Long-term solution, pills or surgery?

I am curious as to what the best long-term solution is for a GERD problem that is only resolved by pills. I am 26 and only get by on Nexium 40mg per day, so does it not make more sense to get the surgery than to be on Nexium for life? Particularly due to its unknown long term side effects...in 20 years I won't even be 50 yet.

Or is a lifetime of pills preferable? I would have thought no but from what I have gathered from other threads people really only consider the surgery, particularly Nissen, when the pills have stopped working for them.

Hi

Welcome to the forum.  I'm a newbie here too but getting ready to undergo the esophyx procedure soon.  I'm 57 and have suffered with GERD for many years so maybe I can help you with your question.  I've been on just about every PPI there is out there, currently on nexium 40mg 2 x day.  Over the years my doses have increased to acheive the desired effect and with the diet restrictions most of the time I'm OK, but there are those times where a trip to the ER was needed.  I admit that it's very hard to live with all the dietary restrictions that go along with GERD. 

This is my opinion, take it for what it's worth.  I'm not a doctor, just another sufferer with chronic GERD. 

If the nexium was prescribed  by your regular doctor.  You need to see a gastro specialist period.  Only they can properly diagnose your problem.

If you've seen a gastro specialiast, had a scope done, and possobly a motility test too, and they put you on nexium, you have GERD.  It's a medical condition and it's not going away.  Your LES is damaged and it's not going to grow itself back.  If you don't want to be on PPI's for the rest of your life, your LES will probably need to be repaired.  Ask your doctor his/her opinion regarding surgery?  If they say something like "don't worry you're not that bad, I've seen worse, take your pills, don't eat this and that and you'll be fine"  GET A SECOND OPINION regarding surgery.  I made the mistake of letting doctors tell me that and realized I should have explored surgical options long ago.  All the pills are doing is covering up the symptoms, not curing the underlying cause.  If I was your age and already on nexium, it would be a no brainer for me.  I'd be looking into surgery.  It sounds like you might be leaning that way too.

Let us know what happens.

theacidrefluxman said...
Hi all,

I am curious as to what the best long-term solution is for a GERD problem that is only resolved by pills. I am 26 and only get by on Nexium 40mg per day, so does it not make more sense to get the surgery than to be on Nexium for life? Particularly due to its unknown long term side effects...in 20 years I won't even be 50 yet.

Or is a lifetime of pills preferable? I would have thought no but from what I have gathered from other threads people really only consider the surgery, particularly Nissen, when the pills have stopped working for them.

Again these are just my opinion but your post reminds me of exactly what I went through early on.

<<<

with nexium my symptoms go away most of the time. still i had the scope and motility and ph tests

and my gastro specialist said the results werent classic, and werent extreme. he said the surgeries he is performing are cases of classic gerd, and mine is not, and he wouldnt be comfortable doing surgery on me.

>>>>

When I first went on Prilosec years age, It was almost like a wonder drug for me.  I was pretty well controlled but I "still" had reflux.  The pills just made it bearable.  I'm somewhat confused as to the term "classic" GERD.  GERD is GERD regardless.  You have stomach acid backing up into your esophagus.  If they did a motility and out on nexium its because you have acid refluxing back up.  There IS a tendency for doctors to treat using drugs rather than fixing the underlying condition.  I personally think it sucks but not can you do.  Makbe try another doctor?

<<<

but my fear is long term nexium use. my other option is changing my lifestyle the best i can and putting up with the pain while being off nexium. I want to try DGL and supplements the best i can.
>>>

You should have concerns over long term PPI use.  The results aren't in yet but early studies don't look good for long term PPI use.  Diet control is a good idea, but remember anytime you eat your stomach is going to produce acid.  If your les is bad that acid has to go somewhere and its going right up your esophagus.  The PPI's slow down the acid, but don't stop it.

>>>>

even though with nexium i still get pain now and then, the dr. said my esophagus looks perfectly normal. he thinks my symptoms are worse than the underlying gerd, that i am very sensitive to it. so i think if i go off the ppis, and get some pain, it doesnt necessarily mean my esophagus is getting damaged.
<<<<

This sounds more and more like what one of my doctors told me early on.  Yea I had GERD but my esophagus looks normal and maybe I was just "over" sensitive to the reflux.  Keep taking your pills, follow your diet and come back and see me next year for another scope.    After 10 months I went to a different doctor due to ongoing GERD problems and my scope at that time showed the beginnings of Barrett's esophagus.  I told the new doctor what my previous doctor said and his response was.  Your LES is damaged, you have stomach acid backing up into your esophagus.  Stomach acid is one of the strongest acids out there.  It WILL damage your esophagus, the tissue up there isn't the same as your stomach, it's not made to handle that acid.  I asked him then about surgery and his answer was "you're not bad enough yet for your insurance co. to OK surgery".  I asked how bad does it have to get?  This is affecting my whole way of life, and we're talking about a quailty of life issue here.  The sad fact is that my doctor at that time was unable to get me qualified to surgery.

>>>>
after all its not the pain that worries me, i can deal with it...it certainly isnt as severe as other posters here...my worry both with the pills and with my esophagus is long term cancer since i am still relatively young.

<<<<

Keep after your doctor, ask him if long term PPI use is bad?  Ask him about possible Barrett's esophagus down the road.  Get answers that YOU are satisfied with.  If he can't provide you with the right answers, go see another doctor. 

Good Luck