Ineffective Esophageal Motility (IEM) and Fundoplication

Hi Guys,

I have been suffering severe GERD symptoms for years, mainly being night time choking, burping, asthma, laryngitis. I have been working myself up to get the fundoplication done, which is tentatively scheduled next week. I got my manometry results mailed to me today and it says I have severe ineffective esophageal motility (IEM). Despite this, all my other results indicate that my reflux is severe (reflux aspiration, lower esohpogeal sphincter not working correctly, and impedance shows abnormal reflux episodes).

Does the weak motility mean that i am not a candidate for the surgery? I have been really looking forward to the relief that surgery might bring, but now feel quite deflated that my surgeon may not agree to do it.

Would appreciate comments/experiences from those who were in a similar position.

Best regards
Jason

Hi Bill,

I saw my surgeon and he explained that in his experience, patients with my problem have no more increased risk of complications/side effects from the surgery that anyone else. He said that even the ones that have a full 360 degree wrap have no increased side effect rates in longer term and that some people's motility actually improves. So i am definitely going ahead with the surgery! the only thing he mentioned is that i might have swallowing issues in the first 3 months but they should resolve.

p.s. i read the latest studies on this issue and they confirm what my surgeon said, no difference in dysphagia rates among those with poor and strong motility pre-fundo, look at outcomes at 3 months post fundo

Thanks LPR,

Sorry to hear this happened to you. I have read a few academic studies on fundos with motility problems with sample sizes of one hundred patients or more, and from those it would appear that your situation arises in the minority of cases, and arises regardless of whether you had pee-existing motility issues. Of course that's no consolation for all of the suffering you've been through. Hope you are doing ok now, and good luck with your future full wrap surgery
Jason

LPR LPR LPR,

that sounds awful! May I ask how your recovery has been from the partial?
Did they test you for gas reflux with your impedance test, or have you done a peptest since your fundoplication?

All the best,

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