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Posted 4/26/2011 12:01 AM (GMT 0)
Hi All,

Had a Fundoplication in 1997 after coughing for two years and being diagnosed with GERD induced Asthma.  Have never been able to go off PPI's even after surgery because my stomach produces too much acid.  Also, have a lot of post fundoplication problems: can't vomit or burp and have a tremendous amount of gas, all the time.

Fast forward 14 years: started having dry heaves and stomach pain, especially at night.  Past month started coughing again after eating.  Am now hiccuping and burping.  Called doc and had barium swallow test done last week.  Just got results, test came back normal.  Showed no reflux.

Don't know where to turn from here.  I have an endoscopy scheduled for end of May.  Has anyone had these problems?  I keep thinking that my wrap is loosening up, but wouldn't that have shown on Barium test?

Am now on two protonix a day, and that is helping a little with the cough.  Can they tell from endoscopy if wrap is loose?

Thanks for your insight.

Linda

 

Posted 4/26/2011 12:28 AM (GMT 0)
Linda,

I had my Fundo in 2008, and wish I had never taken the step.  PPIs stopped working for me, and I did have a small area of Barrett's.  That was ablated with the Barrx procedure, and now,  it's back too, so I wonder how well my Nissen is blocking reflux.  I had an endoscopy this past December which showed it's "fairly loose."  I contacted my surgeon, and he feels it's better to be loose so food or liquids don't accumulate on top of the wrap.  I find it hard to believe anything is accumulating above the wrap.

I was told a barium swallow is the best way to test the integrity of the wrap, but I've been exposed to so much radiation over the years, I don't wish another dose from a barium swallow.  I think I'll opt for another 24 ph monitor to see if I'm refluxing, and go from there.  My biggest problem is transient LES relaxations, and it doesn't appear the Nissen is stopping the relaxations. 

Posted 4/26/2011 12:31 AM (GMT 0)
Hi Linda,
Welcome to Healing Well! I'm sorry to hear you're having problems with your asthma again. I am also an asthma sufferer who had the Nissen surgery to help improve my lung condition.

The problem with those of us who have lung reactions to acid reflux is that it takes a tiny amount of acid to create a problem for the lungs.

It is my belief that a barium swallow is only useful in determining major reflux and hiatal hernia. You could have enough reflux to affect your lungs without having it visible on a barium swallow.

A dual channel PH monitor would be a better way to determine whether any acid is escaping, as well as how high in the esophagus it reaches.

My asthma/allergy doctor is often frustrated by GI docs, as, according to him, they only consider the affect of reflux on the esophagus and don't realize how just a tiny amount of reflux can create havoc with the lungs. The amount of reflux that is considered damaging to the esophagus is much higher that the reflux it takes to cause increased asthma.

It sounds like you're having a lot of trouble and should get seen by your GI doc ASAP. I'm not a doc, but from my experience, I do think it's possible to miss problems like yours (and mine). If you get all the testing and still have problems, don't just accept the answers that are given to you. Get yourself to a second opinion and possibly to a larger center like Mayo or Cleveland Clinic--whatever is closest to you.

Hopefully it's just a stomach bug/upset and you get feeling better without intervention. Be persistent. Don't let a doctor tell you you're not experiencing what you're experiencing. You know your body and what's normal and okay.

Good luck! Again, glad you've joined us! I'm sure others will be by to share their ideas and provide support as you deal with this challenge.
Best wishes!
Denise
Posted 4/26/2011 3:14 AM (GMT 0)
Thanks for your replies, Sunbird and Denise,

I know that something is going on.  I can tell by the way my body is reacting that things have changed.  I also had Barrett's prior to my fundoplication.  It has been under control since then.

I am not familiar with a dual channel PH monitor. I had the PH manometry twice before my surgery years ago. Are they similar?  Is that what the BRAVO test is?

Where I live there are not a lot of options for GI docs.  So far, I have been happy with mine, but we will see how things progress.  I would have no problem getting a second opinion, even if I have to travel.

I have an appointment with my GP in a couple of weeks, it will be interesting to hear his take on all this, since my asthma has been great until this started up again.

This site is wonderful for all the information from so many different people.  Thanks again for your thoughts.

Linda

Linda

Posted 4/26/2011 3:21 AM (GMT 0)
Barium shows my wrap has come loose, stomach is partly in chest again. Mine was from vomiting once.
Posted 4/26/2011 11:49 AM (GMT 0)
Hi Linda,
The dual channel PH monitor is like the BRAVO in that its intent is to measure reflux, however it is wired rather than a capsule the communicates wirelessly. You have a wire threaded through your nose and into your esophagus. The receptors are placed at 5cm and 20cm from the wrap/LES. The hope is to discover the movement of reflux and determine how high it is reaching. (At least that's my understanding as described by my doctor.) It's definitely not a perfect measure, but it can help in nailing down what is going on inside your esophagus. I've had 3 wired monitors, and although they are annoying, it's not that big of a deal. Post surgery you won't have the pain of being off PPI's for a week. Even if you're having some reflux, it's usually not as bad as it was prior to surgery.

I hope you get feeling better soon, and get answers to your problems. The problem with a "loose wrap" when you're dealing with asthma symptoms is that it doesn't take much to get lungs reacting. It's great for swallowing, and for people with normal GERD problems it works great. Some of us, though, have atypical symptoms that don't respond as well. That's why docs and surgeons aren't quick to recommend surgery.

I had the surgery in 2009 and do still get a bit of reflux, as my wrap was created to be loose. It has helped keep me comfortable with very little bloating, etc., but while I'm 99% better and glad to have had the surgery, I do get a bit of reflux, and as I said, it doesn't take much.

Glad you've joined our forum!
Denise
Posted 4/26/2011 4:35 PM (GMT 0)
Linda,

Before my Nissen Fundo, I had the Bravo device implanted, and after the Nissen I had the 24 hour up the nose and down the esophagus monitor. I hated the Bravo device, for it gave me chest pain and was tugged at by everything I swallowed for the ten days it remained in my esophagus before detaching itself. It only records data for 48 hours, so I had another eight days of the irritation is caused without any purpose whatsoever. I was eating celery, carrorts, pizza in an attempt to break it loose. Compared to Bravo, the 24 hour monitor was a breeze. It takes a physician to implant the Bravo Device with an endoscopy procedure. A technician can place a 24 hour ph monitor. (less costly)
Posted 5/7/2011 11:51 PM (GMT 0)
Thanks for all the info. I have an appt. with my GP this week, then an endoscopy at the end of the month so we'll see what they figure out. I'm still coughing after eating, although it is a little better since I started taking 2 protonix a day.

Does anyone know of any good GI doctors in central NY state? I am in between Albany and Syracuse, but not too far from Rochester/Buffalo area if I had to get a second opinion?
Posted 5/9/2011 10:55 AM (GMT 0)
I was just wondering...I had a cough it was dry..than I got a little bit of mucos with it. I went to dr's and they said it was probably gerd. I came back some weeks later and she sent me for the barrium swallow test and a chest x-ray and they told me I had a very small hyadial hernia. Now I have to go back I have a cough again with mucos and this time I have nausea and I have pain in between my shoulder blades like a pinching feeling, it's weird. I also have pain in my throat and neck almost like my lymphnodes are bothering me....I'm just so confused...thanks again for any response...Beannie
Posted 5/9/2011 2:20 PM (GMT 0)
Belle1980

I hope you get results that help you when you have your endoscopy.  I am in the midwest so I cannot recommend anyone for you to check out as far as GI Physicians in your area.  Sorry.

Kindly,

Kitt

Posted 5/9/2011 2:23 PM (GMT 0)
beannie

I think you are making a wise choice in going back to your physician if your sx have returned along with new ones. Perhaps you need to see a GI specialist for an endoscopy to see what else may be going on with your GI tract .

I hope you get to the bottom of your problems.

Kindly,

Kitt


 

Posted 5/9/2011 3:41 PM (GMT 0)
Thank you so much for the reply...my mind always goes to the worse possible thing I can imagine....beannie
Posted 5/13/2011 11:50 PM (GMT 0)
Thanks for your replies.
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