Don't have THE SURGERY unless you're desperate!

[Blasterboy]

Hi Warbonds,

I'm having good days and not so good days. Actually I think that my stomach is starting to settle a little and the loose bowels are calming down. I think it's just that full recovery takes time in many situations of this surgery and I agree that the chances of staying of the PPI's long term are very slim. I'm not taking any right now, but I am having a very mild GERD sensation, maybe it's just in my mind though and I'm certainly a little stressed about some things at present and we all know that doesn't help. I can certainly eat whatever I want and I feel that if I did end up back on the PPI's, it would very likely be at a much lower dose than before.

The worst thing is the pain really, it's dragging on and I seem to have a low pain threshold, so it bugs me. It seems to be some sort of nerve damage from the surgery. They have me on Amitripiline (anti depressent) which is effective on nerve type pain and it seems to be helping, so reason to be optomistic there :-)

I think there's a good chance that a year from now I will look back and be glad I had the surgery.

[mike-2005]

Hey blasterboy


How are you? I am affraid I might have to give you some bad news. Amitriptyline is a tricyclic anti-depressant which is also anti-cholinergic. This pill works for pain too, because it changes the way nerve endings work. It interferes with the way the nerves should work normally. People with GERD should not take this drug, because what it does is that it has anti-cholinergic effects which will decrease the LES pressure. People who have GERD should stay away from certain medications, and tricyclic-antidepressants and anti-cholinergic drugs are two of these meds. Amitriptyline has strong anti-cholinergic effects. This is how I developed a loose LES which right now I have GERD. I broke up with my girlfriend after 6 years and had some anxiety. The stupid doctor mis-diagnosed me as having depression even though I told him I have anxiety and not depression (I am in the medical field myself, so I know a lot about pills and medical conditions). But he insisted that I take the anti-depressants and finally I gave up and did. After 2 months of usage the pills made my lower sphincter so weak that everytime I eat now, I have reflux (I have LPR). I stopped taking the pill when I developed reflux but it is too late. The loose LES is obviously won't go back to normal because what the pill did was it reduced the LES pressure which results in the tone of the sphincter being reduced since the sphincter is just like a muscle and if it doesn't get used it will get weak. You can search this on the internet and find out about it if you like. I took 50mg once a day (at bedtime) for 2 months and that is all it took for this pill to decrease the LES pressure. I never ever had any problems with reflux, I could eat whatever I wanted to and now, because of this mistake I am not sure what I am going to do. So research about this pill because you definitely wouldn't want to be back where you were before. Take care. Mike

[mjcm123]

Since Blasterboy had the fundo, my understanding is there should be no problem with his taking these pills as he is no longer dependent on LES pressure. I believe the wrap creates a new "LES" which is not a muscle ... the fundo wraps the stomach around the esophogus creating a new valve with suturing. Check with your Doctor, Blasterboy (or perhaps with Tricia on the other board), but I do not believe pills can 'relax' the new sutured valve.

[Blasterboy]

I You know I was on anti depressents in my early 20's when my GERD started and my problem was a weak lower LES! makes you wonder when you read about these things!!!

Anyhow I would think that as I'm post fundo then I needn't worry about this. But I will definatly check with my docter on this point. Thanks for the advice guys.

[ginger65]

Hi everyone

Interesting to see what Mike had to say. I too had a relationship break-up many years ago and was on Amitriptyline for a few months. Really bad stuff.
It was after this I developed an ulcer and I now believe a weakened LES. It is an irony that due to the anxiety/depression you let your general health deterioate e.g. diet, alcohol use etc and the drug prescibed to make you emotionally better further erodes the physical. The real effects of the reflux only came to light 12 months ago so LPR most certainly is the silent reflux.

Blasterboy, how does the fundo for LES differ than normal hiatal hernia repair as the success rate of the latter seems very good ?. I have read about people having further corrective surgery either because the wrap was too tight or too loose and of course some do need further surgery down the line to re-tighten the valve. What I have read is that this type of surgery is years down the line and they have enjoyed a reflux free lifestyle till that point. The success or otherwise of the fundo seems still to be properly evaluated but any reference I have seen shows a success rate of 90%.
Hope things improve but I would re-consider the Amitriptyline use.