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GERD & Acid Reflux
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Posted 8/21/2011 1:51 PM (GMT 0)
sunbeam, The surgery is better than taking PPIs and H2 blockers for life. Long term use of them can cause stomach polyps and bone loss along with other problems.
I consider the surgery was a success for me. I was on PPIs and H2 blockers for 10 yrs and by the time I gave into having the surgery I had developed stomach polyps and Degenerative Disk and Facet disease. Since I've been off of them my back is feeling better. The back problem is still there, but slowed down.
The most important thing to remember is to have an experienced Nissen surgeon and to have all of the testing done: manometry, barium swallow, pH test, EGD, and stomach emptying.
Posted 8/21/2011 2:53 PM (GMT 0)
I believe there is a middle road between ppi and surgery. I think you can try to CURE the reflux with diet and PPI. Give It a year or two to work. IF can't then consider surgery an option.

I would like to clarify my diet statement when I talk DIET I mean a super strict diet. To me this means a very boring diet with a few foods and not eating out.

in my opinion some people diet seem to be slight variation of a normal diet.
Of course it's harder to find a trigger if your eating 10 different foods vs two or three foods.

I think maintaining a diet is just tough for most people thus it will eventually lead to surgery or life time PPI.

I have to agree with joy. No way I am taking PPI for more than 2 years.

I think keeping bad diets for many years will make gerd a more permanent problem in ones life. For me I intend to break the cycle for good.
Posted 8/21/2011 4:05 PM (GMT 0)
Thanks guys and gals. So new to this and still trying to figure out my DIET. Started journaling as suggested so I can get a grip on what to eat and what not to eat. Did my first real grocery knowing what to look for and what to avoid. This will be a learning and a lifestyle change for sure. Much rather diet to prevent this than take those stinking meds.

KY we are in Shelbyville but both work downtown Louisville. We are due down your way in a few weeks. Headed to our yearly vacation spot in Pensacola.
Posted 8/21/2011 4:19 PM (GMT 0)
SK55, I believe I agree with you. I am imagining most surgeons would not consider my case if I have not tried alternatives. Surgery always has risks and complications, so it is simply not a first tier strategy. Also, health insurance would rather pay for meds: you can buy an awful lot of PPI's before they add up to the cost of surgery.

With that said, what are the criteria for surgery?
Posted 8/21/2011 5:09 PM (GMT 0)
MMM
I am sorry, I did not intend to imply that everyone is a candidate for the surgery.. that is why I said "You have options... go over them and seek a solution not a bandaid.. please. you will be glad you did.."
Seek a solution... I am sorry if you took it wrong.. shakehead

There are so many who suffer this horror of GERD.. if you are a candidate for the surgery, the probability that you will GET BETTER, is very low. Why suffer for years when it can only contribute to worsen your issues.. seek a solution and do it.

I am 62 and I went in for the surgery 19 days before my 62nd birthday. I had just been given the option 4 months earlier, I was truly afraid, but from what I had read here and the conversations with my surgeon made me realize I would not get better, so I did it.yeah

I would never advise a person who has options other than surgery, to be cut on just because it worked for me.. I am very sorry for those of you who are not candidates for the surgery.. you must continue to seek options and solutions. idea idea

as always Reach for the Sunshine...Rainbows will follow..
Sandi
Posted 8/21/2011 7:00 PM (GMT 0)
No, don't worry. I was just pointing out that there is this middle limbo where you can be considered not bad enough for surgery. Here in the uk if the meds work then there is no reason to look into surgery. I could push for it but I have gastritis and I don't see how surgery can fix that. As I said above, I had the same symptoms as now before I had a hernia, so that makes me feel surgery isn't going to do a lot for me. I guess I just have to live with the ppis for now, polyps, osteoporosis etc included!

I personally feel my GERD does not have a large structural element to it - I think it's part of a systemic problem. I just hope not to be on ppis forever....

MMM
Posted 8/21/2011 7:58 PM (GMT 0)
Sunbeam,
You must have a problem with the functioning of your Lower Esophageal Spincter (LES). The more severe the problem the better canidate. Also some people have trouble with a Hiatial Hernia.
I had a large Hiatial Hernia and a weak LES. I coughed and wheezed for the last three years from acid coming up into my lungs. I had what is called Silent GERD (aka. LPR). I would get dizzy spells and come close to blacking out when food would get stuck in my Hernia. When it got started the Doctor's were scratching their heads at what was happening to me. It took three different doctors to find out what was happening to me. My GI at first didn't think the surgery would help me. I chosed to get a second opinion and found an excellent surgeon who fixed me up almost 19 months ago. I've been happy ever since, no more coughing or blacking out.
Posted 8/21/2011 8:31 PM (GMT 0)
Couchtater, was your response in answer to my question about criteria for surgery? I would imagine it takes more than having a weak LES to justify surgery, because that is maybe the most common cause of GERD? Someone already mentioned that you would need to try PPI's for two years, maybe having Barrets' would be a stronger case, maybe hiatial hernia would earn some additional points. Each case is somewhat unique, but I expect there are standards out there, perhaps unwritten. Someone on  this thread mentioned the tests that would need to be done, but I doubt you can just ask you GI doc and get them. I doubt any GI doc is going to consider surgery for me now, since I am only a few months following my first diagnosis. So I welcome additonal thoughts on the surgical criteria.
Posted 8/21/2011 9:36 PM (GMT 0)
I would think the surgical criteria is along these lines:
- If PPIs are not working OR
- If PPIs are giving side effects OR
- If the patient does not want to continue to take the PPIs
AND
- Symptoms are severe OR are getting worse
- LES pressure is not normal OR
- there is a hiatal hernia

In my case, LES pressure seems to be normal and the root cause is likely frequent TLESRs .. giving rise to symptoms in the throat and achiness around the LES area .... and to top it off .. I can't seem to handle the PPIs (too many side effects). A couple of GIs have told me that the surgeons are likely not going to touch me .. I am pinning my hopes on the LINX beads .. when / if these are made available in the US.
Posted 8/22/2011 12:30 AM (GMT 0)
PPI-less, Thanks. That's the kind of information I had hoped someone would post. Personal stories are fine too.
Posted 8/22/2011 2:45 AM (GMT 0)
Hi sunbeam. My gastritis>heartburn>barretts/hiatal hernia diagnoses expanded just as yours did. I have been on protonics for the gastritis/gerd which definitely helped gastritis, ulcers for about 2 years. My symptoms progressed pretty rapidly over the last 6 months, unfortunately, despite making great lifestyle changes with my diet, etc. eliminated coffee, acidic food and such, but my stom/esoph reached a point where it did not matter what went down, I felt miserable after with food particles constantly rising up to my throat literally. My GI doc said I must have the surgery. I was very scared when he first said it, hoping that there was some other way to get rid of it. But please be very careful with the barrett's. Find a new GI doc if current one is not helping you. Of course, surgery is a last resort, but sounds like we are on the same path. I hope to share very positive results with you after surgery. As far as wedge vs raising up head of bed. Neither one gave me a good nights sleep. I am a side and tummy sleeper. Looking forward to sleeping again after the surgery.
Posted 8/22/2011 2:46 AM (GMT 0)
Hi sunbeam. My gastritis>heartburn>barretts/hiatal hernia diagnoses expanded just as yours did. I have been on protonics for the gastritis/gerd which definitely helped gastritis, ulcers for about 2 years. My symptoms progressed pretty rapidly over the last 6 months, unfortunately, despite making great lifestyle changes with my diet, etc. eliminated coffee, acidic food and such, but my stom/esoph reached a point where it did not matter what went down, I felt miserable after with food particles constantly rising up to my throat literally. My GI doc said I must have the surgery. I was very scared when he first said it, hoping that there was some other way to get rid of it. But please be very careful with the barrett's. Find a new GI doc if current one is not helping you. Of course, surgery is a last resort, but sounds like we are on the same path. I hope to share very positive results with you after surgery. As far as wedge vs raising up head of bed. Neither one gave me a good nights sleep. I am a side and tummy sleeper. Looking forward to sleeping again after the surgery.
Posted 8/22/2011 10:24 AM (GMT 0)
Jen, thanks for your post. The threat of vertebrae fractures from PPI's scares me more than cancer from Barret's. I know that's not everyone's perspective, and I'm only 57. But already I have led a good life, and I will die happy and at peace if death arrives tomorrow. I have no children, my parents are gone, and my husband will be fine without me. He knows these are my thoughts. I fear more being disabled and in pain, though I will deal with that if it happens. I might need a new GI doc, but I should give this one another chance. I've only had the initial office visit and the scope. I will make an appointment with him next month, which is when I complete 2 months on Nexium. I will bring the list of ways GERD has diminished the quality of my life, and ask for his thoughts on the path to surgery.
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