take the PPI's forever. And my GI Dr. said they don't want people taking them for a long time anymore due to liver problems. I actually have seen 2 different GI Dr.s in the last 2 months and they don't agree with each other what's wrong except to keep dilating.....I am done with that though. So, now I eat a roll of Rolaids and 2 Previcid solutabs every day.

Thanks for listening,
Bill

Post Edited (opnwhl4) : 12/29/2008 6:37:36 AM (GMT-7)

rsapooh,
That's an interesting question. I know my surgeon told me he wouldn't do the Nissen without it.

Bill