Support Forum
 Barrett's Support Forum :Barrett's Support Forum :Support Forum
Message Icon Topic: LES Post Reply Post New Topic
Author Message
Acadian
Newbie
Newbie


Joined: 09áSepá2009
Location: Canada
Online Status: Offline
Posts: 11
Quote Acadian Replybullet Topic: LES
    Posted: 12áSepá2009 at 3:24pm
Hello everyone.  It is nice to see that i am not alone in this boat.  After reading all the messages it is strangely conforting to see how we all have the same anxieties.  I do have a question: Since the LES (Lower esophageal Sphincter) seems to be malfunctioning in most of our bodies, Is there any way to fixe this (other than surgery) with medication, exercises, diet...........? Thank you all for being here.....
IP IP Logged
AndyR
Newbie
Newbie


Joined: 02áJulá2009
Location: United States
Online Status: Offline
Posts: 32
Quote AndyR Replybullet Posted: 14áSepá2009 at 6:58pm
Hi Acadian,

Generally speaking according to the medical community the only way to fix the defective LES is with surgery. The most common one being a Nissen Fundoplication, both open and Laproscopic surgery versions are available. I think laproscopic is much more common now, because it is less invasive.

There have been a lot of other attempts at fixing the problem without surgery but most have not proved effective over the long term.

There is a newer surgery that is much less invasive, but still under clinical trial called Linx. I believe that this trial is happening in the US and Europe. It seems to be a better option than the Nissen Fundo, but only time will tell if that is true or not.

This is just what I have found out through my research.

Andy

IP IP Logged
Acadian
Newbie
Newbie


Joined: 09áSepá2009
Location: Canada
Online Status: Offline
Posts: 11
Quote Acadian Replybullet Posted: 16áSepá2009 at 7:57pm
Hi Andy,
 
Thanks for the information.  When the doctor told me about having barrett's I felt so paralyzed.  I am trying to get involved and putting most of my chances on my side.   Since the LES is not the answer have you read about the use of aspirin to lower the chances of getting cancer? 
IP IP Logged
AndyR
Newbie
Newbie


Joined: 02áJulá2009
Location: United States
Online Status: Offline
Posts: 32
Quote AndyR Replybullet Posted: 17áSepá2009 at 1:12am
Hi Arcadian,

Actually I think one of the answers is to repair the LES, that way the acid does not go where it shouldn't. Currently Fundo is the way that is fixed. I know there are a few people on the board that have had it and now are off medication. They will be able to give you more perspective on this surgery.

Of course the other route, the one I am taking at the moment, is medication. That suppresses the acid which is believed to be the cause of the cellular change in the esophagus.

I think there is an on-going trial in England called AspECT. This combines Esomeprozole and aspirin in an attempt to prevent Barrett's progressing to Adenocarcinoma I am not sure where this trial is and if any results have been published.

Other on this board may know more than I do as I think some are in the trial.

I went through the same thing as you when I was diagnosed, and I found that over time my panic subsided. Once diagnosed we are being monitored so if, and it is a big if, something changes they will see it before it is too late. That is what I keep telling myself, and in that respect I feel like I am lucky.

Andy
IP IP Logged
chrisrob
Senior Member
Senior Member


Joined: 01áMayá2007
Online Status: Offline
Posts: 2574
Quote chrisrob Replybullet Posted: 17áSepá2009 at 10:54am
Hi Acadian,

With most muscles, there are exercises we can do to strengthen them but I know of none to help the lower oesophageal sphincter, nor food that could 'repair' it.
Of course the "normal" treatment is to medicate with a proton pump inhibitor to reduce the amount of stomach acid which refluxes through the LOS. However, PPIs do not stop the reflux which currently can only be achieved through surgical means.
There have been treatments using clips implanted around the oesophagus or inserted by gastroscope but, being inorganic, they don't have the same flexion as muscle tissue.
There is endoluminal gastroplication where a few circumferentila rows of stitches cause scar tissue to restrict the lower end of the oesophagus but this hasn't proved as effective as fundoplication where the fundus (top part) of the stomach is wrapped around the lower end of the oesophagus.

I had my fundoplication about 6 months ago and it really changed my life - off medication entirely and, having lost the PPIs side-effects, able to be active again.

My understanding is that by reducing the acid (PPIs) or reflux (fundoplication) the environment wherein the Barrett's developed is removed and, hopefully, the Barrett's is unlikely to develop further.
IP IP Logged
Acadian
Newbie
Newbie


Joined: 09áSepá2009
Location: Canada
Online Status: Offline
Posts: 11
Quote Acadian Replybullet Posted: 23áSepá2009 at 7:42pm
Thanks for the reply Chris,
If you dont mind my asking, how long did you take PPI's for and what made you decide to get the surgergy?
 
Thanks
IP IP Logged
Acadian
Newbie
Newbie


Joined: 09áSepá2009
Location: Canada
Online Status: Offline
Posts: 11
Quote Acadian Replybullet Posted: 23áSepá2009 at 7:50pm
Thanks for the thoughts Andy,
 
Looking at the numbers, our chances are very good.  Sadly my attention tends to focus on the small percentage that goes wrong. Hearing it from someone in the same boat as me however is very comforting.  Have a nice day.  Hope we will have a chance to chat some more in the future.
 
Acadian
IP IP Logged
chrisrob
Senior Member
Senior Member


Joined: 01áMayá2007
Online Status: Offline
Posts: 2574
Quote chrisrob Replybullet Posted: 24áSepá2009 at 7:37am
Hi Acadian,
I was on PPIs for almost 16 years gradually increasing to the maximum dosage. They had stopped the acid (so no more heartburn or oesophagitis) but not the reflux which was causing a debilitating cough.
The medication was giving me serious side effects: the hypochlorhydria (insufficient stomach acid through inhibition of the proton pumps) meant I was absorbing insufficient minerals and lack of iron etc. was making me anaemic and lacking energy (for example).
I was scared of having the operation (laparoscopic fundoplication) and had read many reports from patients where it had gone wrong but as with the vast majority of cases, my op went well and I would recommend it to anyone havong intolerable side effects from the medication.
Chris
IP IP Logged
Acadian
Newbie
Newbie


Joined: 09áSepá2009
Location: Canada
Online Status: Offline
Posts: 11
Quote Acadian Replybullet Posted: 24áSepá2009 at 8:33pm
Hi Chris,
 
Thanks again for your support and information.  I am happy to here all is well with you and the operation.  It reassures me that we have options. I also am a excersize nut so I wish you well in your recovery. 
 
Acadian
IP IP Logged
Post Reply Post New Topic
Printable version Printable version

Forum Jump
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot delete your posts in this forum
You cannot edit your posts in this forum
You cannot create polls in this forum
You cannot vote in polls in this forum