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aikihook
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Quote aikihook Replybullet Topic: Hiatus hernia and barretts
    Posted: 17 Dec 2012 at 9:04pm
Hi,
Newly diagnosed with Barretts.
I always suspected I had a hiatus hernia and have for very long time suffered from heart burn - as long as I can remember some 30 years or more.
I have been an active sports person and always managed to minimise the reflux but of late found it severely hampers my sports - often when my breathing is most strained.

For the last 5 years or more - I have felt my GP has not taken my concerns   or even suggested investigation. Finally I forced a referral to gastroenterologist (- using my company private health insurance to see a consultant immediately)

I wish I had done this earlier but thought my GP new best and accepted his prescriptions and advice for standard acid suppression medicines.
But even these did not help in the extremes of sports exertion when trying to mountain bike up Butser Hill !!

Anyway, to cut a long story short I finally saw my consultant at Spire Hospital and after manometry and endoscopy studies. The results concluded what I long suspected - I did indeed have a hiatus hernia (some 5 cm) and no doubt that this caused Barretts ( 3 cm) .

The biopsy of the Barretts area revealed benign cells which was a great relief - but with the ongoing prospect that these cells could change.

However my desire to continue active sports - and wish to have the hiatus hernia fixed. So I am off to see the surgeon to discuss what this entails- I believe is a procedure called Nissen's fundoplication.

I hope this will cure my GERD and eventually allow unimpeded assault of Butser Hill - but I will still need to use the Lansoprazole for the rest of my life.

Jamie



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chrisrob
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Quote chrisrob Replybullet Posted: 17 Dec 2012 at 11:56pm
Hi Jamie,
Welcome to the club.

It's a pity more GPs don't take the condition more seriously. He should have referred you. You'd probably have seen Pradeep Bhandari at QA. (I'm guessing he's your consultant at Spire, Havant?)

I had the Nissen fundo at Southampton three and a half years ago. I cycle every day -but Butser's about 20 miles from me so I haven't been over that way on my bike yet. (But I used to teach just down the road at Horndean.)

Happy to answer any questions you may have.

Chris
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aikihook
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Quote aikihook Replybullet Posted: 18 Dec 2012 at 7:22pm
Hi Chris,
Thank you for welcoming me.

I'm seeing Bernard Stacey at Spire Southampton - there seems to be 7 or more consultants who have clinics out of Spire. Yes Pradeep Bhandari was also mentioned as very good. But a knee surgeon friend of mine - Phil Chapman-Sheath said Bernard was listed specifically as a specialist in acid reflux.

We cycle over from Corhampton to QE park and Butser Hill is the highlight of the ride down - but then a challenging ride home.

How long did you take to recover after surgery and was able to start proper cycling again?

More importantly when is the surgery considered healed enough to do more strenuous stuff like Aikido and Judo?

Actually I think it was the punishing break-falls that made the hiatus hernia worse. I am kind of hoping I will be able to compete on last time - in the next world championships in Tokyo, October 2013.

Good forum - I'm finding some useful information

Jamie
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chrisrob
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Quote chrisrob Replybullet Posted: 19 Dec 2012 at 8:09am
Hi again Jamie,

Although I don't know Bernard Stacey, he is the best person to see at Spire (apart from Praful Patel of course) as Barrett's is his special interest.

The problem with physical exercise is, if it involves putting pressure on a filled stomach (which may be from tensing stomach muscles) it can be like squeezing a tube of toothpaste. And if your body isn't upright, the contents can spill out of the top.

After my fundo, I gradually resumed physical activity. A short walk around shops after a day leading to a short level cycle of about 5 miles after a few weeks and gradually building up longer loops and including hills until I was managing 30 miles a day to Winchester and back every day before breakfast. Although I now use a rather nicer route to Romsey instead.

I don't know about Aikido or Judo and you'd need to ask the surgeon but I'd guess probably wait a couple of months. The wrap can come undone.

Whatever options you go for, I hope you get things sorted and get to compete in Tokyo. Good luck!

Chris
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jcombs99
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Quote jcombs99 Replybullet Posted: 19 Dec 2012 at 1:03pm
Jamie
    A fundo is a one time thing good for like 10 years or so (95% work) .IF they do the WRAP right and FIX the HH you are OFF PPIs for good because your LOS is normal so no more REFLUX .You can't throw up or risk wrecking your fundo . I wouldn't do any thing Macho anymore but my brother weight lifts and his HH is still good but mine went bad right off even though I was many times more carefull then ANY doctor stated .
You really are in a ruff spot a 5cm HH is HUGH mine is 3cm and my doctor states ppis and diet really can't help much because of the HH .You like extra sports and like to push yourself so look into this a lot before you do it, its not a quick fix it will be a life stlye change if you want it to last .
    If you wait (like I would) and watch what you do something will come a long which will work better .My doctor has done the LINX and likes it BUT doesn't do them .
Remember no matter what you do in the USA we abalte FIRST then do it .

FUNDO,HGD, Jeff

Edited by jcombs99 - 19 Dec 2012 at 2:12pm
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aikihook
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Quote aikihook Replybullet Posted: 19 Dec 2012 at 11:29pm
Hi Chris, Jeff,
Thanks for the good feedback.

I saw John Kelly today and he explained the procedure and the many side effects - like not being able to burp or vomit. He did mention LINX as an alternative but apparently my hiatus is too large to consider this. The only option currently for me is a full 360 fundo - but I have to weigh this up with lifestyle change.

He did say that the more physical sports would be out for quite a while although I should be able to quickly get into cycling and running. However, full combat/competition Aikido would probably be risk to undo the wrap. Too be honest I am on the older side for this now anyway - but I would still want to do the coaching and training with the squad.

Jeff - it is promising to hear that your brother does weightlifting but then you also said yours went bad straight away; so I guess it could go either way.

My main thoughts: if I get the HH fixed and this stops the GERD, then this must be good for the Barretts and other areas of my oesophagus from further damage. I know the Barretts won't just recede or disappear and could still change - but I can't help thinking no more daily wash in acid surely is a good start.

Thanks

Jamie
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jcombs99
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Quote jcombs99 Replybullet Posted: 19 Dec 2012 at 11:49pm
A
    A wise person does well with this and you have done your research (homework) and it seams you have good doctors like I do .You can Burb but no Vomit and YES no more REFLUX is better because hopefully the good tissure wll not CHANGE to Barretts and also you can't return Barretts to normal tissure which you already have correctly stated .Keep an eye on this website and IF you see something incorrect post we need people like you .

Cheers

Do you build rockets for a living ?

Jeff

Edited by jcombs99 - 20 Dec 2012 at 12:44am
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chrisrob
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Quote chrisrob Replybullet Posted: 20 Dec 2012 at 2:03pm
Hi again, Jamie,

Jamie Kelly was supposed to have been the surgeon in charge of my fundo - except I was then, for some reason, moved to Ian Bailey's list and the op was then performed by a newly qualified doc. Jamie's a great surgeon who has been supportive of Barrett's Wessex and was a friend of our first chairman (who unfortunately is no longer with us).

Without acid and bile refluxing up the oesophagus, there's probably little chance the Barrett's will continue to mutate: there's been no change in the condition of mine (just 2cm) since my fundo.

But I do know my wrap is a bit on the loose side. I have managed to vomit (once: it's not something I tend to do normally) and after food, I do tend to burp easily - but only if I sit bolt upright to permit the sphincter to relax normally and the gases to escape as they should.

As far as LINX goes, it is not currently recommended for patients with Barrett's: there are displacement issues and, if you were to need an MRI, you would have to have the device surgically removed first.

I think Endostim looks promising for the future but it is too early yet: it needs trials to collect data. (And sorry Jeff but it's not approved for use in US yet.)

Cheers

Chris

P.S. I guess you're not the Welsh International rugby player?
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jcombs99
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Quote jcombs99 Replybullet Posted: 20 Dec 2012 at 2:34pm
Barretts is ABNORMAL tissure which a common man knows... It can change in one year or 50 years but if it does and you don't catch it you will be "down under " Thats why you should get an OGD every year because if the doctor misses it (common)he could find it the next year and save your O ..Most people never need a MRI and like I stated ablate first .. Most of these treatments are new and I only like 10 years worth of data on anything BUT I went with Halo after 2 years and yes I'm a risk taker .Just because the NHS says you don't need it doesn't mean you don't .I had 3 OGDs in 3 months and the so called great doctors missed it but my halo doctor found it right before my halo so more doctors looking means I got to keep my O ..Chris never no need to be sorry when dealing with me and I'm sure LINX would be at least $50K and your NHS would never fund that ..

CCCCCCCCCCCCCCCCCCCCCCCCCC

Jeff

Edited by jcombs99 - 20 Dec 2012 at 2:58pm
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Quote jcombs99 Replybullet Posted: 21 Dec 2012 at 12:57am
I don"t know if it has been approved by the Gov. But their doing it ... Guide lines No barretts ( Abalte before) and no HH bigger then 3cm and lasts like 10 years. BUT it can be removed or fixed .They did halo before it was approved and it was approved ...

WWW.TORAXMEDICAL.com




Edited by jcombs99 - 21 Dec 2012 at 12:58am
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