Candidate for surgery?

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elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1744
   Posted 11/17/2009 10:46 AM (GMT -6)   
How do you know if  you're a candidate for reflux surgery (any of them)?  I've had severe GERD for years, and even on double dose PPIs, and a daily acid blocker, I always seem to come up with erosive gastritis and erosive esophagitis with my endoscopies.    Seems to me like the problem gets worse as I age.  My  mother had this problem, and  she eventually ended up with the Nissen fundoplication.  It was towards the end of her life, however, and she never really got a chance to enjoy the results.  They never pushed the surgery with her.
 
My doctors have never even mentioned surgery, and when I brought it up once with a doctor whom I was seeing for 1 time only, he literally laughed at me.  Said the side effects of the surgery can be worse the disease itself so they reserve surgery for only the most severe cases.  Yet, according to the criteria I've seen on the internet, I probably meet all of the qualifications for candidacy.
 
What's the deal here?  I see a lot of you have had a procedure done--what were your circumstances?  Given that I'm only 41 and I've been told I'll be on PPIs for life,  is surgery something I should consider?
 
Thanks for any info. you can share,
 
Elcamino
Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Lupus
Current Meds: Enbrel, Methotrexate, nexium, tramadol, nasonex, Nifedipine, Folic Acid, Tylenol PM


Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5028
   Posted 11/17/2009 11:40 AM (GMT -6)   
Hi Camino -
 
Docs are right that side effects are not fun, but the decision totally depends on the individual case.  You have to find out WHY you have reflux.  Mine was triggered by food sensitivities.  I still needed to control the acid with Nexium because I had a bad LES and a small sliding hernia, but by avoiding my triggers I was able to stop the reflux events completely.  I posted my list a while ago and you should be able to search it.
 
Then I had a bad accident and my stomach was shoved into my chest - paraesophageal hernia - and surgery was the only recourse.  My story there was complicated and not fun, but it's also posted below.
 
Ask for all the testing you can get and find out the cause of your reflux.  It's not cured or controlled by acid reducers!  Those only stop the acid.  I lived for 20 years with non-acid reflux and had no esophageal changes or pain.
Alcie
 
 


stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 11/17/2009 12:51 PM (GMT -6)   
Elcamino

Hey there !
The goals of surgical therapy are identical to those of medical therapy. Patients are considered for surgical therapy of GERD if:

Medical therapy fails to control their symptoms despite large doses of PPI.
Medical therapy fails to prevent complications of GERD such as Barrett's oesophagus (thought to be a precancerous lesion), esophageal stricture (leading to increasing difficulty in swallowing), ulcer formation, and bleeding.
Atypical symptoms persist (asthma, dry cough, hoarseness, etc.)
A patient cannot take mediation because of undesirable side effects or poor compliance .
A patient prefers surgery rather than life long medical therapy
I am sure you will be hearing from other members. I wish you peace,



Kitt

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 11/17/2009 4:41 PM (GMT -6)   
I'm one of the asthma related GERD people. My LES is weak.
I'm on maxiumum doses of antacids and asthma meds.
My doctor floated back and forth about me having the surgery. So I'm going on my own to push forward my choice. I chose to have the surgery, because I'm tired of the coughing, voice loss, and horseness. I get major bronchitis because my lungs are affected.
Next week I'm going to get evaluated for the newest surgery...EsophyX TIF. (No Cutting!)


Joy
Health problems: sleep apnea, hypothyroidism, GERD, glaucoma, OA, environmental, food, and drug allergies, asthma, high cholesterol, pre-diabetic
Medications:Nexium 2X a day, 300mg Zantac, K-Dur, Lasix 2X a day, Zyrtec, Zocor, Lumigan, fish oil, B12, Substex, calcium + D, Advair, Albuteral, nebulizer
 
I don't suffer from insanity, I enjoy every minute of it!
 
 


mookiemoomoo
Regular Member


Date Joined Aug 2009
Total Posts : 150
   Posted 11/18/2009 1:13 AM (GMT -6)   
hi elcamino i have asthma and reflux that is not controlled with ppi and they have told me that i need surgery to give me better quality of life . I aslo had gastritis and esophegitis and h polori , my asthma is not controlled either which having read some peoples posts it could be because reflux , I having surgery shortly

elcamino
Veteran Member


Date Joined Sep 2005
Total Posts : 1744
   Posted 11/18/2009 7:25 AM (GMT -6)   

Hi all.  and thank you for your responses.  It appears that I do meet the criteria for surgery.  I guess I would simply need to discuss the surgical options with my doctor.  What is this new surgery that requires no cutting? 

while I don't have asthma related to reflux, I do experience a ton of reflux and often end up in coughing fits.  I recall that I went to an allergy doctor who ended up telling me that allergies were not my problem, it was reflux.  She told me I had LRD and I should be followed by an ENT doctor.  I never went because the only solution for me would be the gastro surgery--Again, I'm already medicated with a combination of PPIs and acid blockers.  These just stop the acid, not the reflux.

I'm due for an upper endoscopy next year--that might be an opportune time to ask about surgery.  I am very curious about the no cutting surgery they  now use.  Can anyone tell me anything about it?  What is the procedure called?

 

Thanks so much,

 

Elcamino


Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Lupus
Current Meds: Enbrel, Methotrexate, nexium, tramadol, nasonex, Nifedipine, Folic Acid, Tylenol PM


couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 11/18/2009 5:58 PM (GMT -6)   
It's called EsophyX TIF. You can find it anywhere on the web. There's a special web page about it and you can watch the video of the surgery on YouTube.
They go down your throat and "staple" your stomach around the esophagus.

I'm a whimp when it comes to surgery, but I believe I can tolerate this.

Joy
Health problems: sleep apnea, hypothyroidism, GERD, glaucoma, OA, environmental, food, and drug allergies, asthma, high cholesterol, pre-diabetic
Medications:Nexium 2X a day, 300mg Zantac, K-Dur, Lasix 2X a day, Zyrtec, Zocor, Lumigan, fish oil, B12, Substex, calcium + D, Advair, Albuteral, nebulizer
 
I don't suffer from insanity, I enjoy every minute of it!
 
 

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