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Hypersensitive Esophagus After Nissen

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Posted 6/24/2013 10:20 PM (GMT 0)
My daughter had the nissen fundoplication surgery last August. She had no acid type pain for about 5 weeks. Then she had an episode of "retching" and since then has had similar acid pain on a regular basis. She has been given a CT (the wrap was intact), an upper gi (no reflux) and recently had an endoscopy, which they say looked fine. She is currently taking one nexium a day and pepsid or tums as needed.
We have been told it might be hypersensitive esophagus, which would make sense due to her personality. Anyone have experience with medications or other treatment for this?

Added thread title.

Post Edited By Moderator (dencha) : 6/24/2013 6:51:08 PM (GMT-6)

Posted 6/25/2013 12:50 AM (GMT 0)
Hi rynlds,

Welcome to Healing Well.  There are several people here at the forum who have been diagnosed with a hypersensitive esopghagus.  One member, drtinsac had a Nissen surgery and continues to have symptoms because of this.  Here is a link to a rather long thread in which he shares his journey.  Hopefully it will provide helpful information for you and your daughter:

https://www.healingwell.com/community/default.aspx?f=45&m=2677835

I wish you lots of luck in finding answers that will help your daughter.  Please give her my best wishes!

Take care,

Denise

Posted 6/25/2013 1:12 AM (GMT 0)
thanks dench!
Posted 6/25/2013 3:11 AM (GMT 0)
I have a couple LONG threads here which I use as journals, provide my test results etc. My conclusion that I've come to after Nissen, is that I probably never had a reflux problem to begin with. What my problem was was a sensitive throat and some sort of neurological issue causing burning tongue and sour taste. The taste was not reflux as I had originally thought.

The PPI helped, and the nissen helped, but since my underlying problem still exists (sensitivity in my throat/tongue), the symptoms are still there.

If a person is diagnosed with hypersensitive esophagus, there are treatments which happen to be similar treatments as those for burning tongue/taste= antidepressants, which are considered "pain modulators".

I never had heartburn pain and I think it's important to consider the specific symptoms one has. The problem is that if someone has "symptoms" associated with a normal amount of reflux, that label of hypersensitivity is given.. but there are so many possible symptoms, typical and atypical, in my opinion they can mean very different things.
Posted 6/25/2013 6:48 PM (GMT 0)
If someone has a hypersensitive esophagus and not reflux then wouldnt the pH test be negative? Did they do the pH test before the wrap? I'm due to see my surgeon for the wrap but do wonder if my symptoms are because of hypersensitivity. My pH test was positive but the the hospital also wanted me to take part in a trial for a new hypersensitivity drug. I never took part in the trial as the anxiety drug I was taking at the time meant I wasn't suitable but now I'm left wondering if all my mouth, throat and stomach symptoms are because of a hypersensitive esophagus. I too hardly get heartburn although I'm not sure if burning at the top of the stomach is classed as heartburn but I rarely get chest pains and I have no esophagitis. Very confusing.
Posted 6/25/2013 7:17 PM (GMT 0)
Hi Albez,

If you have a hypersensitive esophagus, then normal amounts of reflux (the kind that everyone can get--everyone gets some reflux, but it doesn't qualify as GERD).  A DeMeester score of <14 is considered "normal".  Those who experience reflux pain at those lower levels are suspected of having a hypersensitive esophagus...especially if there is no erosion discovered when an endoscopy is performed.

It is confusing, that's for sure.

Take care,

Denise

Posted 6/25/2013 7:43 PM (GMT 0)
My daughters symptom is burning in her throat. She had a ph test done before the nf surgery which allowed her to qualify for it. We have wondered if hypersensitive esophagus could have been part of her problem all along.Does anyone know any info about medications that are used for this?
Posted 6/25/2013 7:47 PM (GMT 0)
Hi Denise,
Yes it is all very confusing. Apparently my test results came back as saying that oesophageal motility is normal but there is evidence of 'pathological acidic GER associated with positive reflux-symptom association'. The thing is when I went back to see the consultant to discuss this, his secretary hadn't forwarded my report, but he remembered mine being the only postive test that came back from his patients so he refererred me to a surgeon before he had confirmed my diagnosis, so now i get to see the surgeon in 3 days before i get to see my GI consultant to confirm the diagnosis. But anyway Im guessing the surgeon will have all the proper details. So if my test has come back as positive that would mean my DeMeester score is higher than 14 and would mean its not hypersensitivity?
Posted 6/25/2013 7:51 PM (GMT 0)

sreynolds said...
My daughters symptom is burning in her throat. She had a ph test done before the nf surgery which allowed her to qualify for it. We have wondered if hypersensitive esophagus could have been part of her problem all along.Does anyone know any info about medications that are used for this?

Well they wanted to put me on a trial drug but the drugs i was already taking meant i didnt qualify.
Maybe soon the drugs on trial will be available.
Think mostly its like anti-depressants drugs they use.
Posted 6/25/2013 9:17 PM (GMT 0)
I too might have a sensitive esophagus . I just don't know. I am going in for an impedance test on Thursday. I had the barium test but that showed very low reflux instances. Score of 1. Which is strange because I have Barrett's. ablated it.
I will ask for the demeester test. Are there any other tests?
If I do have sensitive esophagus I will say, histamine seems to work best for me. Not all, but astepro. Crazy medical condition. I should be enjoying my two week old baby girl and two year old baby girl but I find myself consumed with this stupid condition.
Posted 6/26/2013 1:31 AM (GMT 0)
'Pathological acidic GER' would mean you do not have hypersensitivity. And you have symptoms associated with your reflux.. the thought is if you get surgery, it'll reduce your #s to normal and your symptoms will improve or resolve completely.

Be careful with the association part of the test (SAP and SIA). In my case, I had like 99% SAP for sour taste being related to weakly acidic reflux. But the sour taste is basically constant, and I did not have constant reflux, so it didn't make much sense. Just wish I'd thought about it more before the surgery, which by the way did not help the sour taste symptom (which I believe is neurological, not actual reflux). This despite decreasing my reflux from the surgery.

Albez, do you know specifically which drug the trial was for? Or can you let me know what office it is, I'd be willing to call them to find out about what they're trying.

Teacherman, the DeMeester is a score that is calculated by looking at acid reflux episodes, ph time <4 in your distal esophagus.. and maybe some other stuff.
Posted 6/26/2013 10:05 PM (GMT 0)
drtinsac,
The trial drug was based out of the Royal Bart's hospital in London. They was also doing a trial where they heat up the esophagus to test for hypersensitivity
I was asked to take part but its the other side of London for me and the trial takes a few months of testing if I remember rightly.. If u Google search u can find the info there about the trial.

I also have the dreaded sour taste but it seems it now only happens after I eat or drink certain things. I'm not sure but it seems that maybe the domperidone and/or omeprazole has made it a bit better. Things like eating bananas or sweet foods make it worse and also alcohol has me reaching for the gaviscon double action tablets to get the horrible taste out of my mouth. I avoid coffee/tea caffeine at all costs as that is a big culprit for me. I also get a burning dry mouth feeling but I'm also a diabetic so that probably makes the reflux worse and most likely vice versa.
Hope that trial info can be of some help.
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