Surgical Referral - What to Expect?

I'm fairly new here, just found this forum recently when I started seeing a GI doctor. I've had bad heartburn/reflux symptoms for a long time, and I've been on prescription PPIs for the last four years. Got a referral to a GI doc last fall and had my first endoscopy in October.

I was diagnosed with reflux/GERD, esophagitis, gastritis, and hiatal hernia. Since then I've been on Dexliant, Prevacid, and Ranitidine daily. I was also put on Azithromycin but I could not tolerate it. Had a barium swallow test that revealed a filling defect. Had a second endoscopy with a Bravo ph test.

While on my PPIs the Bravo test showed between 22-24 instances of heartburn and regurgitation per day, while upright. The de meester score was 9.2, which apparently isn't too bad if you're not already on meds, but with meds is not great. Confirmed the esophagitis and gastritis, and added duodenitis to the diagnosis. I had three polyps removed and all results from biopsy were normal.

I'm 33 years old and while I'm mostly physically fit, my doctors suspect I have some sort of undiagnosed autoimmune issue.

I've got a referral for a surgical consult, and a manometry test scheduled. I've been reading as much as I can about the fundoplication surgery itself, but I'm not sure what to expect going forward.

What should I expect from the surgical consult? I know to ask about the experience of my surgeon. Are there other questions that you wish that you had asked? Has anyone else here who had the NF dealt with autoimmune issues, too? I have a lot of other medications I take and I'm not sure how I will manage to take them after the surgery, or what to expect from the healing process. Any other words of encouragement or advice? I'm really nervous and not entirely sure if I'm making the right decision.

Thanks!

I certainly don't feel as good as I would like. In terms of my gastrointestinal symptoms, I struggle with heartburn and regurgitation daily, and frequently throughout the day. I haven't been able to actually burp without acid coming up in years. More often than not I have heartburn. Eating anything more flavorful than a banana or rice and chicken is painful. Carbonated beverages are a nightmare of pain and bloating and foamy regurgitation waiting to happen. While I wouldn't say that I have trouble swallowing, I do frequently feel like food or pills get stuck going down. I have a gurgling sound/sensation in the back of my throat after anything I eat or drink - kind of like pop rocks. If I lean over or sit or move the wrong way, I can feel the contents of my stomach sloshing back up into my throat.

There has been some improvement with PPIs - I used to wake up choking on acid/bile, and I used to have incredible difficulty sleeping without pain. One time it was so bad I literally thought I would choke to death. I still wake up with heartburn, but it doesn't wake me up in the middle of the night anymore. I used to have problems with recurring sinus infections, at least 2-3 a year, every year. Since being on PPIs for most of the last 4 years I have seen a decline in sinus infections, and I haven't had one the last two years at all.

I could probably tough it out and make do for a while longer, my doctor really has left the decision entirely up to me. Although, he did say that it is likely just going to get worse and that I'll need to have it done eventually.

It's impacting my quality of life, and that's my primary consideration right now. If this can buy me a few more years without symptoms, then I think it will be worth it. I'm not ready to resign myself to just living with this quite yet.

Brianala,

Goodness. It sounds like you're a good surgery candidate to me. Some here swear by a manometry or pH study. Considering my situation, I didn't really need those, but I also didn't report troubles swallowing. I would ask your potential surgeon about their stance on it. I came here, told people I didn't have those, and then everyone freaked out.

Hopefully the surgery will get you off PPIs. Long-term, they're not necessarily good for you. You may want to ask your chances of being removed from taking them, however, you may not be able to tell until after surgery. I haven't been on anymore. I started with Omeprazole and then went to Dexilant.

There were a few instances where I'd wake up with bad GERD before surgery and there was no fixing that burn, but it didn't happen too often. It's a God awful feeling. The only similar situation was laying down too fast after drinking some grape juice. My surgeon's assistant says to cut yourself off from eating by 8:30. That's what she does for herself as well.

Altair gave some awesome advice.

John

Glad to help.