Confused Diagnosis

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Acid Prone
Regular Member


Date Joined May 2008
Total Posts : 46
   Posted 9/28/2008 12:48 PM (GMT -6)   

I need some info. I've not been visiting this site in awhile. I'm a candidate for a Nissen but...The surgeon thinks I need the procedure but...my BRAVO 48 hour test was normal. My manometry was good. I keep getting esophageal dilations (I had one about 10 days ago.) I have a continuous epigastric pain that radiates down my arm.  I have stuff in my throat about 99% of the time. Lots of problems with coughing, gagging, voice, ears etc. NOTHING helps. Something is WRONG but what??? I take Prevacid twice a day.

 

Could I have a problem with my gall bladder? My sister-in-law said that she had similar symptoms and that when she had her gall bladder removed everything went away. My surgeon said that part of the problem (since I seem to have no acid in the esophagus) could be too much bile (?) getting into my stomach??? I thought that bile went into the duodenum but can it back up into the stomach? 

The surgeon wants to do a Barium swallow and watch what happens in different positions to see if the Barium comes back up I guess.

 

Are there more tests I should get before I do anything like surgery? Could I have a gall bladder problem masquerading as GERD????  

I need some help. Thanks in advance.


Mary Lynn


Acid Prone
Regular Member


Date Joined May 2008
Total Posts : 46
   Posted 10/5/2008 1:39 PM (GMT -6)   

Okay, my GI doc says it is probably bile and acid and that the NISSEN will fix it. I go see the surgeon again tomorrow; he wants to have an Upper GI. Once we get that out of the way, it'll be surgery for me.

I need to read the posts about the Nissen.


Mary Lynn


stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 10/5/2008 4:38 PM (GMT -6)   

Acid Prone,

You will find lots of info on the Nissen so please do read and see the many differences that members experience. I am glad you have a decision re your surgery.

Let us know when and keep talking to us.

Kitt


 

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sillylilly
Regular Member


Date Joined Oct 2006
Total Posts : 317
   Posted 10/6/2008 5:16 PM (GMT -6)   
Acid prone,

Please, please, get a second opinion before you do the surgery. If your Bravo is negative and your manometry normal, then why would your surgeon just guess at what is wrong. To have the surgery, your Bravo should be showing considerable acid reflux. There is another test that will show whether bile is the problem. It's called an impedence test and it will show acid reflux and non-acid reflux (bile, pepsin, etc.), distribution and clearing time. I suppose there is always a slight chance that the Bravo was giving you a false negative report. Your doctors are doing too much guess work...beware of it.  They have a very lax attitude and this surgery is not something you want to have if you don't need it. 

Why do you need dialations? You said your manometry was normal so what are the dialations for.
You sure want to really be sure you can swallow well before you have any surgery.

Is the prevacid doing any good for you? If you don't have acid, I would think it wouldn't be working for you. What you are describing is not  heartburn but there is a type of acid reflux that does effect the throat. It's called LPR or basically laryengeal phrenoesophageal reflux, not sure of the spelling.

I have read alot of posts from people who had misdiagnosis' and had the surgery and they still had the problems. Don't rush into this. Please do alot of research about your surgeon also. You have to have someone who has done alot of the Nissen surgeries to be qualified with very good successes.   Listen, I would be very concerned about a surgeon who wants to play guessing games with my body.   Don't just accept the surgeon that your GI suggests and especially don't go into this without knowing full well that you have acid reflux. 
 
We are looking out for you here and I don't want to alarm you at all.  The barium swallow is not a definitive test for reflux like the Bravo is.  Be your own advocate and I think I would insist on the impedence test first.  All the best to you, hon.  Take care. 

Post Edited (sillylilly) : 10/6/2008 5:24:05 PM (GMT-6)


LdyJane
Veteran Member


Date Joined Jun 2008
Total Posts : 903
   Posted 10/6/2008 5:40 PM (GMT -6)   
Acidprone, please,please listen to what Carolyn is saying; I agree with her 10,000%

This surgery has a formula for success: The right patient + the right diagnosis + the right surgeon = successful outcome. If any part of the that formula is wrong the results are disastrous.

The Bravo is a very definitive test, yes there are false positives but very few false negatives and this surgery is generally necessary for people who have failed lower esophageal sphincters that allow excessive amounts of acid into their esophagus. A Bravo or a 24 hour ph is the first step to determine if this is the case and it doesn't sound like it is. Carolyn suggested an impedance study and again, I agree with her.

Please do not rush this decision, but you may want to rush to find another gastroenterologist! Where, if I may ask, are you living?, there may be some suggestions that we can provide if you're near a facility that we're familiar with.

Good luck, let us know.
Janice

oakley
Regular Member


Date Joined May 2007
Total Posts : 358
   Posted 10/6/2008 6:17 PM (GMT -6)   
Hi there...
Acidprone, how are you this evening? I hope you are feeling better. I, too, had tests done to find out why I was having so much pain. I am not a candidate for the surgery because I cannot swallow well now and my GI doc insisted on doing a monometry test and I have to say , what a miserable test! My doc said that he knows of surgeons who would have done the surgery just based on their theories , not on facts and a true diagnosis. I am thankful that he was honest and gave me the test first , I don't think that having this surgery is a cup of tea and not having has turned out ok for me. I take two Protonix each day..check into these...I tried all the others, this one really works for me...maybe it would for you as well. I fully agree with everyone else in that you need to be your own advocate and not let doctors tell you what to do or act so casual about it. I hope we can help here and that you find the answers that you need. God bless, Anne
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