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kirsty
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Quote kirsty Replybullet Topic: Eradicate or Medicate?
    Posted: 09 Feb 2013 at 7:32pm
Hi, About 6 months ago I was diagnosed with Barrett's. I'm 42, female. I am in constant pain, not just reflux acid but I have a dull ache right in the centre of my chest. I had a scan recently to see if I have stones in the bile duct - I do not. My question is, medicate or eradicate. What about Fundoplication? I was not really given that option when i saw the Consultant - just told to take Patoprazole am and Ranitidine pm. I believe stomach acid is there for a reason. It's important - it's just in the wrong place. I don't believe the meds are doing much good, especially long term. I am interested to know what people feel about the op? Thanks!
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chrisrob
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Quote chrisrob Replybullet Posted: 09 Feb 2013 at 10:20pm
Hi Kirsty,

Sorry to hear you are still in pain. I hope your doctors manage to get to the root of this and provide relief soon.

Most Gastrointestinal departments are primarily run by medics rather than surgeons.
They know that acid refluxing up the esophagus can cause damage. They know they have a relatively cheap method to stop acid so any reflux will be less harmful.

The alternative remedy is to stop the reflux and presently fundoplication is probably the best way of achieving this. However, all surgery has risks and with fundoplication there is no guarantee about long the wrap will last plus there will be problems if the wrap is too tight or too loose. And some who have had the operation have still needed the PPI as well.

You are right, stomach acid does have important jobs to do. If you are on high dosage PPIs over a period of time, you may develop hypochlorhydria (insufficient stomach acid).
1. Acid kills off bad bacteria. Hence those on PPIs are more at risk of diarrhoea, gastroenteritis etc. and even MRSA.
2. Acid disolves the essential minerals from the food - to be absorbed into the blood stream in the duodenum. Thus PPIs may leave patients deplete in calcium (with an increased risk of osteoporosis), iron (causing anaemia), zinc, magnesium, etc.

The rationale is, although there is increased risk of mineral deficiency, the risks of not treating acid reflux are worse.

I had the fundoplication operation nearly four years ago.
I had been on 80mg omeprazole for some time. Although it had reduced my acid, it hadn't reduced the reflux and my biggest problem was the reflux cough with one or two attacks during the day which would see me almost black out whilst coughing and have to sit up in the middle of the night for a couple of hours coughing.

I was also anaemic with insufficient energy to walk more than 50 yards.

I had to ask for the operation, which took a while to arrange, but for me, it was the best thing I have ever done as I came off the PPIs immediately and. as I recovered from the operation, my energy returned. I now cycle between 20 and 30 miles nearly every morning before breakfast. But I know my wrap is loose (and I did it no favours a few weeks ago when I had a violent bout of norovirus). I still have a cough - though nothing like as bad as it had been.

Apart from the reasons detailed above, fundoplications are probably not usually discussed as they are more expensive than the drugs. (Although adding up a lifetime of drugs may actually cost more than the operation.)

All the best

Chris
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kirsty
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Quote kirsty Replybullet Posted: 10 Feb 2013 at 11:46am
Hi, thanks for the response. Good to hear the op worked for you. I'm going to ask for it but I think it will be an uphill struggle! Was the op painful afterwards? Kirsty
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jcombs99
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Quote jcombs99 Replybullet Posted: 10 Feb 2013 at 12:11pm
K
Try 20 different kinds of PPIs FIRST . Meanwhile your weight and Diet MUST be correct .IF nothing works then ask for a fundo meanwhile they may come up with something better .Ask Chris what drugs you can get from the NHS and where can you buy the other ones(cost) .Could be a good thing to Post on the BW website ..I have tons here but I would go to jail if I sent them ..You must try every single one even if your doctors says its the same type ..We are all different what works for us may or may not work for you ..

Fundo,HGD.Jeff

HGD JEFF   

Edited by jcombs99 - 10 Feb 2013 at 12:39pm
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chrisrob
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Quote chrisrob Replybullet Posted: 11 Feb 2013 at 8:24am
Hi Kirsty,

Regarding my fundo, in my case I had negligible pain - really just feeling a bit bruised. I had soluble paracetamol but hardly needed it. (Mind you, I have discovered I have a high pain threshold.)

My story, on my own website, may be found by clicking here. You'll need to scroll right down to find the heading, "The Laparascopic Nissen Fundoplication Operation".

You may ask your GP about trying a different PPI. The available ones are listed on the drugs page under TREATMENTS tab on Barrett's Wessex website.

Although they all do the same job, some are better tolerated than others by some patients.

All the best

Chris
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