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Thank you, LG. That is very kind of you. I have had both procedures, plus a barium swallow. They have to test the PH level in my esophagus based on my position, when I've eaten, and when I'm sleeping. After that, they should know if my LES is deficient. If it is, then that is a real indication that it is physiologic and a treatment for that can be explored. I also had my doctor do an abdominal ultrasound to check my pancreas just to be safe. It was fine, too, as were my pancreatic enzyme levels. I've just been so deep into the burning for so many days that I was hoping someone might offer up something I have not tried. I've spent way too many hours on the Internet researching, so I was hoping I had missed something.
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As much as it sucks, maybe your next surgery should be a Nissen fundoplication?
"My friends, love is better than anger.
Hope is better than fear.
Optimism is better than despair.
So let us be loving, hopeful and optimistic.
And we’ll change the world."
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Try to chew on some ginger or take a spoonful of freshly squeezed ginger juice NOT on an empty stomach.
It is also possible that the lower GI tract could be the culprit if your transit time is slow. Hope you don't have to suffer through this for long.
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Thank you all. It abated some during the night and didn't start back up until around 3:00 or so. That's something at least.
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DCNGA wrote:Thank you all. It abated some during the night and didn't start back up until around 3:00 or so. That's something at least. Thats good D, When I get my "bouts", they can last for as long as a month, but yours sound much more intense. Hope you get some peace.
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Thanks, Sue. I started the probiotics this morning. They did not bother my stomach, so I'll add VitD tomorrow to see how it does, then Omega3 the next.
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DC, have you had esophageal manometry? Sometimes patients get a huge work up for GERD when they have achalasia instead. With achalasia the LES fails to relax rather than is too relaxed as in GERD. Pain is non cardiac chest pain rather than acid reflux.
Your hiatal hernia puts you at risk for GERD, but if your ph testing is normal I suspect they will consider achalasia if they have not done manometry yet (although your barium swallow was normal and usually shows dilitation above the LES in achalasia).
I thought of you today when a new patient told me he was getting botox to his LES for GERD. That didn't make sense to me as relaxing the LES would make GERD worse. I had to call his gastroenterologist about another issue with the patient and asked him about the botox. He explained that the patient had achalasia not GERD.
Either surgery, nissen fundoplication for GERD or Heller myotomy for achalasia can be done laproscopically.
Miss J can I have CME points for introducing botox into a reflux thread?
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Thanks, Sam! I read about the manometry. I do have a swallowing problem that I keep attributing to my throat phobia and panicking but maybe it is physiologic. Food will just stop moving as I swallow and sits in my esophagus for a second or two even though I'm trying to swallow (but can't) and then I really panic-is that dysphagia? I have no problems whatsoever with liquids, just dense solids (breads and meats) that are heavier. I'm guessing that the PH is first then the manometry if the PH is normal. I've never heard of the achalasia...(note to self, new research project). I'm scared of the manometry test, though. I have to be awake for that and terrified I won't be able to do it. Ugh, I just peeked on MedLine. Don't think I can do this test, I really don't unless they could seriously relax me with A LOT of Xanax and I'm thinking that would skew the test. Nope, don't think I can do it. Thinking about it has my heart racing something fierce. As awful as I burn, I would rather have this than spend an hour with a tube down my throat being told to swallow while they pull it out. Shiver. Thank you though, sincerely. I really appreciate you taking the time to read this whiny thread (LOL). I have a research project to attend to, *wink*.
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Okay, just read up on achalasia. I don't think that's the problem, but of course I'm not a doctor and have not had the test, so can't be sure. My swallowing (food sticking) issue is further up in my throat, I don't really have chest pain, and it does not happen with every meal and never with liquids, which I think all of those sypmptoms (positive) are part of achalasia if I read correctly on WebMD. I sure hope that's not my problem, it so just feeds my whole swallowing paranoia, LOL.
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DC, I'm not a GI so my thoughts were spurred by my patient and I thought of you. I always want my input to be taken like any board member and am not practicing on line.
With that said you have to have the ph test. It is simple. Your fear of choking is very real and you should have someone with you for comfort when they put in the TINY tube. Once that's done you won't know it's there. The risk of untreated GERD is not just pain but Barrett's (which you don't have because your endoscopy was normal so don't start worrying about that). Every problem that doctors see multiple times a day is a unique and frightening event for the patient. You have shown us all your backbone. You can do this. We are all there for you. You will find the answers and get better.
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yes. I gave you 1000 extra points for the good feedback to DCNGA. If you want more, just let me know. sam wrote:DC, have you had esophageal manometry? Sometimes patients get a huge work up for GERD when they have achalasia instead. With achalasia the LES fails to relax rather than is too relaxed as in GERD. Pain is non cardiac chest pain rather than acid reflux.
Your hiatal hernia puts you at risk for GERD, but if your ph testing is normal I suspect they will consider achalasia if they have not done manometry yet (although your barium swallow was normal and usually shows dilitation above the LES in achalasia).
I thought of you today when a new patient told me he was getting botox to his LES for GERD. That didn't make sense to me as relaxing the LES would make GERD worse. I had to call his gastroenterologist about another issue with the patient and asked him about the botox. He explained that the patient had achalasia not GERD.
Either surgery, nissen fundoplication for GERD or Heller myotomy for achalasia can be done laproscopically.
Miss J can I have CME points for introducing botox into a reflux thread?
Can hardly walk. Need hip replacement.
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I do take your posts as those of another poster and not a doc or as advice at all. I give you more creedence however, than the average person with respect to medical stuff though--sorry, can't help it. LOL. (Me being the Little Engine) ithinkicanithinkicaithinkican. I'm DEFINITELY going through with this. The BRAVO is done while they Propofal me, but I'm really worried about how it's going to feel when I wake up. I think I'm asking for something to 'relax' me for a couple of days until it drops off. I swallowed that damn probe like a champ last week, but it was it staying there that was impossible for me. I immediately felt like I was choking. So, out it came. I just keep trying to think of what I did that my Karma is so bad that I'm afflicted with a throat issue of all things!!!! I have to do this BRAVO thingy so I will at least know if it's the LES. I know they can do surgery for that and it's fairly successful for many people. Thanks to everyone for the encouragement. I truly appreciate it.
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When I was in high school I watched a friend's mother waste away because of something similar. In those days there were limited treatment options, though. Anyway, I think you're going to have to do something drastic, my friend. Given that you've tried just about every available injestable option, I see surgery in your future . . . and the boring kind, the kind that doesn't make you look any better or younger . . . just regular ol' slice and dice surgery. But until your doctors can figure out the best route, have you tried an otc product called Gaviscon? It's the only thing that works for me or my mother, and my partner, who is an internist, swears it's the best thing out there. You have to follow the dosing instructions, though. Chew up two or three (or six or seven) tablets and then drink a full eight ounce glass of water. If you don't chew them up, or if you fail to drink the water--the full eight ounces, mind you--it doesn't work. Keep us updated. I know several people who suffer with this problem, so I know how frustrating and painful it can be. http://www.gaviscon.com/
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I had something similar going on last year. Turns out it was a reaction to the two-three ibuprofen a day I was taking for my sinus-related headaches. Are you taking anything like ibuprofen, aspirin, tylenol or any other pill that could hurt your stomach? At any rate, I hope you find out what the cause is and that you get some relief. btw, I second the probiotics suggestion.
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I cannot take anything but the occasional Tylenol--maybe 1 a month, if that. I had to stop all NSAIDS a long time ago. My reflux is better some days and worse others. At least it is not bad every day like it was. I have decided not to go through with the BRAVO procedure. I'm losing sleep worrying over it and afraid I'll go into a full blown panic attack with I come out from under the anesthesia with the device hanging in my throat for two days with no way to get it out until it falls off on its own. Supposedly it causes a 'heavy tugging' feeling until it falls off and you can have phantom feelings for days after that. UGH. I thought I could go through with it, but I have changed my mind. I know me and my own limitations.
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Oh, DC.....I really feel for ya...I hate that you're having this thing. Wish I could wave a magic wand over your head. Awesome Miss J...sam deserved those brownie points!
Pay no attention to Caesar. Caesar doesn’t have the slightest idea what’s really going on. Kurt Vonnegut
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Thanks, Shaz! Sam is a real sweetie!
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DCNGA: GOOD LUCK on the upcoming exam Monday! Let us know what the doc finds out. For me: I had about a year of really bad acid reflux when I was 49. I was on low-dose BCPs back then - which my doc assured me, was totally comparable to taking an HRT. But it turns out that even low-dose BCPs can have 3-5 times the estrogen that a typical HRT has (mine is PremPro 0.626 estrogen). Too much estrogen (or progesterone) can actually cause acid reflux in post-menopausal women. Here are a couple informative articles that list other causes (stress, antidepressants, taking antacids for too long, weakened esophageal sphincter, etc.,): http://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/page2.htm and http://www.womentowomen.com/digestionandgihealth/acidreflux.aspxYou may be surprised to learn that even that warm cuppa milk before bed can trigger a reaction, because calcium stimulates the production of stomach acid. Hope you get a clear diagnosis so you can treat this very uncomfortable condition!
I Bug U
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Thanks, Bug, but I cancelled the appointment a couple of weeks ago. As it turns out, the doctor who was going to do it abruptly left the practice anyway. I've been using the enzymes, fish oil, and a couple of other things and the reflux is probably 70% better, improving more each week. I'm just having a bout here and there, mostly in late evening. Appreciate the check-in, though.
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Hey DCNGA,
Are you still seeing improvement with your reflux? I'm having a bout with it myself. Was wondering what brand of enzymes you are using? I'm tired of the going the Zantac route myself...it's my belief that these drugs can exacerbate the problem while also giving you a eventual resistance of the drug. I know DGL didn't work for you, but I am planning on buying some of that as well.
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