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Merl@2018
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Quote Merl@2018 Replybullet Posted: 22 Feb 2019 at 8:39pm
Hi Bob, thank u for the advice. I have been on esomeprazole 40mg/day for 8 mos, Lanzoprasole for almost 2 mos but despite that, I am tasting acid everyday . I wasn't having this much symptoms before I was on PPI. I am worried that my Dr might increase the dose which I think will not be helping. I feel that the acid is just directly spilling all over my esophagus to my mouth. I'm scared to have fundo but I think thats gping to be a better option rather than in a high dose of long term ppi . I asked my GP what she thinks and she told me that fundo will weaken the sphincter all the more which will be more detrimental,but then again thats what she thinks. My GI specialist only told me abt risks of dysphagia and other side effects. How long will be the waiting time for the op to take place? I am 42 y/o, not smoking, not drinking. I am slightly overweight after giving birth 3yrs ago..I am watchinh what i eat, stopped drjnking coffee ,etc but still tasting acid in my mouth.
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bobdigi
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Quote bobdigi Replybullet Posted: 22 Feb 2019 at 9:17pm
So I'm assuming you have barrets oesophagus? As far as I understand, ppi's can cause more reflux than before. Simply due to the fact by diminishing the amount of stomach acid, food is finding it harder to digest, hence staying around for longer and causing reflux. In theory, this stomach reflux shouldn't burn if the ppi's are doing there job in dramatically reducing stomach acid. But it could be more often.
Remember there is a difference between reflux and acid reflux. Another possibility is what you are tasting isn't stomach acid. It could be bile. Ppi's won't help with bile. And with less stomach acid your body could be producing more bile to help the digestion process.
Either way, if you have barrett's and bile or stomach acid is still burning your barrett's, oesophagus and throat, that isn't good.
Ppi's will only be less effective over time. So have it now while your still young. Why wait till you're older? And when you're older it probably won't even be an option!
Ask the surgeon what your doctor is on about. Perhaps the valve does weaken. But after tge op you won't be relying on your valve to keep the contents in your stomach anyway. But perhaps it does still play a role. I'm not sure.
Either way it stops acid leaving tge stomach, so who cares.
What are you afraid of?
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Merl@2018
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Quote Merl@2018 Replybullet Posted: 22 Feb 2019 at 10:38pm
Yes, I have barretts, diagnosed 5 mos ago. I am scared of the procedure, side effects and the fear of maybe it will not work, etc. I know I have to make the decision now rather than wait until it gets worse. Thanks
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chrisrob
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Quote chrisrob Replybullet Posted: 22 Feb 2019 at 11:14pm
There's so much rubbish propagated about PPIs.
Read the risks including all the research, in this excerpt from the newly revised Down With Acid book about to be sent to the printers.

If you prefer read this article, Adverse Effects of Proton Pump Inhibitors: Fact or Fake News?.
“When PPIs are prescribed appropriately, the benefits greatly outweigh potential adverse effects. The absolute risk to an individual is extremely low (less than 1 in 500) and fear of these risks should not dictate prescribing habits. … Not only has the information derived from these observational studies been unhelpful, but also the unattended consequence is that patients who require PPIs to prevent UGI bleeding are not receiving these medications, mainly due to fear on the part of the patient and provider.”

However, although great at reducing acid they do not reduce reflux, just make it less damaging.

Fundopication surgery is the best way to manage reflux if lifestyle modification doesn't work.

I was offered the operation back in 1999 and delayed 10 years before I had it because I was scared. I wish I'had it sooner!
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Merl@2018
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Quote Merl@2018 Replybullet Posted: 23 Feb 2019 at 4:55am
Thank you, Chris and Bob for your kind replies and information given. I will discuss with my GI om my next appointmentn. Chris, I am living in Berkshire - do you happen to know any surgical team around here who does the fundo? Will it be a long waiting procedure as to when it will be done?
Many thanks.
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bobdigi
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Quote bobdigi Replybullet Posted: 23 Feb 2019 at 7:14am
Hi Chris. I wasn't trying to scare anybody off ppi's. It's just my personal view that ppi's do effect the stomach and intestines, which then effect the natural gut flora. Which in turn can effect a person's overall health. But as I stated its only my opinion.
Perhaps they have no effect on gut flora, bacteria or fungus. But it's just my opinion they do.
Either way Merl I would suggest going for the op. The two things I worried about was damage to the Vegas nerve something else (I can't even remember what the other thing was now). The surgeon did tell me the statistics of damaging the Vegas nerve. And it was very low. And he told me the risk of the other thing was so low it wasn't even a concern. He even said its only something that sometimes happens in America!
Speaking to the surgeon really put my mind at rest. So I would definitely advise atleast getting a referral to speak to him.
I was in and out the same day. I just have five small scars.
No pain, just uncomfort for about 10 days. But that was more due to trapped gas. And from what I have read it doesn't usually effect people as much as it did me. The stomach area just feels tender when moving around. But all the time you're sat down doing nothing, it's absolutely fine.
If my fundo came lose I wouldn't hesitate to have it done again. It really is no big deal!

Edited by bobdigi - 23 Feb 2019 at 7:21am
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chrisrob
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Quote chrisrob Replybullet Posted: 23 Feb 2019 at 11:14am
Hi Merl,

Michael Booth is the upper GI surgical consultant at Reading. Although I have heard of him, I don't know him.
From my own experience, I can recommend the surgeons at Southampton but I'm sure Michael Booth is probably very good.

I had two fundolications at Southampton under NHS. Unfortunately the surgery is classed as "elective" which means it's placed on the lists below "emergency" and "essential" meaning it can take months of waiting. (I had to wait 9 months each time.)

You may read patients' experiences of the operation here and my blog about my Collis-Nissen revision surgery (after my wrap became loose following 5 hours violent retching due to norovirus here.

The surgeons Jim Byrne and Jamie Kelly at Southampton prefer incorporating the Collis procedure when performing Nissen fundoplication to provide for a more permanent wrap. It resections the stomach to effectively provide a longer oesophagus to make for a better wrap.
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Merl@2018
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Quote Merl@2018 Replybullet Posted: 23 Feb 2019 at 12:55pm
Thank u Chris,I am under Mr Bob Zoin as my GI consultant, not sure if u heard of him or not sure if he will be doinh the fundo,too. He said that if fundo is to be done, he will refer me for ph test in Reading. I will know some details maybe on my next appointment next week. I am getting more anxious everyday due to so much acid in my mouth constantly-some days are better than others but its constantly there. I just wonder if there are any other causes of this so much acid spillage. If there are there other organs actively secreting all this acid for some reason or its just mrchanically due to weak sphincter. It can make u go crazy thinkinh and feeling all these. Many thanks for the information.
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chrisrob
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Quote chrisrob Replybullet Posted: 23 Feb 2019 at 1:11pm
Don't know him. Googled him. Seems OK.
Acid is produced in the stomach. If you're getting it in your mouth, it must be refluxing there.
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