Gerd to Fundo to Doubts.. can you help..? - Acid Reflux / GERD Message Board

star2u · 09-22-2004, 04:14 AM

For several years now i have had a constant soar throat,( never any heart burn ) and this problem was diagnosed as being due to reflux acid and LPR, the endoscope and biopsys also showed Barretts esophagus ( low desplasia)
and chronic gastritis, and for 18 months i was put on a high dose of Ranitidine, Domperidone, Omeprazole and nexium. ( 12 tablets a day )
which over the 18 months I took them , made the soar throat feel a bit better but not go away completely, my doctor then recommended that I have further tests to evaluate the possibility of having a Nissen laparoscopic fundoplication
The tests he recommended were , a mamometry test , a 24 hour double probe Ph test, along with a barium meal swallow test.
The problem was that the recommended tests were not available where I live (in Thailand where the doctor said that Thais do not seem to get barretts esophagus / reflux acid problems , due he said to the fact of the Thai diet and the Thai's drink large amounts of water every day...? ) . so i took the decision to fly to europe to obtain further tests to confirm my situation.
The tests confirmed that I had a weak LES, and high numbers of acid reflux episodes over a 24 hour period. The doctors recommended that due to the fact that the high dose of drugs I had taken for 18 month's, had not seemed to completely reduce my throat problem and the fact I had Barretts Esophagus , a Nissen Laparosocpic Fundoplication would be the best option.

So i went ahead with the surgery, I was admitted to hospital at 8.pm Friday night , and discharged on Sunday 11am, The operation went well, The surgeon had outlined the possible after effects of the surgery, such as gas bloat, chest pain due to traped air, etc, and he gave me a run down on the post op eating requirements. He said a full wrap had been carried out , which was stiched to the esophagus to stop the wrap from turning he also said he had used a " bloon probe " inserted down the esophagus to gauge the correct tension of the wrap around the esophagus. In his words he had done a " loose" type of wrap , as this was considerd the best option ,he also advised me to only take 40mg of Omeprazole a day for one month after the surgery.
All went well and I have now returned to Thailand, but now back home , away from the comfort of knowing I could easily contact the Doctor who carried out the surgery, I am starting to have my doubts !!!, here's where I hope forum members can offer me some advice or comments.
First I know its only been 5 weeks since I had the surgery, and may be I am just panicking too soon ?.... heres my doubts ...
1. A week after the surgery my soar throat seem to be getting better, I thought great, the wrap has started to do its job..?, on returning home Two weeks later , my old enemy the soar throat has returned and feels worse than before the surgery ( this includs the same symptoms of a soar,red and what appears to be small blisters on the back of the throat area ).... so with the symptoms returning this makes me now think....... , could it be that the loose wrap was done was in fact... too loose, this combined with me now only taking a small dose of Omeprazole(may be not enough to control the acid ..?) this has now allowed the acid to return to my throat area again to a greater degree ...?
2. Or could it be the my soar throat has returned due to a miss-diagnosis in the past , and in fact there's some thing else comming into play that's effecting/causing my soar throat .
3.Or could it be the soar throat has returned due to some sort of post re-action to the surgery...?( and hopefully will get better in the future..? )
4.The doctor also recommended having an endoscope/biopsy done 6 months after the surgery,.... would it be possible from the endoscope to tell if the wrap is at the correct tension...? and working as it should do...?
may be I am just over reacting and jumping the gun , but from just having my old soar throat symptoms return in what seem's a worse state , stright after undergoing the surgery makes me wonder if its all been worth it , and as medical advice on my condition is difficult to obtain here in Thailand, I can only hope forum members can may be offer some advice to enable me to decide just where to go from here. Many Thanks,

goody2shuz · 09-22-2004, 06:11 AM

Hey...Star!! I'll try to answer your questions best I can. I have a daughter with Chronic GERD since birth who is now 13. She, thank goodness has not required surgery as of yet, however, she has testing every 3-4 years to monitor her condition.

Sounds to me as if you definitely needed the surgery and I am sorry to hear the anxiety you are experiencng after going through so much. The sore throat could very well be coincidental. My first suggestion would be to go back to your primary physician and have it checked out. Perhaps you have developed a virus or throat infection. I know that when I had surgery.....my throat got sore a few weeks afterwards due to the irritation from the tubes that were down my throat from anesthesia etc.

Are you following your postop dietary instructions....avoiding foods that are spicy and acidy, trying not to overeat at any given time, avoiding carbonated beverages etc? The fundoplication is not an overall cure for GERD. And yes...I do believe that your 6 month endoscopy will be able to see if the work duri9ng surgery is indeed intact since it goes looking all the way into the stomach when done. As far as the LES function I believe there are other tests they run to check it out which you should ask your doctor about.

I'm not all that familiar with Barrett's esophagus....is that when the mobility factor of the esophagus is affected? Or is it severe erosion of the esophageal lining?

I hope what I have shared is of some help to you and has alleviated some of your fears. It must be difficult being so far away from the surgeon...do you have his phone # or a way via the internet to ask him some questions? Sounds to me as if you deserve to have some way to contact him after all that you've been through and shouldn't feel bad if you need to do so.

Keep me posted with your progress....having had abdominal surgery 4 months ago laproscopically...I still am going through the recovery process. Good luck to you and feel free to chat if you find the need to do so.....Goody

star2u · 09-24-2004, 06:04 AM

Hi goody2shuz,

Thanks for your reply - one of my main problems living here in Thailand has been getting sound medical advice about my condition. This is why I decided to go to Europe to have further tests before having the surgery carried out there . Yesterday I went back to see my Thai Doctor to outline my situation after the surgery I told him about the surgon doing a " loose " wrap, and that I still have a bad throat.
The doctor thought yes my bad throat may be due to the wrap not being tight enough, or the wrap stiches comming undone he has recommended that I have a barium meal swallow X-ray to try and see what's going on..? my current throat symptoms are identical to the symptoms I had before the surgery. As for my diet I am still following the " normal " reflux diet, no spicy foods, no fizzey drinks, no orage juice, no coffee, no alcohol etc. I did ask my Thai Doctor about having a new endoscopy and he said first have the berium meal X-ray then let's see . ( also there's no facility here to have a 24 hour Ph test or a manometry test) He also said if the X-ray showed continuing acid reflux then I would have to start a new programme of drugs again ( which is why I decided to have the surgery in the first place) He did say if I had to start again with drugs, he wanted to try a " new" drug thats come onto the market from England ...? (I did not get its drug or brand name yet ) As for contacting the surgeon in Europe who did my operation, I do have his e.mail address, but I want to wait a bit to see just how things progress rather than jumping the gun and telling him about my present condition , and then it changes in due course .
The thought of having to fly a 15,000 mile round trip again and going through a second operation is some thing that I would be happy not to have to do !!. .
After the X-ray berium test next month, I will let you know the results and what my Thai Doctor has recommended, so again Goody , thanks for you advice and comments and I hope your are also recoving Ok, .... Star.....

jeforeman · 09-28-2004, 07:22 AM

I'm going thru the same thing you are Star. It's been almost 6 weeks for me and my throat just started to hurt again. My stomach is always upset and nausiaus. I'm almost never comfortable and it's really hard to sleep. My doctor insists on being patient and not worrying but It's impossible for me to not worry about this. Also, on top of everything else, I'm lactose intolerant now. I wasn't before. My doctor said that he has two other patients that became lactose intolerant and one of them stayed that way and the other one went back. This scares me a lot. I'm having doubts if I should have had this surgery. I had a hiatal hernia so I would have had to have had something done sometime. I just don't know if I should have waited. Does anyone have any comments on my situation? Should I not worry? Should I get a second opinion?
Joel
ps. good luck to all of you on your recoveries as well.

jeforeman · 09-30-2004, 02:32 PM

I was told about a product that you might want to give a try. It's called ACIDOPHILUS. You buy it in health food store or any GNC store in the U.S. It helps with digestion and in my case most of the reason why my stomach gets so upset is it's still trying to learn how to digest everything. Some things are really bad, let me tell you. So this stuff has "friendly" bacteria in it to help your stomach restore it's own bacteria. I know it works because when ever I eat chicken I get really gassy and if you eat your meal and then pop 2 of these pills the gas was almost totally absent. let me know if you try it and how it works for you. Good luck.