Has anyone with motility problems managed to have surgery for Gerd/LPR?

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GC1pink
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Date Joined Nov 2012
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   Posted 11/25/2013 1:26 PM (GMT -6)   
Hi,
 
I'm having terrible trouble with reflux, finally been diagnosed with LPR - throat now red raw, vocal chords red and adenoids swollen - I don't get the burning but can feel the sour taste in my mouth after every meal and during the day, whilst on 2x2 ppi's and a ranitidine, and Gaviscon. This has now caused me dysphagia (trouble swallowing in my throat)
 
I have poor motility, and am told I can't have any operations because of this - I have a hiatus hernia of at least 3cm. Can anyone advise what procedures they have had done, and what was their weak motility scores please.
 
I'm fast running out of options and time. shakehead
 
Thank you.

Hevzi
New Member


Date Joined Dec 2013
Total Posts : 1
   Posted 12/16/2013 12:36 PM (GMT -6)   
Hiii, I have afew similar symptoms, so I understand where you are coming from.
what have the doctors said to you?

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4961
   Posted 12/16/2013 6:58 PM (GMT -6)   
Since my esophagus tear, I developed some motility issues and still have a full wrap. They have greatly improved how they do the wraps now to help those with motility issues.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

Baza
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Date Joined Jan 2011
Total Posts : 513
   Posted 12/17/2013 3:10 AM (GMT -6)   
Hi,Gc1pink, you can definitely have a fundoplication if you have a motility problem.The fundoplication can be tailored to suit you with a partial wrap that can be done to various degrees ie 270,180 and even 90.
I have only 50% of my esophagus working and had a 200 degree wrap and im doing great with no reflux and swallowing fine.
If your surgeon is not willing to operate maybe you could get another opinion. Barry

Retired Seabee
Regular Member


Date Joined Feb 2013
Total Posts : 129
   Posted 12/17/2013 8:02 AM (GMT -6)   
I had motility issues as well, but mine turned out to be the result of the HH. I am not an expert as far as motility goes, but in my case part of my stomach was above the diaphragm and the LES was not able to close. In effect, I could swallow, but when the food reached the LES it would free-fall from there. During the Barium swallow X-ray/fluroscopic tests, the Radiologist could see the Barium refluxing back into my esophagus when he moved me from verticule to the horizontal position. He diagnosed a medium sized HH and referred me to surgery. Shortly thereafter I had the motility swallow test.

During that test, everything went smoothly the first time but the readings were all screwed up. The probe went down the first time without a hitch. However after it was down, the technician had to fish around quite awhile to try to get it to what he thought was the proper depth. The next day I had to go back and do it all again because the Gastroenterologist who evaluated the test knew something was wrong with the readings. He suspected that the probe went down until it hit the upper part of the HH and curved around and started back up. As it turned out he was correct.

He conducted the re-test himself and had his entire Gastroenterology staff as an audience.......naturally it did not go smoothly....I barfed and gagged the whole time....but he recognized when the probe started to curve around again and managed to fish it into the proper position.

By itself, repairing the HH could have eliminated the problem. However, in order to prevent recurrance, they insisted on also doing the NF wrap. I really was worried about that part of the operation but it all worked out fine. I had an easy recovery and have been symptom free since the repair was done in March of this year.

GC1pink
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Date Joined Nov 2012
Total Posts : 532
   Posted 12/17/2013 5:14 PM (GMT -6)   
Thank you everyone for your posts.

I have unfortunately continued to decline. I have had crucifying spasms at the LES and stomach for the last 2 months, and I was told to just go on an antidepressant to reduce the pain. Now I am having trouble with the LES not relaxing and the pain with every bite of food going down, I am fairly sure the sphincter is shot now.
At my last meeting with my surgeon he said that my motility was so bad especially in the lower 1/3 of the esophagus he would not dare to even do a hiatus hernia repair on its own as he could make me so much worse.
However since this has all started I now have upper and lower dysphagia all done by the acid - and if the gastro's had been a lot quicker, I would not be in this situation - I am so mad about it.
I am now refluxing all day long, I can taste it constantly in my mouth - I am going back on Friday for another manometry and PH test to see what is actually happening, but right now it's a struggle to eat.
I hope that this is a warning to everyone else - trust your instincts - get yourself fixed straight away- before you get into a catch 22 situation. x
LPR, Hypothyroidism, Glaucoma, Dry Eye Syndrome, Positional Vertigo

"I am simply stunned...that is this age of technology not one company or individual has managed to make a valve that could be placed BELOW the LES to STOP reflux!"

Mcedge
Regular Member


Date Joined Aug 2013
Total Posts : 292
   Posted 12/17/2013 7:30 PM (GMT -6)   
Hi GC1pink

So sorry to hear about your problems.

I saw my surgeon today and after reading your post something came to mind about what he said. He said that he had performed surgery on someone with really bad motility issues and that turned out fine. I don't know if that's any help to you.

Maria

GroverCat
Regular Member


Date Joined Mar 2013
Total Posts : 174
   Posted 12/17/2013 11:30 PM (GMT -6)   
GC1pink,

I think you should get a second opinion as others have suggested. There may be a surgeon who thinks otherwise-- if you have the means, seek out the Mayo Clinic. There are many doctors out there with different experiences and knowledge banks. Not all are equal. I would double check with your thyroid doc as well- I saw a thyroid doctor in LA who showed me this article:

http://www.ncbi.nlm.nih.gov/pubmed/20351569

Quoted below:
"Thyroid disease is common, and its effects on the gastrointestinal system are protean, affecting most hollow organs. Hashimoto disease, the most common cause of hypothyroidism, may be associated with an esophageal motility disorder presenting as dysphagia or heartburn."

This might not be the case for you, but make sure you have your tests read by a top expert in endocrinology, because I discovered my internist who was making my thyroid decisions for a year COULD NOT EXPLAIN TO ME HOW THE THYROID WORKED. If your doctor doesn't know about the possible effects of the thyroid on the gut (beyond the standard constipation symptoms), and if they don't know how to read a thyroid panel of Free T3/Free T4 (not just TSH), then find a new doc and investigate this lead as well. It's possible that insufficient meds and/or insufficient transformation of T4 (synthroid) to T3 in your body could be adding to your problems. My LA endo just added Cytomel (T3) to my treatment to see if it would help me... No luck yet, but fingers still crossed.

Again, no guarantee, but definitely worth chasing down that lead until you're 100% positive that's not a factor.

I wish good things for you,

GC

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 12/19/2013 12:41 PM (GMT -6)   
Thank you everyone - I'm going for a second opinion, after my repeat PH & Manometry tests.
LPR, Hypothyroidism, Glaucoma, Dry Eye Syndrome, Positional Vertigo

"I am simply stunned...that is this age of technology not one company or individual has managed to make a valve that could be placed BELOW the LES to STOP reflux!"
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