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gavlaa
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Quote gavlaa Replybullet Topic: PPI's or Fundo plication>
    Posted: 06 Nov 2010 at 2:02am
Hi
Just wondering what peoples experiences are after having the fundo op compared to life before the op while on PPi's?

On my travels to understand this condition and the best ways to treat,control and live with it i now have a dilema.

My Ph and Manometry results showed a fairly bad hiatus hernia and a high DeMeester score.

Ive now seen a GI consultant at a private cottage hospital that i belong too, he has advised due to my symptoms being under control while taking 20mg omeprazole to keep taking the pills and leave the fundo op for another day, year or decade so long as the pills keep working.

Ive also seen a Top consultant in london who also recommends to not have the op all the time my symptons are controlled with PPI's.

Now my dilema!

I had an appointment with my local nhs hospital several days ago, the consultant fully recommends a fundoplication operation as the only way to go with this condition.

I trust all 3 consultants i have seen and feel they are all very experienced professionalls. Im happy to undergo the op if its the best thing for my health long term but i understand there is risks involved with any operation.

I have 2 friends that have both had this op, one 10years ago and still reflux free (he doesn't have barratts).
The other was diagnosed 2years ago and had the op six months ago and has not taken a pill since. Both fully recommend the operation.

I know this is a decision only i can make but would be interesting to hear the views of all those that have undergone this procedure.

Many thanks as i realise its a long post!!!!

Gavin.






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chrisrob
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Quote chrisrob Replybullet Posted: 06 Nov 2010 at 8:07am
Hi Gavin,

PPIs stop acid and fundoplication stops reflux.

PPIs have side effects. High doses over a long time may cause problems requiring additional medication to deal with the side effects.

Fundoplication carries surgery risks.

20mg omeprazole isn't a particularly high dose (my dose was eventually 80mg) and if it works, and you're not getting side effects, you may be better staying on them for now.
The point is, the fundo wrap may not last for ever and isn't so easy having it redone. I guess what you opt for depends on how old you are.

Having said all that, having the fundo (19 months ago) was, for me, the best thing I did - but I had been experiencing considerable side effects from PPIs. I am now totally drug free and fitter than I have been for a quarter of a century.

Don't know if that helps

Chris
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RichardT
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Quote RichardT Replybullet Posted: 06 Nov 2010 at 10:43am
Much depends on your age.

I am 67 and am likely to be on PPI for the duration - but see my www site
http://www.Torrens.org.uk/Med/Ome.html
for my experiences

PPIs are apparently much more tricky drugs that the professionals admit. Statistically, they are the most commonly prescribed drug so statistically they are safe. Individually may be another story.

However - ask two professionals and it does seem you will get two different opinions. Opinions are many - facts are few!

I am currently investigating alternatives: there are certainly foods, herbs, lifestyle changes etc that can help. To investigate that needs more knowledge that I can gain myself, so I need help there so I have made contact with a medical herbalist. No idea if she can do anything but there's only one way to find out.

If my experiences with the herbalist produce anything of relevance here, I'll let you all know.
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org

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gavlaa
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Quote gavlaa Replybullet Posted: 08 Nov 2010 at 12:10am
Thanks Chrisrob and Richard T

Im 39 years old so still relatively young, its strange as you say different consultants give different advice.

On one hand im told im still fairly young and have many years ahead of me (i hope) and due to my age and lack of noticeable symptoms (while on PPI's) im best off delaying surgery and staying on PPI's until either my symptoms get significantly worse or the side effects of the PPI's get bad. I understand the pills only treat the acid and not the reflux but have been informed there is no evidence that having repeated reflux on top of the barratts increases the risk of the condition progressing.

On the other hand im told im still fairly young and have many years ahead of me, due to my relative young age im told i need the fundo op (instead of taking PPI's for years to come) to stop the reflux as this is the best way to treat the condition, both the reflux and in turn the barratts.
Im told after the op i could cut the frequency of scopes to every 2 or so years instead of yearly.

The problem is i can see sense in both of these options and as i have said before i fully respect all 3 consultants opinions in how to treat the condition.

Just a little confused as to the best way forward for long term health as im sure we all are and the best course of treatment.

Many thanks for listening as im just trying to get a balanced view of peoples experiences and views.

Gavin.


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RichardT
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Quote RichardT Replybullet Posted: 08 Nov 2010 at 7:48am
Personally, the more I learn about PPIs the less I like them. I am probably bout to add another finding to my page. For 37 days since going on the 3 x 5mG dose, it was fine. Then, at night, I had a bile reflux incident. Not severe but distasteful.

PPIs are certainly not the only cause of bile reflux: all my life I have had very occasional bouts, so I thought little of it. Then 9 days later, another bout slightly worse. Then after 52 days, a third, worse again.

I had been noticing refluxate acidity: was it getting worse. It had ben hard to tell but after 50 days, acidity level has indeed worsened. So I've just started taking 4 x 5mg doses instead of 3.

So it looks as if my body is learning to metabolise omeprazole.... If so - I have already taught it to metabolise the stuff by taking very heavy doses.

If such leaning is taking place it also explains why I found the half life to be around 2 1/3 hours whereas Wikipedia says 1/2 to 1 1/2 hours.

If such learning does take place then logically one should start on the minimum dose and gradually over time increase either the frequency of doses or the strength.

What I find particularly disturbing is that the doctors prescribing the stuff know nothing at all about it and are basically shooting in the dark and do not seen interested in feedback from the users.

The good news is that all of this is still an area of high medical interest. I am lucky to have been born late enough that the disease has been discovered and the technology and knowledge is being uncovered to sort it.

I will be interested to learn what the medical herbalist I have arranged to see can tell me. Herbal remedies are numerous and most modern drugs are developed from herbal originals: in many ways herbal remedies are actually leading the field. Certainly to learn how to maximise the quality of my remaining life I need to get as much information as possible from whatever sources are available.

Edited by RichardT - 08 Nov 2010 at 7:49am
www sites and contact:
www.Torrens.org.uk/Med/
www.GreenBottom.org

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