3 fundos and still GERD

Hi, I am new to this forum, I am 32, live in Mexico , work as a computer engineer , but I have read very interesting posts and finally, decided to post .

I have undergone 3 nissen laps, first in Aug/2003, second in Feb/2004, 2 lap , 1 open, the most recent one was on Sept 9 2006 .

Tha last 2 failed because,1/3 of my stomach was up on my chest, and they definitely had to open to fix it.
I was operated by a very good surgeon, who also did my brother´s nissen and my aunt´s ( my bro is okay, no heartburn after all, but it was hist first)

I had partial vagotomy performed on the second Nissen (but I believe it made my problems worse), my GI says it created havoc in my stomach movements, but gave no further explanations.

However, right after the 3rd Nissen fundo on Sep 9 2006, aproximately one week after surgery, I started feeling heartburn, I mentioned this to the doc and he said it was all in my head, but I kept feeling the heartburn, terrible heartburn, but different than before the surgery, this is a constant but somewhow low-medium intensity heartburn, different from the very intense heartburn I felt before surgery, sometimes I have nausea , but cant vomit , and a lot of constipation (result of the surgery?), my GI says that constipation is causing all the backup in my digestive system and that I need to calm down , he refused to put me on benzodiazepines(diazepam,Xanax)

I started taking PPIs (Pantoprazole or Nexium) and they did not seem to work, finally, I decided to take a barium swallow 2 weeks ago, and it shows no signs of reflux, everything is normal, except for a mild gastritis , the nissen is in place, and even the walls of my esophagus look more straight (without inflamation according to the doc) after comparing the xrays before vs after surgery.

There are no signs of hiatus hernia, since everything is below the diaphragm.

As a side note, I cant burp , and have only done it espontanesously about 3 times since surgery, yes, I get these phantom burps everyday , many times during the day, but no air comes out, is this an indication the knot is well done?

Prior to surgery blood test came out negative for H Pilory.

I am puzzled as I do not know what to do , I feel a burning sensation up my throat and esophagus as well as a burning sensation in my stomach.
Sometimes, the burning in my throat starts right after I eat ( 5 mins or so) , then it stops on its own sometimes without taking antacids,I have noticed some white foamy form of saliva, very sticky, and I have to clear my throat, during this episodes, can this be a throat infection or is it reflux?

I cant sleep at night, maybe only 5 hours a day, because the burning in the esphagus is non-stop, but does not increase its intensity , it just remains there.

I discovered that if I take one .5 Xanax the burning goes away for sometime.

I am taking 40 mg Pantoprazole daily, but to no avail , also take antiacids like Magaldrate to cope with the burning.

I am eating bland diet, no red meat .

I am desperate, anxious and depressed cause I have battled this for over 10 years, being the last 5 the worst, since heartburn has been by my side everyday and almost every hour , as a side note, I live a very stressful life, and have anxiety attacks ( I know about Dr Shipko yes) .

I have 3 theories :

1 - The cause of the heartburn is the high anxiety that overrides the PPIs
and I am secreting a lot of acid or bile or is a "nerve ending" thing that calms down with some Xanax.

2 - The cause of the heartburn is just inflamation after surgery, does this burning last for so loong? (I wish this could be it )

3 - The cause of the heartburn is a weak LES even after surgery ( But I cant even burp, so, it cant be weak, can it be?)

4 - Some throat infection or microorganism may be causing all this "burning" down the pipes .

I am very concerned that this is real heartburn , cause I dont want to have further problems or undergo a 4th nissen!

I have some questions:

Can I trust an Xray swallow as to say there is no reflux?
If so, what can be causing this burning in my throat and
I plan to undergo endoscopy,PH test and manometry in Jan. on my own, to discard problems but my GI says they are unnecesary, since xray proved I am ok.

In the meantime I cant wait to have some suggestions or answers that calm me down cause I am about to go crazy since this thing does not stop 24/7.

Anyone have some remedy or recipe to stop this??? I feel devastated .

Thanks for your feedback.

DANIE , I am interested in your exercises for the esophagus, but could not find them , as well as an alkaline diet , can u help me?

I have started a pure vegetables diet, and my stomach pain (gastritis) is gone in 2 days, my heartburn is 50% less, so I hope a diet approach and some stress management helps me out.

The key could be the diet, since my digestive system is so weak after 3 fundos, that I need to feed it like a newborn baby, so it can be back on its feet.

I do not really know what started first , GERD or anxiety, since, GERD started in a very stressful moment in my life wen I lost my job and had a family to support and could not find a job for 8 months and started selling the house, the car, and all the assets I had.

It could be interesting to see if anxiety and stress cause GERD, cause most of the people I know with GERD, have also stress, or have had stress present in their lives together with GERD, yes, at some point, stress and anxiety are gone, but GERD remains for some of them.

I strongly believe there is a anxiety-stress conection with GERD, unfortunately this has not been scientifically proved.

I have not had a calm life since I married (lol) , stress has been always present in my life since GERD started either at home or at my jobs, that is why
I believe GERD is caused by what you eat or what eats you.


Anyway, like many people here, I am totally determined to take this into my own hands, because doctors wont help me much .