OT - any gerd cures?

[herefishy]

My son has had it for years and now they want to operate. Anything to keep him from under the knife?

[McSleepy]

If his gastroenterologist wants to operate, then some damage must have occurred. I don't know what it is, but a typical results of longtime GERD is Barrett's esophagus, which is a precursor to gastric cancer. I had that years ago and my doctor put me on proton-pump inhibitors and I've been free of any issues (confirmed with periodic endoscopies) for years (10). We're talking a cheap, harmless over-the-counter pill (Omeprazole) once a day to keep you trouble-free. I'll take that any day.
McSleepy

[LSAT]

If the doctor is recommending the nissen fundoplication...let him do it (assuming it is a qualified surgeon that has done hundreds of this procedure). I had the procedure done 10 years ago and I have not taken any meds for GERD since. Most GERD comes from a mechanical problem involving a lower esophageal sphincter that will not close. Meds can reduce symptoms but will not solve the problem. If you are afraid of the surgery, there are some newer less invasive procedures available, but they have no long term history. The nissen has been around since the 1970's. I was in my early 60's when I had the procedure and I was out of the hospital the next day.

[PST]

If the doctor is recommending the nissen fundoplication...let him do it (assuming it is a qualified surgeon that has done hundreds of this procedure). I had the procedure done 10 years ago and I have not taken any meds for GERD since. Most GERD comes from a mechanical problem involving a lower esophageal sphincter that will not close. Meds can reduce symptoms but will not solve the problem. If you are afraid of the surgery, there are some newer less invasive procedures available, but they have no long term history. The nissen has been around since the 1970's. I was in my early 60's when I had the procedure and I was out of the hospital the next day.

I'm curious what effect nissen fundoplication has on aerophagia. Does it keep air out or trap air in? So many of us here struggle with that, it would be interesting to hear from someone who's had the procedure whether it makes a difference.

I'm another person taking a proton pump inhibitor. Cheap and effective. If the doctor is recommending surgery instead, he presumably has a good explanation why and ought to be willing to spell it out in detail. I agree with LSAT that nissen fundoplication by a surgeon who does the procedure frequently has a good reputation for effectiveness and low rate of complications. I say that as a malpractice defense lawyer who seldom sees cases arising out of this operation.

[khauser]

If his gastroenterologist wants to operate, then some damage must have occurred. I don't know what it is, but a typical results of longtime GERD is Barrett's esophagus, which is a precursor to gastric cancer. I had that years ago and my doctor put me on proton-pump inhibitors and I've been free of any issues (confirmed with periodic endoscopies) for years (10). We're talking a cheap, harmless over-the-counter pill (Omeprazole) once a day to keep you trouble-free. I'll take that any day.
McSleepy

Just FYI, I am pretty sure that Barrett's esophagus requires a genetic component, because I was tested for it and told that I don't have it and therefore can't get it. I have GERD too, and take a protein pump inhibitor. I am normally very cautious about surgery ... my experience with back surgery has made me so. On the other hand, I did have both hands operated on for Repetitive Stress Injuries. Also, long term use of PPI medications has been linked to calcium deficiencies and (in one study that I know of) an increased change of lower GI cancer ... but as always it's hard to establish cause and effect. Is the increased risk due to the medicine or the problem the medicine is being used to treat?

I would love to be free of my "little purple pill" (that isn't purple now that its generic)....

[LSAT]

If the doctor is recommending the nissen fundoplication...let him do it (assuming it is a qualified surgeon that has done hundreds of this procedure). I had the procedure done 10 years ago and I have not taken any meds for GERD since. Most GERD comes from a mechanical problem involving a lower esophageal sphincter that will not close. Meds can reduce symptoms but will not solve the problem. If you are afraid of the surgery, there are some newer less invasive procedures available, but they have no long term history. The nissen has been around since the 1970's. I was in my early 60's when I had the procedure and I was out of the hospital the next day.

I'm curious what effect nissen fundoplication has on aerophagia. Does it keep air out or trap air in? So many of us here struggle with that, it would be interesting to hear from someone who's had the procedure whether it makes a difference.

I'm another person taking a proton pump inhibitor. Cheap and effective. If the doctor is recommending surgery instead, he presumably has a good explanation why and ought to be willing to spell it out in detail. I agree with LSAT that nissen fundoplication by a surgeon who does the procedure frequently has a good reputation for effectiveness and low rate of complications. I say that as a malpractice defense lawyer who seldom sees cases arising out of this operation.

Since I started treating my OSA after I had the nissen procedure, I can't comment on the 'difference'. I can tell you, however, that I have never had any discomfort from aerophagia.

[BlackSpinner]

Has he been tested for sleep apnea and Celiacs? Both are associated with GERD.

[chunkyfrog]

This is interesting; I wonder if it's available yet. (edit: Germany now, not US yet)
http://www.medgadget.com/2012/08/endost ... eflux.html

[NotLazyJustTired]

Surgery? wow that is extreme and my heart goes out to you. My Internalist prescribed Dexilant to me, but I have no idea if this is even available to children. It is expensive and I had to beg my insurance to cover it. I tested negative for Barretts, but the endoscopy pics were pretty ugly. I can tell you the drug is working for me and the doc thinks I may be able to cut back or even get off of it once the sleep disorder is treated. My best wishes to you.

[purple]

Uh, I also have, and had GERD. And then developed Aerophagia with higher machine pressures, I was taking Omeprazole and doc prescribed a PPI, as it should work better. Sleep doc suggested that my gasping for breath caused a sump pump type thing from the stomach, which drew the acid up, and damaged the valve. If I surgically get valve fixed, the basic problem of drawing stomach acid up will still be there, and almost surely damage it again.

A Bi-level machine has helped a lot in reducing GERD, Aerophagia, even to the point that my nose does not run so much.

Short suggestion. Like Backspinner suggesed, if the person has not had a Sleep Apnea test (which is known to have a genetic component), then do the Sleep Apnea test, It is less invasive than surgery, surely less painful, and he may still have to do the sleep apnea test later.

I know nothing about the type of diagnosis the doc had for the nature of his GERD problem.

[Todzo]

My son has had it for years and now they want to operate. Anything to keep him from under the knife?

1. Raise the head of the bed a couple of inches. Simple gravity. I have always found the necessary concrete bricks for under five dollars at a building supply store.
2. Reduce stress. Less stress hormones quieter stomach.
3. More raw veggies in the diet. It kind of keeps things for me balanced in the gut.
4. Kimchi, Yougurt and other ferments. We actually have ten times as many microbiological structures other than our own cells in and on ourselves. In the digestive tract this is in particular true. They do many things for us that we very much need. Better digestion will likely promote less harm from bad digestion.
5. Many posit that GMOs and artificial growth hormones in the food supply are at fault.
6. I find many aspects of Traditional Chinese Medicine helpful and very calming. Qigong currently being studied by me.

[khauser]

Uh, I also have, and had GERD. And then developed Aerophagia with higher machine pressures, I was taking Omeprazole and doc prescribed a PPI, as it should work better. Sleep doc suggested that my gasping for breath caused a sump pump type thing from the stomach, which drew the acid up, and damaged the valve. If I surgically get valve fixed, the basic problem of drawing stomach acid up will still be there, and almost surely damage it again.

A Bi-level machine has helped a lot in reducing GERD, Aerophagia, even to the point that my nose does not run so much.

Short suggestion. Like Backspinner suggesed, if the person has not had a Sleep Apnea test (which is known to have a genetic component), then do the Sleep Apnea test, It is less invasive than surgery, surely less painful, and he may still have to do the sleep apnea test later.

I know nothing about the type of diagnosis the doc had for the nature of his GERD problem.

Hmmm ... Omeprozole (aka Prilosec) *is* a PPI. In fact it is the purple pill I alluded to. http://www.drugs.com/omeprazole.html...

[purple]

I know that Omeprazole is a PPI, I should have said "another' PPi instead of "a", but I was focused on making other meanings clear. That is the part which not all agree with, that Sleep Apnea is related to Gasping for breath, and that has a sump pump effect, which brings acid up from the stomach, and damages the valve at the top of the stomach. We can have gasping even after starting xPAP. and that Aerophagia can be treated with a bi-level machine.

I had thought I could have added the phrase that if has GERD, and ones needed pressure is 12 or over then one should be titrated for a bilevel machine. In truth, in my case, I think it should be a bi-level machine for a much lower pressure, like 10. Seems some of this has to do with how much additional air I need to inhale on the high side. Meaning, while awake, I can take in air faster than the machine seems to pump it to me, which is like gasping. Taking in air faster being related to how small the airway from my face to my lungs is.

Can anyway suggest some specific numbers for this? Exhale pressure, Inhale pressure, tidal volume and so on.

[khauser]

Ah, understood ... and I am sorry if I seemed nit-picky!

Regarding Bi-PAP, I am of the opinion that if cost wasn't a factor we would probably all have them, as I don't think they make treatment worse in any situation, as long as they are properly programmed.

UNTREATED Sleep Apnea definitely does cause people to wake up gasping for breath. I don't understand the sleep doctor's suggestion that it will occur again now that you are treated.

[purple]

[/quote]UNTREATED Sleep Apnea definitely does cause people to wake up gasping for breath. I don't understand the sleep doctor's suggestion that it will occur again now that you are treated.[/quote]

Once again my poor writing comes back to haunt me.
While having a Sleep Apnea machine, if the pressure is too low, then a person will gasp for breath. One of the reasons Sleep Studies are so frustrating is that often the first several hours happen with the pressure being too low for a person to get all the air they need. Then the study tries to focus on choosing a pressure that either opens the air way, or keeps the airway open. In truth, my airway is so small, that when I am awake, at fifteen, I can clearly inhale air so fast, that the machine is not keeping up. That is I have a really fast flow rate in the narrow tube which goes from my nose/mouth, to the bottom of my windpipe. When I inhale that fast, I am in effect gasping, and drawing up whatever is in my stomach up over the valve which is between the top of my stomach and the bottom of my esophagus.

Sleep studies choose the pressure based upon what seems to be working for most of the time in the study, they are not aware if I am gasping a little every breath. In fact they might suggest that after I start treatment, my body will adjust and the problem might not be there. I can gasp a bit, and my heart can beat a few times more, and I can still have good O2 levels.

What then can recur, I suggest, not the doctor, is after having the valve surgically fixed, is that more acid on the valve again, can damage it again.

Further, I am not anxious to have surgery on that valve, because I have spoken to those who had such surgery, and it creates a big problem while eating and getting food into the stomach. Which means they can not eat what they want, when they want, or how much they want. They are constantly compromising their food enjoyment so the stuff does not get stuck, well they did not describe it so well. Just said, do not get the surgery to fix the valve.

Gaviscon is, in my experience, best at keeping some stomach contents climbing into the esophagus.

If we want to worry about other things that cause GERD. In some women, the only warning that they are having the beginnings of ovarian cancer are something like GERD. If they seek diagnosis then, they might be saved. If the woman waits until they have more symptoms, then - Ovarian Cancer is frequently fatal after the earliest stages.

Can you tell how old you are by how late in the day you can eat pizza?