esophageal manometry test relationship with Nissen side effects

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BMcD
New Member


Date Joined Aug 2009
Total Posts : 18
   Posted 8/25/2009 11:59 AM (GMT -6)   

Do any of you know if there is a relationship of test results of a manometry test and the possibility of side effects in a Nissen Fundoplication?

 

I am still very much on the fence and leaning toward not going through with Nissen surgery despite my Barretts esophagus.  This is primarily due to the fact that I have very little pain currently (occasional minor pain in the chest), and the surgery comes with a 30% chance of not ever being able to burp or vomit, and the possibility of not being able to be as active as I am now:  Daily Weight lifting, heavy cardio, ect.

 

I just had my Esophageal Manometry test done today and the tech showed me the results and said I have perfect, textbook pressure all the way down to where my hernia is.  At that point my LES is not closing and he could show me where the test indicates that.  My question is if my Esophagus is working perfectly aside from my LES then would the 30% chance of all of these side effects of surgery still apply to me? if so to what extent?  Or does it not matter and its even 30% of people with perfect Esophageal function still have the permanent side effects?

 

 

Thanks,

 

Ben


couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 8/25/2009 3:20 PM (GMT -6)   
The nissen is to tighten your weak LES. It's good you have no pressure problems. You probably won't have any bad side effects from surgery.
I unfortunately have terciary movements, which is a third unproductive movement. I don't know if this will affect my surgery, but my surgeon didn't seem that concern.
If your hernia is less than 2cm you might be a canidate for EsophyX procedure. It's not as invasive as the nissen and you have a shorter healing time.


Joy

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/25/2009 8:16 PM (GMT -6)   
Hi Ben,
The manometry sounds like you'd be a great candidate for the surgery. Your LES is open, which means you're getting reflux, but your swallowing is normal, which means you aren't likely to have swallowing problems post-Nissen, which is one of the problem issues that can occur. The wrap produces more resistance to food as it passes through, so that's why it's important to have a good swallowing reflex.

As far as the surgery goes, I'll say this. My first GI doc was very negative on the surgery. He listed off lots of reasons why it's not that great. He never even tested me for the possibility--even though I was hospitalized over a week for severe GERD that led to uncontrolled asthma. He was not keen on the alternatives, either--Esophyx, etc. because they hadn't been time tested.

I switched GI docs, and the second one did the 24hr PH monitor, and found my GERD to be fairly "mild", so didn't recommend the surgery. He was definitely more positive on the procedure, though. During all this time, my asthma doc and family doc felt that the GERD was causing problems with my lungs.

I suffered for four years. The 40mg Protonix twice a day wasn't doing the job. I still had Maalox and Tums everywhere in my house, and had plenty of breakthrough reflux. My most severe problem was the asthma caused by the refluxing acid inflaming my lungs.

Finally, fast forward four years.
I had suffered with uncontrolled asthma, and had taken so much steroids that I was having adrenal insufficiency, my skin had thinned (my arms look terrible--bruised and skin tears) and I had developed further bone thinning. Still refluxing quite severely at times.

My family doc finally got me to see a surgeon who did an endoscopy and a barium swallow. With the input from my family doc, he declared me a good candidate for surgery.

Not being one to jump into things, I went back to my GI doc with the information from the tests. He gave me the PH monitor test again, and the score was quite a bit higher, but not anything like yours probably is...14, which is considered average...not generally indicating surgery.

At this point, however, he gave more consideration to my asthma symptoms and communication with my asthma and family docs. He then told me, I could either go on treating the reflux with medicine, or give surgery a try.

I went to the surgeon he recommended highly, and discussed it with him. The surgeon's only concern was that my number (14) wasn't very high. He also deferred to my doctors, though.

I finally decided I had to try the surgery. I was tired of not being able to breathe, coughing up mucous constantly, and wheezing. It was not healthy for my lungs or my body. I wish I'd done it years earlier.

I am telling you this story for one reason.
You are the one who ultimately has to decide if the changes that the surgery can cause (no burping--by the way, I was told I wouldn't be able to burp, but I am--no vomiting, etc.) At some point, if your symptoms are bad enough, and you get sick of living that way, no matter what the surgeon/GI doc says, you're the one who has to make the decision.

My son is a lifter, so I know how much that must mean to you. You might research that further, and see if it is absolutely restricted if you have the surgery.

I just hate to see someone be deterred from the surgery by docs who don't really know what it's like to live with the symptoms caused by uncontrolled GERD.

The surgery may not be right for you now...but if your quality of life is negatively affected, it may be right for you at some time in the future.

Good luck, Ben. I hope you don't have to have the surgery, but don't be afraid to have it. It might just be the best thing that ever happened to you...many people here have found it to be a lifesaver!
Take care,
Denise turn

rlopez75
Regular Member


Date Joined Jul 2009
Total Posts : 199
   Posted 8/25/2009 9:54 PM (GMT -6)   
My tests showed perferct readings other than the lower sphincter as well and I went ahead with the surgery. My recovery is going well so far. I can bup ocasionally allready, and allways as soon as I swallow, and its only been 15 days since my surgery.

I was also told that I can go on with life as normal. I explained to the Surgeon that I work construction and exert myself at work more than any other person who works in an office and he assured me that nothing will change after I have healed. Healing is key though. And healing comes with time so you must be patient.

So if you do move forward just remember to take it easy afterward. You wont gain any weight due to the lack of food consumption so you wont have a real need to work out. Walking is fine. But no heavy weight lifting for at least 6 months. This all comes from talking to Dr.s.

Good Luck.
Rafael

beareilly
Veteran Member


Date Joined Mar 2009
Total Posts : 553
   Posted 8/26/2009 7:15 AM (GMT -6)   
I can burp with no problems.Good luck
b

k9lov3r
Regular Member


Date Joined Nov 2008
Total Posts : 230
   Posted 8/26/2009 9:17 AM (GMT -6)   
I too can burp I have no desire to see if I cam vomit. Never liked to throw up before. I work as a public service officer with a police department. One of my job positions is working in ourjail. I have the possiblility of ending up in a fight with a prisoner who is either drunk, high on some type of drug or just does not want to be there. Go figure they dont want to go to jail but it did stop them from breaking the law. My thought is you don't want to go to jaill then obey the law but that is another story. We have had to phyusically interract twith these people while trying to get them restrained. I run the risk of beeng kicked in the stomache. We do have the option of light duty where I will just work in the dispatch office. So I am hopefully going to be released to light duty soon then back to full duty after about 3-6 months. My surgeon was aware of my job requirements before I had the surgery.

I too had a surgeon 3 years ago that said I did not need the surgery and to try dfferant medications. He also wanted me to taise the headboard of my bed. I did what he asked and still got no relief. Went to a differan doctor becasue my insurance had changed and sent me to the surgeon I have now. long story short had the surgery was felling good today having some small problems but it is to be expected during the recovery process. I have no regrets about having the surgery
Mary

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 8/26/2009 9:30 AM (GMT -6)   
Ben-
Sounds as if you are a good candidate for the surgery. Only your surgeon would know for sure though. I can burp this time and have no restrictions as to what I do. I can play any sports, weight lift, anything. You just have to do things by the book for about 6 to 8 weeks then go about your life as normal. I still can't vomit this time either, unfortunately I found this out about week 6. Not a big deal I just keep a prescription of Fenergan on hand to cover that.

Take care,
Bill
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