Nissen with hypersensitive esophagus?

Hi

Has anyone had the NF surgery that is thought to have esophageal hypersensitivity? I guess that would be symptoms such as heartburn even on maximum PPI therapy and low acidity.

My reflux really is becoming unbearable and I am thinking of starting the process to see if i qualify for surgery but my ph test last year was normal with low correlation of symptom with acid exposure, but i couldnt bear to be off the PPIs for long enough, so despite significant symptoms on the day it was 'normal' which makes me think my esophagus is hypersensitive. I am scared that a NF will put me in a considerable amount of pain given I'm hypersensitive.

I have tried the antidepressant therapies for hypersensitivity but this hasn't resolved it.

Interested to hear if anyone has been through it, what your symptoms were like before and how hard was the recovery.

I get mild pain and irritation from even non acid exposure, acid gives me quite a bit of pain but I try to control it with a very restrictive diet. But even things like mildly cold water give me mild heartburn at the moment. Antacids like gaviscon can also give me heartburn. In fact water seems to give me worse heartburn than food.

To me it feels like I have irritation in my esophagus all the time, but a lot of the time it does feel like there is something sitting in it and I am constantly swallowing trying to get it back down. I burp all the time I think partly because I swallow so much air from the constant swallowing.

I have strange symptoms in that lying down isn't a huge trigger for me, in fact being seated gives me just as much if not more reflux. Standing and walking and pushing out my abdomen is the only thing that really gives me any relief. I have a hiatus hernia and esophagus motility problems which I think cause these strange symptoms.

Andy 1986,
I'm sorry to say that at 13 weeks post-op (LNF & hiatal hernia repair), my burning chest pain is still there only now it's even worse. I thought I was doing well but the narcotic pain meds I was on were masking the chest pain. I also thought that I was having some withdrawal from the Nexium I was taking before surgery. My surgeon told me I would not need it after surgery so I no longer use any acid controllers; what's the point?

Last week, a barium swallow showed NO REFLUX and my wrap is secure. I feel just as rotten as I did before surgery. Perhaps there is something else going on. I do not fault my surgeon as he performed a successful surgery, but there is something else going on that I've been suffering with now for 7 long years. I have this chest pain 24/7. It is worse after sleeping at night and I feel deathly ill after I get up in the morning for a couple of hours. Also have very little appetite and still careful what I eat, but dietary choices don't seem to help. I read somewhere that Gluten is actually NOT a problem for the majority of people.

I am seeing a new Gastroenterologist next week to see where I go from here as I'm at my wits' end and SO TIRED OF SUFFERING. I don't regret having the surgery as I had no other option and so at least I'm no longer refluxing.

Also, my throat hurts if I talk a lot. It actually hurts to talk! I had this problem before surgery, as well. Geez, I wish I had some good news to report ...

Andy1986,
I've been comparing my recovery to the many others on this forum who didn't have this kind of pain and didn't need pain meds after a week or so. My pain seems to be concentrated in the center of my chest. My symptoms are the same as before surgery, mainly the chest pain, discomfort when talking, fatigue. I was on Nexium 40mg twice daily for 3 years before surgery. It did NOT give me much relief and I didn't want to take this crap the rest of my life for no relief, although when I had to get off of it for 10 days before I had the esophageal pH test, my symptoms were a LOT WORSE, so I guess it did help to some degree. I wasn't popping pain pills all the time before surgery. I had the pain but it was much more bearable then than it is now.

I just recently tried Nortriptyline HCL which sounds similar to what you referred to, but it's an anti-depressant and my system can't tolerate them. I took one pill and had severe reactions the next 2 days. I didn't take anymore.

I don't know if I'm being premature by seeing a gastroenterologist, but I need to rule out a problem that doesn't seem to be improving. Very depressing.

By the way do you have a recovery journal? I'd be interested to follow your recovery and how it goes, hopefully you'll find some relief soon.

Linda, please do share your journal I think it will help people with situations like ours know what they're in for. Are you on narcotic pain killers still for the pain? I've read there are some other pain killing drugs that aren't ADs that you can try.

So sorry to hear this. You can try asking for gabapentin, its not a narcotic but apparently a good drug for this kind of pain so hopefully they don't have any problems with you using it

Low dose amitryptaline or nortryptaline are two others that act similarly to gabapentin to help control pain. Just incase you're not aware, nortryptaline and amitryptaline are antidepressants, and gabapentin is an antiseizure medication, that can concern some people but the amount needed to treat pain is a pittance of the dose used for their primary purpose. The benefit over narcotics is, as well as not being addictive, is that they shouldn't make you as drowsy, or drowsy at all.

Another one I've heard of is lyrica , not an AD but apparently can treat this sort of pain

Linda Sue said...
I was just prescribed Gabapentin and feel a bit better this morning; not so sick, so this might be something I can take longer term than narcotics.

I am back to 'square one'. My new gastroenterologist has ordered an esophageal pH (ugh!), and I will have an endoscopy to see what is going on with my esophagus. That is where the burning pain is. She mentioned the possibility of my wrap being too loose or possibly a hypersensitive esophagus. I am waiting for a call to schedule the pH test.

Just can't believe this crap! It certainly feels like my surgery failed...

If it is hypersensitivity the Gabapentin should help, its really good with nerve issues, I had it a few years ago from CRPS in my leg and I noticed the difference within about a week so fingers crossed it works as well for you!

Thanks for the support; I know you both understand, fully. I am only 2 days on the Gabapentin and still waiting for relief and know it will take some time...