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GERD & Acid Reflux
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Posted 1/31/2011 6:22 AM (GMT 0)
Hi All,

I just wanted to ask a couple of questions if I may about my case of Acid Reflux. Long story short for the past year I have been having digestion issues as I call them, nausea, reflux or regurgitation feelings, at times a lump in my throat (Just below the adam's apple) pressure behind my rib case or breastbone and a metallic, burning feeling in the back of my throat more often then not.

I had a endoscopy (Camera down my throat) and the only thing the specialist found was that my L.E.S. valve was wide open. I have tried multiple medications - Nexium 6 weeks, Somax for a month and then Pariet for a month - none of these made much of a difference even when I was on a double dose - plus I found this out the hard way because my acid levels were lower you can catch stomach bugs a lot easier ? I got two just around Christmas when nobody else around me had them - the doctor confirmed that this can happen - so even if they did work I would not want to be on the medication forever ?

Anyway I am now scheduled for a 24hr PH test and a motility test for my throat or something like that - the doctor has not really given me any idea on where I am headed as he wants to take one step at a time which is cool and I am happy with that.

- I guess what I want to know is if the above symptoms are common, doctor said that heartburn was the more common symptoms - I have a constant burn in my throat but no heartburn as such - not that I even know what that is?

- Why would the meds not work - it is just a hit and miss thing ?

- Is the Nissen Fundoplication the next step ? And are they good, do you get a full or partial one ?

I am in a small city, so thinking I would be happy (Rather prefer) to go to a larger city with a doctor who does more of these types of procedures - probably Melbourne ! Does anyone have any suggestions on who to go to - names etc if you feel comfortable to do so ?

Thanks heaps in advance, it is really starting to get me down and make me stressed, which makes the acid burn worse I think ?

Regards
Chris
Posted 1/31/2011 4:35 PM (GMT 0)
Hello Chris and welcome to HealingWell.  I know one of our members will be along to answer your questions so know you have joined a great forum.

Also take the time to read through the posts of other members who have had the surgery as it will give you much informaiton.

Kindly,

Kitt

Posted 1/31/2011 10:46 PM (GMT 0)
Thanks for the reply !

Is it common enough that I get more of a regurgitation/reflux (Upward feeling in throat) and nausea with an acid burn in the back of my throat - rather than just the heartburn ?

My throat certainly has a burning feeling a lot of the day and it just feels like I have the taste of whatever I last ate for ages after eating it, so I guess it repeats on me heaps ?

Should also mention I have tried just about every natural treatment available - apple cider vinegar, herbal etc etc none made any difference and to me if my LES valve is not working or closing then nothing will really fix that unless it closes or starts to work properly again ? I guess that is what surgery is all about ?

Cheers
Chris
Posted 1/31/2011 11:11 PM (GMT 0)
Hi Chris -
I had regurgitation for 25 years but no "heartburn." I didn't have chest pain, but I sure knew acid was coming up, especially when I tried tolie down after eating. Various acid blockers over the years, as they were invented, helped with that.

You should ask for a barium swallow in addition to the tests your GI doc is running. It won't hurt, and the doc can see if there is anything wrong with your swallowing pattern (nutcracker and such). It will also show better than any other test whether you have a hernia in the diaphragm and whether the stomach comes up through it.

Forget the herbals. They won't repair the LES. It probably won't get better on its own either. The barium study will show whether it works at all better than the scope down the throat. At least that test doesn't hurt or gag you. (Unless, like me, you happen to be sensitive to the additives they are now putting in the lovely barium drink.)

Nissen is the last step, but necessary if the LES really doesn't work or if you have a particularly bad hiatal hernia. The decision about which type depends not on your preference, but on whether you can tolerate the full wrap and whether your surgeon does them. That's what the tests your doc is doing will show! I had to have a partial wrap because I have a very weak swallow from having polio as a kid. You don't choose surgery based on advertizing or because it looks nice. It is determined on what you need - IF YOU NEED IT AT ALL.
Posted 1/31/2011 11:22 PM (GMT 0)
Thanks so much Alcie, so by all accounts yes it is Acid Reflux that I have I guess !

I don't want any surgery - but in saying that I don't want to take drugs that might (Yet haven't in my case) help with the acid burn but don't help with the regurgitation or nausea type feelings - to me that is pointless. Plus to add to that as I said after 3 months on various PPI's I got two cases on the stomach flu and even the specialist said that they lower the acid so much that they don't get rid of the bugs present in everything so you get the stomach bugs easier.

Once I get these tests done, the 24hr PH thingy and the wind pipe pressure test I think it is, I will see what he has to say and then ask about the barium test.

When they did the camera down the throat they said there were no hernia's or ulcers so I think I am clear for those.

Scary to think that they can happen to me, I am only 32 years old not overweight etc not usually the typical patient I don't think. God it gets me down and stressed at times though, I am just so sick of dealing with it everyday !!
Posted 1/31/2011 11:45 PM (GMT 0)
Welcome to HW,
Your symptoms are normal for gerd. If your LES is wide open then no drugs will help you.
The nissen is usually the next step. I got the 270 degree partial wrap and I'm doing fine with it. The doctor usually decides which kind to do based on the results of the motility study.
I'm not a fan of the motility study, but it's a necessary evil. Without it the doctor has no idea how tight to do the wrap. If you have any swallowing issues and he does a tight wrap then food won't go down proper. They feed a small catheter down to your stomach from your numbed nose. The computer read the pressure of your esophagus as you drink water. You feel a little gaggy as they adjust it, but it calms down when they lay you back. I had the BRAVO capsule done instead of this.
The 24hr pH test involves a small wire traveling from your nose to your stomach. It read how much acid travels up your esophagus.
And yes, stress does make acid worse. sad

Post Edited (couchtater) : 1/31/2011 4:48:36 PM (GMT-7)

Posted 1/31/2011 11:55 PM (GMT 0)
Thanks HEAPS once again everyone, god you don't know much it helps to have others with the same thing say - yes I have that and I have been told I have acid reflux too. The specialist thinks it is acid reflux but said it's more common to have heartburn as the main symptom rather than myself who is more regurgitation, reflux, nausea and acid burny.

Thanks for the info on the tests - yeah I am not too keen on doing them but want to just to see what they come up with.

Burping - it that another symptom ? It is like I just threw down a fizzy drink at times and of course I have not. Food does not seem to be the only trigger for me, yes if I have deep fried anything it is shocking - but I can drink water and get the acid burn just off of that.

How can you tell if your LES is wide open all of the time ? I guess in a way I am lucky that when I had the camera down there that the LES valve was wide open - otherwise they may not have known what to do ! Could this valve be open all of the time and what could make it just stop working ??

I guess if you had to have a sphincter stop working, it must be better to have that one breakdown rather than the one for the back passage - not keen on the adult nappy look just yet !!! haha
Posted 2/1/2011 12:13 AM (GMT 0)
Burping- yes! After my surgery I can still rock the house, but not as often. It comes out the other end more now. :(

It's probably open all the time. My surgeon said it's a birth defect.
Posted 2/1/2011 12:23 AM (GMT 0)
Weird hey, I have not had it all the time only for the past year I would say - sometimes some bloating and gassy too - but I increased my fibre intake etc and that seems to have kept things a little more normal.

So glad I found this site ! Awesome to ask people who know - I do know heaps of people with acid reflux but they all seem to respond to Nexium or one of the others and it does not bother them anymore - perhaps theirs is food related whereas I don't think mine is so much more system related ?

On a positive note I am the thinnest I have ever been since way before getting married !! Helps when you feel sick a lot of the time and don't know what the hell to eat !

Where is everyone located, is it mainly the US or some from the UK and other countries ?

Thanks heaps once again !
Posted 2/1/2011 12:32 AM (GMT 0)
We have a mixed bag here. I'm in the US. Georgia mainly.

This site helped me a great deal in deciding to move forward on having the surgery. It eased my fears and answered many questions I had before and after the surgery. I decided to stick around and help others through this puzzling disease.
Posted 2/1/2011 12:42 AM (GMT 0)
Well I am so glad that you did Joy - like yourself I am pretty much in the same boat ! Nobody really knew what was wrong with me, my doctor just did the trial and error method kept giving me scripts for Nexium and others and said see how this goes etc. But they did nothing for me, it was like taking a mint or something !

So after pushing to see a specialist I just hope I am on the right track and doing the right thing, if surgery is the answer then I want to research which doctor as I understand and definitely think I want someone who does these operations often - not someone who is training - train on my little toe not my stomach !!

Obviously I am in Australia, a small town of about 100,000 people, if I was to need the operation I will go to Melbourne - a friend of mine is a nurse and actually assists with these operations and gave me the name of a specialist/surgeon to go to - so I think that has to be a great way to know who to go to - of course I need to ask how many he does etc etc - he looks older like late 50's to 60's so hopefully he is great and has lots of experience !

Only thing that does help a little is Gaviscon - but this doesn't last that long maybe an hour or so ? I try to take my mind off it cause it drives me nuts thinking about it all the time - i'm sure everyone around me is sick of hearing about it, I am always saying god I feel like I want to vomit and like my throat is on fire !

It is a strange disease hey, I wonder what causes it so much, maybe we are not designed to live as long as we do these days ? I often wonder that !

Cheers
Chris

PS If anyone else wants to reply please do so, the more the more confident I am I think that I am on the right track !
Posted 2/1/2011 1:19 AM (GMT 0)
Hi Chris,
Welcome to Healing Well! You're the second friend we've had from "down under"--the first was from New Zealand. It sounds like you're in the right place. Don't you just love the internet?!

If your LES is open, it is not working. Anyone with a wide open LES isn't really going to find medication sufficient to solve their problems. They'll help, by reducing the acid that is bathing your esophagus, but won't stop food from refluxing.

You are wise to pursue this with a specialist. You've suffered long enough. If you do end up pursuing the surgical fix, you should definitely seek out a skilled Nissen surgeon who has done hundreds or a thousand-plus fundoplications. It's an art. The surgeon needs to create a flap/wrap that is tight enough to keep acid out of the esophagus, but is loose enough to allow food to pass through freely. A great surgeon is critical to the success of the surgery.

It makes sense that Gaviscon would work the best, as it coats the esophagus and protects it from the reflux. Most of us prefer liquid antacids.

Let us know what you find out from your tests!
Take care,
Denise
Posted 2/1/2011 1:50 AM (GMT 0)
Thanks SO MUCH Denise ! That's exactly what I think, even if they can get me on a PPI that helps it is only going to help with the acid burn not the reflux, nausea, burping, pressure behind the ribs etc etc etc. If my LES was "wide open" especially when I had not eaten anything then it was wide open by itself not because I eat tomatoes all day !

Yeah that does make sense about the Gaviscon being the best to work - does not last long though !

Did you also have a lot of reflux, regurgitation and nausea with yours and has that all improved since your op ? Does anyone who of anything that can help with these symptoms at all, I just try to drink lots of water and try to eat smaller meals if I can - but it is so hard to eat and stop before you even feel satisfied !

Thanks again !
Chris

PS I am hoping to become one of the crowd who can help others way down the track !
Posted 2/1/2011 2:29 AM (GMT 0)
Chris,
I've got you beat on small town. I live in a town that has population 1,500. We have one elementary school and it's student body from pre-kindergarten to fifth grade is 253.

How about asking your doctor for some carafate? It sticks around longer and coats better.
Posted 2/1/2011 3:40 AM (GMT 0)
I might have to ask about those Joy, never heard of them before I had to google it. You guys get anxious with it, it makes you that way cause every moment you are trying to deal with some symptom - burn, burping, gas etc etc etc ?
Posted 2/2/2011 2:12 AM (GMT 0)
Hi Chris,
I do think many who suffer from GERD symptoms also suffer from anxiety. It's not easy to deal with severe symptoms day in and day out.

Carafate Suspension is the best formulation as it coats your stomach and your esophagus. I'm not sure if it's available in Australia. You'll have to check with your doctor. Gaviscon works in a similar way, but it doesn't stick to your esophagus and stomach lining the way Carafate does.

Many here who have had the surgery had a wide open LES like yours. People with a wide open LES are the ones surgeons like best...they know for sure that their situation will be greatly improved after surgery.

My situation was different. I didn't have a wide open LES...I just got a somewhat "average" amount of reflux, however it was enough to create problems in my lungs. It's harder to be sure that someone like me will be helped by the surgery.

Fortunately, the surgery did help my lungs. Because a bit of reflux can still get through the wrap I can occasionally get a lung reaction, but it's still much better than pre-surgery.(Absolutely no reflux at all is pretty much impossible to achieve, as the wrap needs to be loose enough to allow food through.)

The only things that helped my symptoms were 40mg Protonix before breakfast and dinner, and 300mg Zantac at bedtime. Also in between I took Maalox and Tums as needed. It still didn't help my lungs.

That said, I didn't have as severe reflux as you do.
I hope you find answers soon.
Take care,
Denise
Posted 2/2/2011 2:27 AM (GMT 0)
I agree - I also get heaps of gut sort of aches and pain's from time to time, I can feel when my stomach is empty and it is worse then ! Glad I don't have any of the lung issues - well yet anyway ! Do people get the upward pressure, like from stomach to mouth and bloated at times too ?

It upsets my whole system I think ! I even get a little bit of phlegm every morning, only for an hour or so but it is weird !

Thanks again !
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