Peristalsis Question

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Regular Member

Date Joined Jul 2012
Total Posts : 44
   Posted 5/15/2014 6:51 AM (GMT -6)   
Hi, earlier this year I had rescheduled a Nissen Fundoplication because I was managing OK on PPIs. To date, I've been on PPIs for 12 years.

A the time (last December) my manometry showed some weak peristalsis (a few failed contractions). Not enough to cause either surgeon I consulted to be concerned though.

However, I wanted to ask the question. As GERD progresses, can it cause peristalsis to weaken or get worse. In other words, if my GERD is causing my peristalsis to weaken, would I be better off having the surgery sooner than later? I wouldn't want to wait so long to have surgery that my peristalsis gets so weak I can't have it.

Thank you!

Veteran Member

Date Joined Oct 2009
Total Posts : 739
   Posted 5/15/2014 11:00 AM (GMT -6)   
This is an area that isn't well understood. Just a few things that experts in this area have told me, as I have also had abnormal motility on testing.

" general, patients with active reflux disease often have other problems with relaxation of the esophageal sphincter (that "hypotensive LES"), and various other motility problems of the esophagus. These findings may or may not be a direct result of reflux-related injury. In some cases, abnormal esophageal motility results from acid-related injury, and in other cases, reflux may we worsened by abnormal motility. It can be a vicious cycle. And one must remember that the motility test results are a snapshot from the time of the test, and that actual function can fluctuate over time. There is much we still do not understand about esophageal motility, and how to promote normal esophageal motility. "

"...Furthermore, severe IEM (90% or more non-transmitted/hypotensive contractions) make surgeons pause before doing anti-reflux procedures, and many will offer a partial wrap rather than a full 360 degree Nissens’ because they’re afraid the patient will be more likely to get difficulty swallowing after surgery if they have severe IEM."

Regular Member

Date Joined Jul 2012
Total Posts : 44
   Posted 5/15/2014 2:04 PM (GMT -6)   
Thanks for your feedback!
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