I am investigating here for my husband. He has been taking nexium for a few years and has developed weakening of bones, vascular disease, gets pneumonia very easily. He does have GERD from a darn hernia.

I would say it interferes with important nutrients from the food(which is what I have read about). The food just kinda sits in the stomach without being neutralized by lack of stomach acid. It is like having chronic constipation which leads to developement of cholesterol, plaque in arteries. That is just my opinion anyway.

He is a very healthy, slim,44 years old. He does not eat very much and gets plenty of excersize. I really am worried about this plaque buildup in his caratoid artery.

Anyboy have problems like this?

Plaque build up is not a side effect of Nexium that I know of. It seems highly unlikely to me that it is, since plaque is made of fat, and Nexium does not effect the enzymes that break down fat. Machanical digestion moves food from the stomach, and enzymes break it down. There's really no need for acid in the stomach, and if your husband has heart problems, I would doubt it's from the Nexium.

I have said this before, but my GI doctor insists the only side effects of PPIs are increased risk of pneumonia (which reflux causes anyways) and increased risk of food poisoning. There was recently a thread about the pneumonia.

What dose is your husband on?

Yes he get pneumonia very easy. He only takes Nexium.

I looked it up and it is not suppose to be taken longterm. He has been on it for a couple of years I believe every single day.

It just seems weird because he eats like a bird and is very active. I did do some more research and found out it can decrease your intake of vitamin B12 and some others.

I don't know it is just a guess but it seems like if it neutralizes your stomach acid. It just seems like it would not break down the food and make it just kind of sit there like in constipation. I have had constipation from hypothyroidism and made me have high cholesterol.

There are no longterm studies on Nexium I know. Well anyway, I made him quit taking it everyday, only as needed. He listened to me Yay, yay!!!!

I don't know it will take awhile to see if it is the cause. This is just MY assumption.

thanks for your reply. You think I am crazy huh?LOL

Nexium is a proton pump inhibitor. It is itself a fairly new drug, but it is almost identical to Prilosec, and drug that has been on the market for many years and proven to be safe long term. Both drugs are made by Astro-Zeneca.

Nexium DOES NOT neutralize stomach acid. It stops these things in your stomach called proton pumps from making it altogether.


Nexium takes 2 weeks at least to work. IF YOUR HUSBAND DOES NOT TAKE IT EVERYDAY IT WILL NOT WORK AT ALL! The drug needs to be at consistant levels in your system or else it will not do a thing. There are other drugs that can be taken as needed, like Zantac. These drugs are called H2 blockers, and do work to neutralize the acid. I cannot empathesize enough that Nexium cannot be taken as needed.

Again, let me point out to you that acid does not break down fats. Enzymes do. Coronary artery disease is not a side effect of proton pump inhibitor use.

If your husband only takes Nexium once a day, he is taking 1/2 to 1/4 of the maximum dose. Your husbands risk of pneumonia is higher if the acid reflux goes uncontrolled than if he takes nexium. I have been on very high doses of proton pump inhibitors for a long time, and no pneumonia. It's a rare side effect.

The condition you describe concerning vitamin B12 is called pernicuous anemia. It is VERY, VERY rare. It does not effect a person intake of vitamin B12, since only that person controls that. It can effect how well a person absorbs vitamin B12. Chances even on very high doses of PPIs of getting it are low. With that I would say just go off it if it happens. I have a friend who got it and she went off the drug and was fine within a week.

In most people acid reflux, which can cause cancer, electrolyte imbalances, tears in the esophogus, cavities, ulcers, and a whole host of breathing problems, is much more dangerous than proton pump inhibitors.

I would encourage you to make an appointment with a gastroenterologist to discuss your concerns rather than just telling your husband not to take it. The effects of acid reflux go way beyond the pain.

Well I know that medicines will effect each individual in a different way. If I want to tell my husband not to take it, because I care about his health, that is strictly my business.

I am not saying that it DOES cause vascular disease, but anything that is taking that messes with nature, is going to cause problems.

My husband has been on PPIs for more years then you have.

I'm not saying it's not your business if you don't want your husband to be on them. I'm saying you should talk with the doctor about treatments that will work if only taken as needed, because Nexium won't.

Hi ladies. One more voice to ring in here: As Blondie says, it is also my understanding that Nexium will not work if not taken on a regular basis. If lack of B12 is a concern, as it should be, have your husband take a B12 supplement. I take a multi as well as an additional supplement because I do share that concern. Lady50, when I get nervous about being on ppi's for long term - or some of the side effects kick in too strongly, I will go off of them and try Carafate for a while. Inevitably, the pain in my body and the concern of the gerd damage leads me right back to the ppis. It is a vicious cycle ... there is no easy answer. Blondie, I didn't know that the ppi's can cause electrolyte imbalance? How do you counteract that? Drink gatorade? Would love to hear your thoughts. Jen

PPIs don't cause my electrolyte imbalances- the reflux does when it's not controlled. My reflux causes me to vomit a lot, which this leads to electrolyte problems. I make sure and drink plenty of water, and I also have electrolyte pills I can take. If my blood pressure drops really low I have steroids to bring it up.

I take Carafate too as needed. It's a nice drug with few side effects that helps a lot.

I looked up the prescribing information and one of the side effects is blood disorders(in very tiny letters). Us guinea pigs will not know what the effects are until it happens.

I agree Lady50, we are guinea pigs. And if I think about it too much I get concerned ... so I try not to focus on it. Unfortunately, I don't know that we have any other choices. GERD can be very destructive ... it seems to be one of the bodies' more vulnerable areas. Once this disease progresses, it is very hard to repair. I have decided, until I require the fundo, I will stick with the ppi's until they don't work or the side effects are too unpleasant. If I don't take them, the acid will destroy my esophogus - that is a given. If I do take them, there is a chance that my esophogus will stay healthy until the medical establishment gives me another alternative. I am 39 and am not ready to give my esophogus over to the acid without a fight.

I agree with Lady, I was shocked to see the huge list of "rare" side effects listed in the presribing information of all the PPIs. My RX said don't worry about it these don't cause side effects and my GI dr was unaware of most iof the rare ones in small print!!

I admit the Prilosec worked for my reflux and all the pain I had associated with the reflux damage but I am afraid of the side effects down the line. I have been having trouble with my lymph nodes in my neck since taking the prilosec and I have been off of it a week and they still haven't gone down!!

Reflux is terrible and I was amazed and all the pain and trouble it had cause me but I would love to have another alternative to taking a pill for the next 30 years.

I think it's a pity if people just live with reflux disease, when there are a lot of meds that work to treat it. Reflux is a horrible disease. I think they should keep finding more remedies, but right now the ones approved are pretty good for the most part.

Omperazole has been in use since 1996. That's longer than a lot of other drugs.

I think it's important to be aware of the side effects. The ideal time to do that is when your doctor is prescribing the medication, talk to him or her! All medications have side effects.

Aspirin is considered probably more dangerous than PPIs. My doctor told me I could take the whole bottle of Prevacid at once and most likely be fine. If you do that with aspirin you will die.

tyboyz, I also had swollen neck issues with prilosec. I am now on Nexium and so far so good. Unfortunately, with meds, the situation is constantly evolving. However, if you are getting something unpleasant from one, try another ... it might not be the case. Each med had a list of potential side effects the length of a Steven King novel (and many just as scary!), we don't know what will effect each of us until we try it. And sometimes, one side effect will disappear only for another to appear. As I said earlier, it is constantly evolving and a person can only cope with the current situation. I am going to keep with the Nexium until I can't, and then I will have to figure out what is next. However, doing nothing is an option I will never consider. Blondy, how old are you and how long have you been suffering with this? What med are you on and for how long? I feel it is so important to understand other people's situation so that I can better understand my own. As you are a 'senior member', it looks like this has already been a long haul for you.

I am 19. I've had reflux since I was 16. I was diagnosed when I was 16 after a year of constant vomiting, loosing 50 pounds, tearing a hole in my esophogus, giving myself 14 cavities. I have also thrown my electrolytes off countless times. I was diagnosed by the peds GI after no other doctor knew what the heck was wrong with me. I had the hole in my esophogus then. I went on 60mg of Prevacid. It worked wonders for awhile. Then symptoms returned and I was switched to Prilosec, then back to Prevacid, then they added Carafate. I still was pretty sick and then I was getting fevers everyday and getting dizzy. That was the first time I threw my electrolytes out. I had a gastric empty scan, and was tested for rare diseases, but it was just the electrolyte problem. I got better for awhile using the Carafate and Prevacid, then got sick again. I was switched to Nexium, when my first pH probe was done. pH probe showed major problems still, so I was switched back to Prevacid and Reglan and Phergan were added. I actually went off the Reglan because of side effects.

I have yet to find a treatment that really works for me, but the Prevacid seems the most effective without the side effects. Right now I'm looking into the fundo as myu most recent pH probe still showed severe reflux on meds.

I have a lot of posts because I post in more than one board- I have blood sugar problems, so I post in the diabetes board (though I'm not diabetic yet- I'm heading that way), I have reflux-related asthma as well, and allergies to dogs, pollen, dust, dust mites, grass, and trees, so I post in the allergy board as well.

Hope this isn't too much info mjcm. I agree that it's important to understand other people's situations.

I'm glad doing nothing will never be an option for you.

Lady 50, I'm sorry if I came across as harsh, but I really hate for people to suffer. As you can tell, I've been through a lot with reflux and know first hand how damaging it can be. I do a lot of reading and truly feel that the side effects are much less dangerous than the disease, but that's just me. You are right that it is your decision whether the drug is used or not, but please talk to your doctor about your concerns with the side effects.

I want to apologize for sounding harsh myself. I have a thyroid problem and get aggravated easily.

I feel bad about being so rude with you. Also, I worry about my husband because he seems to have had a personality change from being sick. With this vascular disease of the carotoid artery that he has makes me worry. I know that one of the blood clots can go into the brain and cause a stroke.

God bless :angel:

No hard feeling here :) I really hope your husband is okay. It can b e scary. My dad has congestive heart failure, and was waiting for a heart transplant, but recently a new medication made him be able to live without one. I think that's part of the reason I'm not into trying to avoid medications. Has your husband seen a cardiologist? My dad's cardiologist helped him a ton!

Blondy, just wanted to tell you that I think your opinion has really opened things up so that everyone can make an informed decision. I think it is always best to have all perspectives so that you can see how you situation fits. I think I am going to take a month off of the PPIs and see how I do with diet control and a pepcid when needed.

Mjcm, do you know how long it took for your lymph nodes to go down after you stopped the prilosec??

Lady, thanks for starting this discussion. It has really helped me.

There is another option you can try. I found an AcidEase product at Wild Oats. You might look into that.

I have never heard of Wild Oats.

Hi Blondy. You have really been through the ringer! I am also researching the fundo ... it is a big move but I figure when I get desperate enough it will be there. Are you on single or double doses of Prevacid? I also had nausea, electrolyte and dizzy problems when I was on 300mg ranitidine. Finally ended up in the hospital for 2nights getting a drip ... nausea is unbearable! The situation really sucks but you seem to have a fighter's attitude which I believe is the ultimate lifesaver! Stay in touch. :)

Tyboyz, it took quite a while for the lymphnodes to calm down. Now I am on Nexium and we'll see how it goes. Frankly, I'm not completely sure if the swollen lymphnodes are from the meds, the GERD, or a combination. I have developed very sore joints and muscles and again I'm not sure if there is a systemic cause or just if I have parallel tracks going on. :confused:

mjcm, sorry to keep bugging you about this but having my lymph nodes swollen makes me very nervous......... When you say quite a while do you mean weeks or months?? Did your doctor ever say they might have been from the Prilosec or reflux?? Could you actually feel them ?? Thanks again for your help!!!

Hi Tyboyz. You are not bugging me! I wish I had more specific answers for you. Unfortunately, I was never that attuned to my body until all of this began (I had no idea how lucky I was to wake up in the morning assuming my body would do as it should!). In any event, truthfully my neck and lymphnodes still sometimes feel swollen which leads me to believe it is one of the symptoms of LPR. It was much worse when I was on Prilosec which makes me assume I had a reaction to the prilosec. Part of the insidiousness of this disease is how it contorts itself daily due to what we eat, what meds we take, which way our body bends (I have a hiatal hernia so when I bend I can feel the acid in my nose), and who knows what else. Go to your ent and get it checked out ... being anxious will only exacerbate the symptoms. I have also developed joint and muscle pain, why? Meds, arthritis, virus? Who knows. I have had so much blood work and scans that I give up and just try to take each day as it comes. If you have a symptom, check it out. Try different meds. I know it is so hard when the docs can't pinpoint why something is happening ... I'm sorry I don't have more specific answers.

Thanks mjcm! I was the same way. Just went along thinking everything was fine until I got sick of the heartburn. Then the scans and tests started. I know my lymph nodes were not swollen before the prilosec because my doctor checked them out when I originally went to him for the heartburn. I noticed them after the prilosec because I had a bad sore throat which has gone since stopping the med.

Anyway I guess I need to get refered to an ENT. Has your ENT checked your nodes out?? Nothing to worry about I guess?? I definitely don't like having mine swollen!!! Thanks again.

Well I did some searching and found out that longterm use of PPIs can cause a decrease of Vitamin B12. It said it also aids in the digestion. It said something about interfering with the meylin in the stomach.

That is all I found. He does get tired easy.

Hi Lady. Definitely have your husband take a b12 supplement. Also, what helps in aiding digestion? What is meylin in the stomach?

Patti, did your son ever have any lymph nod swelling related to the prilosec??

I did not read any further about myelin. My eyes were crossing.

I am going to try to get him to take B12, vitamin C.

Thanks

Patti, does you son take a b12 supplement? I understand the b12 is harder to absorb through food with the ppis but I thought for some reason the body could still absorb the supplement. Have you heard this?

Nexium DOES NOT neutralize stomach acid. It stops these things in your stomach called proton pumps from making it altogether. Again, let me point out to you that acid does not break down fats. Enzymes do. There's really no need for acid in the stomach,

Nexium does not stop acid production altogether . That's why PPIS are deemed relatively safe. You say enzymes break down the fat. Not acid.

But these" enzymes" need acid in order to be activated. Pepsin is secreted in an inactive form, pepsinogen, which is activated by STOMACH ACID

So Acid is needed to initiate digestion of protein, and kills bacteria in the stomach ... PPIS cut down most of the acid but do not stop it altogether .

PPIS do cause fundic gland polps in humans, but they are not deemed serious and often go away on their own. Sometimes they have to be removed though.



The long term safety of PPIS is unknown.... they are too new.... presently they are deemed relatively safe.

I said that PPIs stop acid production- they do. I didn't say they stop it all together. I'm going based on what my GI doctor told me. He said I'm on a high enough dose of Prevacid that I shouldn't have any acid in my stomach. The pH probe showed I did though.

I did a little research on omeprazole. It can interfere with absorption of vitamin B12 from foods(if it is taken everyday). My DH has been taking 40 milligrams for several years everyday.

People with low B12 can develop high homocysteine levels. HIgh hemocysteine levels are seen in people with cardiovascular disease, high cholesterol etc.

I am not saying for sure that this has caused him to get vascular disease of the carotid artery. It could be hereditary. So, the question is, would it be helpful to take vitamin B12?

I did a search for omeprazole on search engine "G" and that is what I found.

Ladies, I have definitely heard one should take a vitamin B12 supp with long term daily ppi use. How does the body absorb the b12 vitamin but not be able to efficiently extract it from food I don't know. It seems these meds are so new there are no clear cut answers. I guess we are the guinea pig generation. Question: if I take digestive enzymes, does anyone know if that will counteract the issues the ppi causes with digestion? Jen

I always thought that vitamin b12 was best absorbed as an injection and is a prescription that way. If you're concerned, I would have the doctor test the levels and prescribe the injection for if necessary.

If you can find an OTC pill, it can't hurt to take it for peace of mind.

Absorption of vitamin B12 from foods is complex. A defect in any step can lead to deficiency.

Concerning the stomach....... gastric acid and pepsin release B12 from animal proteins.

B12 diffiency from PPIS comes from the fact that lack of gastric acid and pepsin from long term PPI use -- causes a failure to digest food protein. It takes a long time to get B12 diffiency from PPIS , and the elderly are most at risk. B12 decreases on it's own as people age. Plus acid production decreases in everyone as they age. A B12 problem with PPIS is rare . A person should get a blood test before using supplementation.

Even if a person is taking 2 PPIS a day--- there is still ample acid in the stomach to digest protein. As soon as one proton pump is shut down , another pump is made to replace it. You would need 10 PPIS a day to totally stop acid production. Or be on PPIS for a long time where the proton pumps would eventually stop regenerating.

TJN, where exactly are you getting your info from? My doctor tells me on 60mg a Prevacid a day I should not have any acid.

Blondy :) I've been reading on GERD and pharmacology for a long time. I don't read off websites for lay people.

I don't think your doctor meant that literally . Most of these doctors just can't be bothered explaining things in detail . I'm sure he meant you were getting adequate acid suppression-- not that ppis totally stop all of the acid. Because of course they don't . Call the manufacturer . Next time you go, ask him what happens when the proton pumps are shut down... well he'll tell you new ones are instantly made. PPIS stop most of the acid , but not all. Your stomach would be a mess if it had no acid. You'd definately have an awful bad case of gastritis... and a B12 problem.

Acid isn't the only thing causing symptoms in GERD . Now with sleuth testing they know that lightly acidic reflux, gas ( Intraluminal air ) weakly alkaline reflux etc. also all cause symptoms. GERD is quite complicated.

TJN, about how many years on ppis would be required before the stomach stops making new acid pumps? I guess I always assumed naievely that when I stopped taking the ppis my stomach could return to normal. Also, would taking digestive enzymes help the stomach break down the food in order to get the b12 and protein? I am currently taking a multi and an additonal b12 supplement. Any additional info would be greatly appreciated. Thank you.

My doctor does take a lot of time with me- I have had him spend an hour with me before. He sure did sound like he meant it literally. He told me that acid serves no purpose what so ever. I don't know, maybe I misunderstood him. I have read in depth on GERD also, and of websites for healthcare professionals, and I have never read anything about PPIs regenerating when they are shut off. Wouldn't that defeat the purpose of taking PPIs? I know on my last pH probe he said the level my stomach's pH should be at is 7 because I should have NO acid in my stomach.

Blondie :) I don't know what to say other than ask him again , what he told you as far as PPIS eliminating all acid in the stomach is not at all accurate. . There is no single pill on earth that can completely shut the acid down . I can 1000 percent guarantee that. Email Astra Zeneca and ask them.


As for acid serving no purpose ....Everything in the body serves a purpose. Acid is very important in killing bacteria as well. People can live with no acid though , just like they can live without a gallbladder , although some may have digestive problems , develop atrophic gastritis, malabsorption syndrome B 12 diffiency, bacterial related infections etc .

As for the ph test, it does not measure how much acid is in the stomach. There is a different test for that. The ph measures acid exposure to the esophagus ONLY. Not the stomach.

Do you understand how a ph test works? It counts reflux episodes. Any drop in the ph below 4 for 4 seconds or longer is defined as one reflux episode. If you have less than 50 of these reflux episodes, and your ph is above 4 for 95 percent of the total time in a 24 hour period, you are getting sufficient acid suppression.
.

mjcm123 Hi :) It's different for everyone, some are affected more than others by PPIS . Some never stop producing acid pumps. Some people aren't affected much after 10 years of use-- where others have problems after 5 years minimum . It depends on multiple factors such as dosage , age etc too. A good clue is what shape your stomach is in during endoscopy.

Once symptoms are controlled many doctors encourage the patient to scale down to the least amount of meds they can.

PPIS also elevate serum gastrin levels in many people as shown in virtually all studies. , This can be proven via blood test.

Digestive enzymes are helpful , they seem to help a lot of people with digestive / bowel problems attributed to many by the PPIS.

TJN, I have LPR so I am double dosing Nexium. I was on Ranitidine 300mg but it made me so nauseous and didn't do much for the LPR. I am under the impression 6 months to clear LPR and then try to scale back to one dosage. At 40, I was figuring a 5 year timeline and then look into surgery (assuming the meds work for 5 years as I understand they lose their efficacy for many people). Will endoscopy determine how my stomach is surviving the ppi onslaught? And if so, how often should an endoscopy be done? One more question, what is serum gastrin?? Thanks.

Blondie :) I don't know what to say other than ask him again , what he told you as far as PPIS eliminating all acid in the stomach is not at all accurate. . There is no single pill on earth that can completely shut the acid down . I can 1000 percent guarantee that. Email Astra Zeneca and ask them.


As for acid serving no purpose ....Everything in the body serves a purpose. Acid is very important in killing bacteria as well. People can live with no acid though , just like they can live without a gallbladder , although some may have digestive problems , develop atrophic gastritis, malabsorption syndrome B 12 diffiency, bacterial related infections etc .

As for the ph test, it does not measure how much acid is in the stomach. There is a different test for that. The ph measures acid exposure to the esophagus ONLY. Not the stomach.

Do you understand how a ph test works? It counts reflux episodes. Any drop in the ph below 4 for 4 seconds or longer is defined as one reflux episode. If you have less than 50 of these reflux episodes, and your ph is above 4 for 95 percent of the total time in a 24 hour period, you are getting sufficient acid suppression.
.
Yes, my doctor did tell me that I have to be very careful about bacteria and food poisoning and such. Maybe he was exagerrating.

As far as the pH probe is concerned- I had two probes. One was placed in my esophogus, one in my stomach. On the computer two numbers were displayed- one was my stomach's pH, the other was my esophogus pH. The purpose of the test was to determine how well the PPIs were working, which is why they wanted. The answer was not very well, since both numbers rarely went above 4. My first probe was done on 80mgs of Nexium, my second on 60mg of Prevacid.

I;ve also tried Reglan with Prevacid, and didn't tolerate it. I have Carafate and Phenergan as needed, but those aren't really controllers. I have been doing a lot of reading, like I said, and pretty much decided fundoplication is next, but neither one of the 2 GIs I see is a huge fan of that. Since you have been doing a lot of reading too, what do you think I should be looking more into. I'm also realizing I have LPR symptoms- sore throat, horseness, random voice loss. I have asthma as a result of reflux (and my asthma doctor is pushing for a fundo), and have torn a hole in my esophogus and thrown my electrolytes out several times from vomiting. I'm just not sure where to go from here. I'm thinking adding Zantac 300 or Erythromyacin.

Blondie, with the way you are suffering, what reason did the GI give for being against surgery?

I wonder if low B-12 could be associated with degenerative disc disease. My husband has that also. It could have been from a bad wreck he had back in October and just now showing up. It is also called osteoarthitis,spondylitis.

The cartilage is wearing away and bones are rubbing together. I am reseaching that one also.

Hi mjcm123


I had LPR too for almost 2 years. After 6 months of double dosing on nexium and one zantac , i scaled back gradually and was able to get off of all medications altogether. Have been off of them for a year now. This illness often goes into remission,-- unforunately it doesn't often stay away--- i have a friend who had been GERD free for 5 years however it just returned recently.

Yes endoscopy will check the stomach , if you had an ok endoscopy already you really don't need another one for 3-4 years... depending on how you feel too of course.

Gastrin is a hormone produced by cells in the stomach. Gastrin in the bloodstream stimulates cells in the stomach to secrete acid.

Gastrin is secreted into the blood when we eat and when the PH level of the stomach is less acidic --- and it causes the stomach to produce more acid.

Hi Blondy There is no ph probe for the stomach. You must of had a double probe, one in the esophagus, and one in the throat. They DEFINATELY don't put one in the stomach. :) If you had a tear in your esophagus at 16 from vomiting , you definately don't have one now. , they heal on their own within 96 hours if not severe enough to need surgery. These are called Mallory Weiss tears.

It's unclear what is causing your vomiting , when looking back at your prior posts , it looks like the ph test on meds was ok , and you had acceptable amounts of reflux according to one doctor. Remember even people without GERD reflux . What was your Demeester score, do you know?

Has anyone ever mentioned Cyclic vomiting syndrome to you? Teenagers/ Young adults usually DON"T get Mallory Weiss tears from GERD -- it's practically unheard of and primarily happens to people in their 60s, however Cyclic vomiting syndrome often does cause these tears in teenagers and young adults.

You need a ph test without meds to get a clearer pic of what's going on and to see if reflux symptoms such as nausea correlate with ph scores. And if there is significant reflux . Noone would do any procedure on you without a ph test off of meds which you have never had. It's possible you could have a couple of conditions overlapping which makes GERD seem worse. Was your gastric emptying study OK ? You should see an ENT as well.

I'm not a big Fundo fan myself. I would do the Hill Procedure before ever doing that. Although many of the newer non invasive procedures haven't been perfected yet , such as the endocinch, etc ... Look out for the Gatekeeper . It shows the most promise by far and is reversible and results look great in Europe.

TJN
Please give more info on the treatments you mention. The hill procedure? Endocinch? and "Gatekeeper" you mentioned in your post. I have never heard of these and would like more information. Thanks

My doctors aren't big fans of the fundoplication because they say at my age I'll be back on meds within a year, so they want me to wait until I'm older.

I am well aware that the tear in my espohogus is long gone, but that is how much vomiting I was doing. I have looked into CVS, but my doctor ruled it out because I improved on reflux meds, and my episodes were everyday, rather than going in cycles.

I have been diagnosed with delayed gastric empty time, they I don't remember my specific results. I don't take any meds for that right now because I did horribly on Reglan.

My pH probes on meds WERE NOT okay. They were "highly abnormal" according to my doctor- enough to make him change my meds. I have not gotten the "official" results from my second one, but I know they were better than the first, but still abnormal. When I see my doctor Monday I am scheduling one off meds. I am positive I had a number measuring my stomach's pH. I'm not sure if it was a classic pH study, but I know one is there. I saw the result chart and one line on the graph was "stomach" and the other "esophogus."

They think my vomiting is from reflux. I have been diagnosed witha hypersensitive gag reflex as well, so when I reflux they think the reflux is irritating my gag reflex causing me to vomit.

As far as Endocinch, Gatekeeper, and Hill, my doctors consider them too experimental for the time being, even though I know they are approved and such. His exact words were: "Let them test it on other people- not my patients." That was enough to totally turn my parents off to the idea, though I am still interested. I would have to go to another city to get a consult on that because there are no centers in my city that do it. Endocinch is the most favorable in my mind at the moment.

Hi all. From everything I've read, the endocinch is not having a tremendous success rate in terms of longevity. I am also keeping my eyes open for Gatekeeper info. Apparently there is a big study going on ... some people on another board were talking about Emory looking for candidates. TJN, do you know where I could get info on the Gatekeeper success in Europe? I am also interested in getting info on the Hill Repair. I like the fact that it keeps the body more "anatomically correct". Unfortunately, most of the surgeons who do it seem to be in the northwest and I am on the east coast. I can't figure out why the proceedure never made it across the country (it has been around for many years). It seems a person can still burp and vomit after the Hill whereas that is not always possible with the Fundo. Since being on medication for years on end may not be effective or healthy and with the proceedures also being an unknown, it seems the choice is really between the lesser of two evils ... and that too can vary!

Hi Mjcm :) You're right . There haven't been glowing reports on the endocinch. It's been disappointing. The Stretta can ruin you for life if done by an inexperienced doctor. There have been serious problems with the enteryx . I know 2 people who had the plicator and it didn't help .. Right now the Gatekeeper looks like the most promising, hopefully it will pan out. I like the fact it is reversable.

If you go to the National Library of Medicene online ( pub med ) and do a search on gatekeeper you should be able to find a few European studies. But studies are deceiving as it is always the companies that have an invested interest in the product who run them. It is better to hear from people who have actually had these procedures done.

The Hill has been around for a long time but is a technically more challenging op, and not a lot of doctors know how to do it. The fundo is an easier money maker. There is not a lot of info on the Hill on the net, unless you email one of the doctors for info. I know of noone who has had a failed Hill , not that there aren't failures . That's another thing, it is much easier to repair a failed Hill than a failed fundo.

lisman1408 Here is a rundown of various procedures

The ENDOCINCH device, like a tiny sewing machine, is attached to the end of a standard, flexible endoscope. The EndoCinch suturing system allows the physician to place a suture (stitch) near the lower esophageal sphincter (LES). Two stitches can be placed and tied together to create a pleat near the LES .



The GATEKEEPER (Medtronics Inc.), is an expandable hydrogel prostheses implanted into the submucosa of the esophagus augmenting the lower esophageal sphincter .The implants are about the size of a small vitamin capsule. They cannot be felt and are non-allergenic, . Nor do they impede food going down the esophagus. And they can be removed easily.
The gatekeeper has been approved in Europe since 2003, they're doing trials in the US right now at Emory University in Atlanta.

PLICATOR--- The Full-Thickness PLICATOR Procedure is a non-surgical, endoscopic GERD treatment based on the principles of anti-reflux surgery. The procedure allows the physician to create a full-thickness plication at the gastroesophageal junction under direct endoscopic visualization; enhancing the competency of the gastric cardia and restoring the normal anti-reflux barrier. The Plicator enters the stomach and is retroflexed and positioned
to within 1cm of the gastroesophageal junction. The Plicator arms are opened and an endoscopic tissue is advanced into the gastric wall, up to the level of the serosa.The full-thickness of the gastric wall is retracted, and the Plicator arms are closed.A single, pre-tied implant is deployed, securing the serosa-to-serosa plication.

THE HILL Procedure is an invasive surgical procedure . It differs from the fundo because with this procedure things are kept more anatomically correct . There is no seperating a portion of the spleen from the stomach as in the fundo and taking down of the gastric vessels, wrapping the stomach around the esophagus etc.

To be technical in the Hill , the cardia of the stomach is anchored to the posterior abdominal areas, This also has the effect of augmenting the angle of His, an important anti reflux mechanism -- and thus strengthening the LES

To be non technical ...the esophagus is pulled down and a portion of the stomach is sutured to the bottom of the diaphragm. Nothing is wrapped around anything as in the fundo.

The Hill has been around for a long time but is a technically more challenging op, and not a lot of doctors know how to do it. The fundo is an easier money maker. There is not a lot of info on the Hill on the net, unless you email one of the doctors for info. I know of noone who has had a failed Hill , not that there aren't failures . That's another thing, it is much easier to repair a failed Hill than a failed fundo.

TJN, you know people who have had successful Hills? If so, do you know which doctors they have used? What was their recovery like? Any feedback you have gotten from people I would love to hear.

So my appointment is tomorrow. Any ideas on the Zantac or Erythromyacin ideas? ANy other ideas? Should I discuss the fundo alternatives tomorrow? Please let me know anything else to discuss tomorrow? I think I have a lot of ideas already :)

'RARE' SIDE EFFECTS OF PPIs. After being diagnosed with reflux after a Barium swallow (and a three-month sore thorat) I was prescribed Omeprazole (20mg day) and started sessions with a speech therapist here in the UK to hopefully get my oesophagus working again! Omeprazole stopped my acid immediately - no ore heartburn or nasty tatse in mouth. BUT after 4-5 weeks I began to get groin pain, lower backache and Gynecomastia (tender, slightly enlraged breasts) - all worrying symptoms for a male (can all be testicular cancer related - had doctor check 'downstairs' and he was satisfied that nothing was wrong). Reading the insert, all of these symptoms were also listed as side effects from Omeprazole (albeit 'rare'). Groin pain went after a couple of weeks and I stopped taking the Omeprazole for a week but the acid came back so went back onto them. Symptoms all receded after about ten days but came back after a week or so. Have now been on 30mg of Lansprazole a day for a week - fingers crossed but all PPIs have similar effects so I'm not getting my hopes up. Anyway, so although these side effects are listed as rare, they do happen - a friend of my family (female) suffered exactly the same symptoms as me on Omeprazole - how 'rare' is that?

Hi Nagsrope,

I am reluctant to return to PPI's as the side effect of Protium that I noticed when on it for 3 months was an increase in my male breast tissue. For many years I took the H2 blocker cimetidine which also had this unfortunate side effect for me. Your GP or consultant will be sympathetic to this fact and will suggest an alternative PPI. They did not eleviate my reflux in any event so the side effect was just not worth having. If they work for you it would be worthwhile finding one with no side effects. I have not experienced your other symptoms.

Hope helps

I seen a TV show by the name of To Your Health with Dr. Becker. He claims that Milk Thistle eases GERD. I have Gerd, and a hernia. I find under stressful times like I am under now my GERD has been out of control. Prilosec usually is the only thing that ever helped me. I rather go the natural approach though. Let me know if anyone ever tried the natural route to help their acid reflux? Thanks in advanced!!

Hi Mjcm Sorry i took so long in getting back to you, haven't been on the computer. Dr Robert Wright out of Puyallup Washington State seems to do alot of the Hill Repairs. Recovery with the Hill is quicker than the Fundo from what i have neen told.