drtinsac journal - GERD/LPR - extremely long

Hi BG- I am glad to hear you are doing better! I think you're right, in either of our cases, the surgeries can help us to heal by fixing the abnormal exposure, but they are not going to heal us right away. I don't remember -- have you ever tried one of those nerve/pain modulator medications like Elavil? I've read online where docs put people on those types of meds after fundo to help the "nerves settle down". I've considered taking the full 25mg of Elavil again to see if it does anything. I just don't like the zombie effect it has on me.

Will have to update on the NP tomorrow, she's not in today but I left a message for her to call me. I don't know how experienced the surgical team are with non-heartburn cases.. I think she could have mentioned to me on my 2 week f/u appointment that some people continue to have symptoms for a while. They may be trying to figure out what to do with me.

BG,

Does georges aloe have citric acid in it?

Spoke to the NP today at my surgeon's office. Told them I'm still having same symptoms and that I'm on PPIs 2x day and zantac overnight. She said they are going to schedule a barium swallow, to determine if the wrap is intact (sure feels like it is..). If it is, then they refer my care elsewhere like ENT or GI. I asked her about trying the medication, and she said they only deal with surgical management, medical management would come from ENT or GI.

I told her that I've read experiences of people having symptoms clear up after months post fundo, and asked if they had that experience. She said honestly no, she really never sees that. She said that people tend to do very well quickly with it, and that throat/voice stuff might clear up after a month. I didn't argue, it was good to hear their experiences of it. I know they are dealing mostly with heartburn cases.

I believe there is some hypersensitivity going on with me.. my tongue/throat are very sensitive to spicy foods, even as mild as Spanish rice will cause a stining sensation. I don't recall ever having that before I started the PPI, I just had throat tightness, which the PPI solved. Then came the bitter taste, and I think sometime after that, the sensitivity to spicy foods. Still not sure what to make of the white tongue coatings that I've experienced around starting/stopping PPIs.

Since my attempt at cold turkey stopping PPIs last week, I've been on the 2x PPI/day + zantac overnight and I think my throat is feeling better. Not noticing much improvement regarding taste or tongue.

I think I'll email my ENT to give him an update.

Dogbones, that is interesting. I'm glad to know there is someone else with similar symptoms out there, despite what a crappy situation it is.

Do you have a thread with your history on it? I'd like to read about how your symptoms came about, your tests etc.

I know there is still plenty of time for symptoms to improve, so I am not declaring the surgery a failure yet. It has shown me at the very least that I was burping excessively before the surgery, and some reflux was coming up when bending over, both of which are now gone. At the same time I still want relief so I want to try whatever possible treatments there may be for this as long as they will not hurt me.

I've read other people's accounts on here, and sometimes they say that they met with a doctor for an hour or more who really listened etc. I never got that feeling from any of these docs I've seen, it is always a few minutes here and there. I don't know where to go to find someone who will actually try to take all my clues and go about trying to solve the puzzle, even if it takes 30 minutes. Frustrating.

Sixness, sorry so many of us are in the same boat. How long since your TIF? And is that 24 hour Ph impedance study after your TIF?

I've done so much googling about this condition, I'd hate to think of the hours spent. I wish I had it indexed somewhere so I could search through what I've found. But I do recall 1 fundo patient saying his globus lasted 3 months after surgery, and others that were still noticing improvement after a year. Its hard to imagine how bad it must be for improvement to still be occurring at one year.

There was something I was just reading today that meshes with the 6 month figure your surgeon told you. It was someone who had a fundo who still had symptoms and was looking for help, he said that his surgeon told him that some patients can take 6 months to improve.

The strange thing is, even though this information is clearly out there-- there are definitely cases that have improved after 3, 6, 12 months, it seems like some surgeons or doctors/NPs have no idea. And does no scientist care to explain WHY? I think it would be a brilliant study.. why some patients are helped immediately while others take months? What is the mechanism.. someone must care about it.

Hypersensitivity is an interesting thing. I don't mind the label, as long as the diagnosis can be empirically confirmed via treatment.

I've read case studies of people being cured of symptoms (usually involving "pain") by taking tricyclics or the newer pain modulators like Lyrica and Neurontin, but they are not reflux or hypersensitive esophagus cases. The times when I've heard of those drugs working in reflux patients, is when someone notices a sudden onset of throat burning that seems to be located in a specific area in their throat.

Here's one paper on hypersensitivity in patients who had NO response to PPIs. After 6 months, the group receiving the SSRI had a lower percentage of members having symptoms, by 20% over placebo. That still leaves 4/10 patients with symptoms. It would be great if they found out what was wrong with those 40% who are labeled hypersensitive but do not respond the same way to treatment. I think many of us around here are in the crevices where there is no direct strong evidence of any clear cure.

gastroenterology.jwatch.org/cgi/content/full/2013/118/1

Yes, my 24hr restech and my impedence study was done after my TIF. As for the procedure itself I had it done about a year ago.

Welcome to the world of lpr! Doctors think your nuts and your left to fend for yourself! The typical regiment for LPR seems to be double dose of ppi's. One before each meal. If you go to an ent they will slowly up your dosage until your maxed out at like 40mg twice a day with some kind of h2 antagonist at night. Once you get to that point they will have nothing left to do except recommend you for surgery or tell you to deal with it. I got this point with my doctor and he said to try acupuncture...I laughed at him haha.

Anyways, I'd recommend getting your throat scoped by the ENT to confirm redness or irritation, after that get a PH study done. Preferably getting the restech 24 hr probe. It just seems to yield the best results when dealing with the throat.