Gerd and constipation

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Near40years
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Date Joined Jan 2013
Total Posts : 6
   Posted 1/24/2013 1:40 AM (GMT -6)   
My gastroenterologist recommends Mira-Lax or any of the generic brands. Start with a 1/4 capful in water, juice or hot beverage. He told us it could be taken for long period of time with no side effects. It works!!! Tasteless and with stirring, dissolves almost completely. I have severe hemorrhoids so I take about 3/4 to a full capful each day. What a relief.

I have had hiatal hernia and GERD for nearly 40 years. Have tried nearly every medication, recently changed from Prevacid to Dexilant in AM with Zantac in the evening. Both are 300 mg. Still spend most nights sleeping in my recliner because when in bed, even when propped up and bed elevated, when I turn on my side, up it all comes. I am unable to turn onto my side in recliner. Meds have controlled the burning but not the upchuck. Mine is not an ooze. I am in my 70's and have other health conditions but am considering surgery. Just heard about the TIF and am very interested. I know that with any of the other surgeries, burping, vomiting and the like are not going to be very well tolerated. The recovery time is about the same for the first month, but I think the TIF sounds like a more reasonable and natural approach. I am a very active Rancher type individual and would appreciate hearing from someone who has had any of the available methods done and what your activity level returned to after the completed recovery time. I need to finally get some good rest.

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 1/24/2013 12:12 PM (GMT -6)   
Hi Near, and welcome to the forum.

I'm not that much younger than you, drive a tractor for a living, but didn't suffer quite as long. I went to an allergist after figuring out my refluxing/near upchucking followed a pattern of usually being after certain meals or foods. I've posted often about keeping a food log with times, everything I ate or drank, all meds and symptoms. Just food journal in the search box at the top of the page.

Of course you may have a totally different reason than trigger foods, since you mentioned it comes on at night. Or you may have more than one problem! A lot of people are better if they don't eat anything at least 3 hours before going to bed. A barium swallow can show if you have reflux when you are lying down. It can show if your stomach is in the abdomen where it belongs or is popping into your chest through a "hiatal hernia" part of the time.

I got my refluxing to a minimum but needed a Nissen (Toupet) after I got a giant hernia from a bad wreck. I didn't recover as fast as some of the youngsters out there, but it was a success, and I'm glad I got it fixed.

If it's determined you need surgery, make sure you get an experienced surgeon. Mine was a top thoracic surgeon - since they had to go through the abdomen up into the chest chasing the stomach back down. I'm glad I didn't insist on one of the newer types of surgeries and went with what my doc said was right for me. Don't worry about the lack of burping or vomiting. Your doc is more experienced than us patients.

Near40years
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Date Joined Jan 2013
Total Posts : 6
   Posted 1/29/2013 7:29 PM (GMT -6)   
He does have the hiatal hernia and the reflux. 40 years worth, worsening as the years have gone by. He eats nothing at least 6 hours before bedtime and still, with just a swallow of water, will sleep for about an hour until up it comes. Other times, that is not the case and he will get a full nights sleep. We know his trigger foods, peanuts being one of them but even avoiding those foods, he may or may not have a problem that night. We have consulted a surgeon who suggested the Nissan you mentioned. However, we have recently found out about a new procedure being done at Swedish Hospital in Denver CO called TIF using something called an Exophyx device to form a new valve and it is Incisionless, done through the mouth into the stomach and altering the hiatal hernia at the same time. Wish we could get some input from someone who may have had this newer procedure completed.

Alcie
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Date Joined Oct 2009
Total Posts : 5028
   Posted 1/30/2013 11:30 AM (GMT -6)   
Hi Near-

A bunch of threads are on the forum from TIFF people. There is someone in Denver who does them. You can probably find him by doing a search with "Denver Tiff" in the search box at the top of the page.

My docs have done TIFF and other alternatives in the past, but they don't do them now because the rate of success just isn't nearly as high as their rate for Nissen in the high 90s. TIFF isn't supposed to be reversible either. Nissen has been reversed according to posters, although I thought it wasn't either. It doesn't really make a "new" valve as in heart valve replacement, but just tightens up the tissue there. You can find complete surgery videos and description online.

More importantly, Tiff can't correct hiatal hernia, since it's done through the mouth. If the stomach is hanging around partly in the chest, like mine was, the only ways of getting it down is through the abdomen or through the ribs. I've already got slipping rib syndrome, so I wouldn't want any more pain there from rib spreading.

Avoiding trigger foods won't stop stomach contents from coming up while lying down if there is a defective valve. PPIs should help with keeping it non-acid and therefore not burning. Avoidance did help me though, with not spasmodically heaving up stuff that I shouldn't have eaten soon after eating.

Post Edited (Alcie) : 1/30/2013 9:38:58 AM (GMT-7)


Near40years
New Member


Date Joined Jan 2013
Total Posts : 6
   Posted 1/30/2013 5:10 PM (GMT -6)   
The info we got from Swedish Hospital indicates that this is relatively new procedure and is reversible as well. We appreciate any and all information out there because we want to do the most appropriate surgery for my husband. In lieu of his age, we also need to go about this looking at the shortest recovery time and the easiest surgery. He is a strong man but due to age and other health issues, he is not the man he used to be. The desire is there but the wherewithall is gone. Not sure if we are talking about the same surgery because this is just TIF. It uses a devise called the Esophyx and can compensate further into the stomach for placement therefore repairing the hiatal hernia at the same time. At least that is what they say and show.

Thank you for your input.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5028
   Posted 1/30/2013 6:05 PM (GMT -6)   
Is his hernia greater than 2 cm? According to the websites, that's the limit for TIF.

You might want to get a second opinion as to whether the surgery is reversible. The company markets it as being so. Since the stomach tissue adheres itself to the esophagus, or maybe it's to part of the stomach, I would be suspicious that it would take an open surgery to take it down. But I'm not a doctor!

Near40years
New Member


Date Joined Jan 2013
Total Posts : 6
   Posted 1/31/2013 1:11 PM (GMT -6)   
You may well be right. We are soliciting information from the Mayo Clinic in Arizona where we have had numerous interventions. They have yet to return our call regarding the TIF surgery and its long term results. Hope to hear back from them soon.

Thanks for all of your input. Every little bit helps.
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