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chrisrob
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Quote chrisrob Replybullet Posted: 14 Aug 2009 at 1:57pm
Hi Richard,

Good news about the op. Your insides may feel bruised for a little while and you shouldn't try anything too strenuous for a bit but you will get back to normal.

All the best,

Chris

Hi Twix,

I'm not answering for Richard, I'll let him tell his own story.
I had the hiatus hernia repair and fundo op on NHS without problem. I asked for it as I was having a problem with the side effects of the PPIs. My endoscopist said OK and he wrote to the surgeon.
You will need to discuss the possibilities with you GP and consultant and see what they say.

As regards the HALO/Barrx RFT, you're not likely to get that done unless you have High Grade Dysplasia with a slight possibility for Low Grade. As with all treatments, endoscopic or otherwise, there is always a risk attached. Since the chances of your Barrett's moving through LGD to HGD are small, is it worth the risk? Your regular (2 or 3 yearly?) scope should show any changes in time to have RadioFrequency Ablation if necessary.

Chris
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twix38
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Quote twix38 Replybullet Posted: 14 Aug 2009 at 2:24pm
thanks chris,

I asked my Doctor about fundo over 10 years ago and was told to treat reflux with medication as not worth the risk. Back then I didn't have (or didn't know I had Barratts and was not on PPI's). I wanted to rectify the Hiatus Hernia rather than treat the symptoms for the rest of my life, knowing it could get worse but not better.

I will enquire at my Doctors again.

Re Barrx RFT. I'm not looking to get that done yet with non dysplastic Barratts, though I note that quite a few in the USA have had it done with non dysplastic barratts, though as I stated  i'd want to see more data and for it to be professionally recommended for non dysplastic barratts first, which it currently is not, so no worries there.

Thanks for info


Edited by twix38 - 14 Aug 2009 at 2:28pm
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Quill
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Quote Quill Replybullet Posted: 14 Aug 2009 at 2:43pm
This is great news Richard. I hope that your recovery continues apace.
Kind regards
Quill
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RichardP
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Quote RichardP Replybullet Posted: 14 Aug 2009 at 4:37pm

Hi Twix,

It was my Gastroenterologist that referred me for surgery. At the point I was referred my Barretts was only 1cm. The effectiveness of my PPI (Lansoprazole) appeared to reducing and I was experiencing some side effects. The main driver however was that I wanted to take a proactive approach and reduce my risks with regards to the Barretts. I didn't like the idea of the what and see approach that seems to be regularly recommended.
Another reason for having the op was to be in a position whereby if a cure for Barretts is developed (I am sure we all have our fingers crossed here) then I could have it safe in the knowledge that the original cause of the problem had been fixed.
 
This initially began on an NHS basis. I had the manometry and 24hr PH test and met with a surgeon to discuss the options. To be able to have the operation the results of the manometry and PH tests need to achieve a certain level to show there is a need for the operation. He advised me that the most successful procedure is the full Nissen Fundoplication, you can have a partial wrap but this is less effective and mostly used as a fall back if there are problems with a full wrap.
As we know this op is not a cure for Barretts but my surgeon agreed that logically if acid is the cause of the problem then if we can limit or remove it from the equation then it may possibly reduce the risk of the Barretts progressing. 
 
I had done some research before I met the surgeon and asked about the plicator procedure and although this is more straightforward I understand the success rate is lower and the repair may not last as long.
 
My surgeon is very experienced in the Nissen fundo and has been doing them since 1988 which gave me great confidence in his ability.
 
I found out that the surgeon also does private work and as I am fortunate to have healthcare insurance with my job I went down this route. Had I not I would have been waiting a further 3 months. Had the NHS route been the only option I would still have gone ahead with this procedure.
 
Hope this answers your questions. Any more please let me know.
 
Regards,
 
Richard. 
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twix38
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Quote twix38 Replybullet Posted: 14 Aug 2009 at 4:54pm
thanks Richard,

I will see what my Doc says about a fundo.

I gather you could still have gone ahead under NHS with just a 3 month more wait, but yours may be based on PPI effectiveness reducing and side effects. I don't have either right now that I am aware of.

I have the same view as you, but got talked out of it 10+ years ago. Probably right for then, but maybe if I had insisted I would never have got Barratts. My thinking back then was it could only get worse over a lifetime and I was then in my 30's. I had not even heard of Barratts back then. I should have perhaps told my Doctor he was wrong (in my case as it turns out) and got it done ;-)

btw, TIF is a brand new procedure, but don't know how it will pan out. Had good indications from USA


Edited by twix38 - 14 Aug 2009 at 4:56pm
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AndyR
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Quote AndyR Replybullet Posted: 14 Aug 2009 at 5:02pm
Hi Richard,

I am very glad to hear that the op went so well and that you are recovering nicely. This gives me some perspective on what to expect should I decide to go for the fundo at some point. I am doing well on the meds and will continue with them for the moment.

Regards,

Andy
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Moggs
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Quote Moggs Replybullet Posted: 14 Aug 2009 at 5:14pm
Hi Twix38
 
I had my routine 2 yearly gastroscopy in April this year. The result was my Barretts is now 7 cm but no dysplasia  this time although in the past I have got up to just between gade 1 & 2 - so the lanseprozole is working together with me watching what I eat & how much to keep the acid reflux at bay.
 
My consultant had good chat with me about a 6wks after the gastroscopy and advised me all the ins & outs of Barretts. This included advising it is not normally considered to have the op unless I get Dysplasia of 2 or more (i.e. heading towards the big 'c'. )
 
I do have bowel problems which he is sending me for a Barium X Ray next week just to be sure all is ok there (I had an endoscopy in April too but that can only see so far! & that showed Hemoroids only that end of my large intestine)  but this other x ray will look where the consultant can't . He thinks though that the problems are side effects of the Lanseprozpole and other medication I am on  together with it being a side line of Barretts! 
 
I am also sick  about once a week or so but I think this is me eating what my eyes see and not what my stomach can cope with!! in other words  my eyes are to big for my stomach  as mum used to say!!  LOL 
 
Any way let us know if you decide on the op and we'll be routing for you as we are for Richard. Smile
 
Moggs
 
  
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susan333
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Quote susan333 Replybullet Posted: 14 Aug 2009 at 7:37pm
Hi Moggs
It is good to hear that your dysplasia disappeared, from being between grade 1 and 2, to having no dysplasia. I didnt realise this could happen, but really good news for you. Was this due to your medication?
All the best
Sue
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twix38
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Quote twix38 Replybullet Posted: 15 Aug 2009 at 3:23am
Hello Moggs,

Thanks for your info.

I assume when Doctor did not recommend the op you are referring to Barrx RFT though using the "op" word made me wonder if you meant fundas op? If you mean Barrx RFT as I suspect then that fits in with what's said before as not recommended for non dysplastic and only perhaps LGD though certainly HGD. If you meant the fundas op, then could that have been due to your age as a significant factor, in not recommending?

Pleased to hear you are non dysplastic and echo the earlier question from Susan Humphrey about going from grade 1 or 2 back to non dysplastic assuming you have been on your PPI's that whole period? (I know prior to taking PPI's the dysplasia reading can be higher due to inflammation and can come down as this happened to me to. I was LGD then started my Omeprazole and next Gastroscopy I was non dysplastic, but I assume you have been on your PPI's all this time and had an improvement to non dysplastic. That's unusual isn't it?

Many thanks and I hope your other symptoms (sick etc) also improve.


Edited by twix38 - 15 Aug 2009 at 3:28am
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heidi
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Quote heidi Replybullet Posted: 27 Sep 2009 at 11:41am
I have got to have a Nissens redo,my first Nissens in October 2008 was unsuccessful and since then developed Barretts.I am still waiting for an operation date post seeing the consultant in June.My consultant is one of the 'best' in Fundo surgery so am quite optimistic.Just wish i did not have to have it redone,,,but i cannot go on with this suffering and want to eat normally again.Any advice welcome
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