Posted 10/13/2015 2:56 PM (GMT 0)
Hi Dani
First thing I'd suggest is splitting your dose of Nexium to 20mg in the morning and 20mg in the evening before dinner. I find this works much better and 20mg is an effective dose for Nexium. My GI told me that its equivalent to 40mg of Prilosec so it is very strong. You should be able to find tablets or capsules at a 20mg dose. It not you can split tablets or empty half a capsule in a little water, I do this and it works just fine.
Secondly I wouldn't put too much emphasis on the manometry test or your sphincter pressure, mine is normal (right on the lower limit though), but I get reflux. Also I don't rate the pH test really, the impedence is much better and I would insist on it if your pH test results are normal. I had my pH test come back negative but I couldn't be off PPIs for long enough. All it tells me is that my symptoms aren't caused by acid (pH<4). So I still don't know whether my symptoms are related to non-acidic reflux episodes or not. I'm due to get the impedance test done soon, as it also measures weak and non-acid reflux.
You really need thorough testing before going for surgery, because you need to be sure that your symptoms are correlated to reflux. There are cases of people with typical GERD symptoms but that is poorly correlated to actual reflux, and a lot of surgery failures are related to these people who go through a very tough time without any resolution to the problem.
You say you had a normal barium swallow, so did I, but it is just 5 minutes out of the day so its not that useful. The important question is whether you felt like you had reflux during the test, as if you did then that could be important.
Most people that have positive symptom correlation with reflux and have the surgery have no regrets, satisfaction is well over 90% so I wouldn't worry too much about it. Just try and get the right diagnosis as once you have that, the surgery is highly likely to be the best decision you've ever made