6-months post Nissen update - new Demeester score after surgery

I think many of us thought that our Nissen surgeries would take our reflux to zero, but unfortunately that is impossible if we want to be able to swallow food and expect it to enter our stomachs! 

This is the thing...Because reflux is possible after surgery, we still have to be aware of what and how much we're putting into our stomachs.  Otherwise, that pesky reflux will start up.  Certain triggers will cause reflux, but NOTHING like the reflux you had prior to your surgery.

All surgeons aim to do is get your reflux back to "normal amounts". Wouldn't it be nice if we were able to get it to zero?  Unfortunately, no such luck.  Since "normal" reflux amounts are not generally damaging to the esophagus, your surgeon isn't likely to recommend PPIs for protection purposes.  Still, if you're experiencing discomfort at times because of eating extra amounts of trigger foods, you can pick up PPIs for a short duration, until things settle down again.

My PCP and asthma docs want me on 40mg Protonix before dinner, and I still sleep with the head of my bed elevated to minimize even tiny reflux events.  That's because I have very reactive lungs and asthma. 

Before my surgery I was on dangerous amounts of steroids to try to keep me breathing.  Now I take a tiny fraction of the inhaled steroids I was taking, and my lungs are GREAT.   I'm fine wth the proactive treatment of possible reflux, because I trust their judgement and want to keep my lungs in the great condition they are right now. 

Prior to surgery, even though I was taking 40mg Protonix twice a day and 300mg Ranitidine, my reflux was bad enough to keep my lungs an a "life-threatening" condition (my doctor's words as he pushed and pushed me toward surgery). 

Some take PPIs regularly if the small amount of reflux they're experiencing is bothersome.  The main thing is to remember that you still have to be careful with trigger foods.

Since you were really challenging your stomach/reflux during the test, I'm sure that it was the reason your reflux was more extreme. The rebound effect was another exacerbating issue. 

I'm very glad to hear that your wrap is in tip-top condition!

Have a great weekend,

Denise

This recovery is very different for every person (although it's true that certain post-op symptoms are universal).  I'm no expert, but it's my understanding that people with LPR (I'd count myself among those) are more reactive to small amounts of refux than people with typical GERD.  Therefore, I'd say yes...even with "normal" amounts of reflux you can have LPR symptoms.

That's not to say that you won't find relief as you continue to heal over then next months.  I can say with confidence that my symptoms and the post-surgical quirks that I had continued to improve into the second year of recovery.

It's not easy to trust that things will get better.  I understand that. I wouldn't discount the possibility that PPIs at a lower dose might help your symptoms.  In my opinion, even if I have to take a PPI I'm far better off than I was prior to surgery.

Here's hoping that you healing continues to provide noticable improvements for you.

Very best wishes,

Denise

Those DeMeester scores are all you can hope for!  It does take time for things to heal, so hang in there...

It'll happen.

Denise

Thank you all for answering, it really does help in this very special kind of healing. Long live the internet!

JPT: I will look into the J Kaufman diet, but for how long will this pepsin thing go on? Does it work the same way as regular reflux? And shouldn´t the Nissen surgery prevent pepsin to back up aswell? I really do appreciate our knowing in this, need some guiding on this matter.

Joe1619: I am really sorry to hear about your ongoing problems with reflux. I am also a bit puzzled about the fact that we have almost the same De Meester score, but I read that you have non-acidic reflux, could that be the problem? How do they know it´s non-acidic? I didn´t know that the PH-test could see that aswell as "regular" reflux.

I think my score is realtivly "high" (my score was 7,6 everything under 14,72 are "normal")  because of the long (21 min) reflux episode, without that one I guess I would be down to almost nothing.

But if you (and possible me) have troubles with non-acid reflux, wouldn´t the surgery help us? I mean, things should at least be thighter and let almost nothing sneak out, acid or non-acid - does anyone know?

You also wrote about your allergies, is it possible that they are the root to some of your troubles?

Hope all is well!