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Tough decision

Printed From: Barrett's Support Forum
Category: Barrett's Support Forum
Forum Name: Barrett's Oesophagus
Forum Discription: Your Questions about Barrett's Oesophagus
URL: http://www.barrettscampaign.org.uk/forum//forum_posts.asp?TID=1700
Printed Date: 20†Nov†2019 at 6:29pm


Topic: Tough decision
Posted By: Richp
Subject: Tough decision
Date Posted: 25†Jan†2017 at 10:17am
So a little while ago I had a scope done by a surgeon who believes my best possible course of action would be a fundo. I'm currently on 80mg omeprazole 40mg morning 40mg night. I don't really suffer with heart burn but do with regurgitation and lpr symptoms. I've been shown my hietus hernia and it is rather large thus causing the issues. I'm not overweight and have adapted my diet as best I can but with no avail. After researching I'm still really unsure wether to have the fundo or not. Has anyone here done the same and been happy with the outcome?

Thanks



Replies:
Posted By: chrisrob
Date Posted: 25†Jan†2017 at 10:57am
Hi Rich,

You sound as if you're in the same situation I was 10 years ago.
I was on 80mg omeprazole daily. Although years before I started on the PPI, I had experienced raging heartburn, that was no longer a concern but the other reflux symptoms that have plagued me all my life, were - particularly in my case, the chronic cough.

I had originally been offered a fundoplication over 20 years ago when I first discovered I had Barrett's. Then, laparoscopic surgery for the fundoplication was relatively new and mine would have been by open surgery and I was too much of a coward to countenance that.

However, as time progressed and my reflux symptoms increased, despite the increasing dose of omeprazole (which I now realise reduces acid but not reflux), I decided even the most drastic of surgery could only be an improvement on what I was then experiencing and I asked for a fundo.

It took a while get the correct referrals and all the necessary tests etc (and I delayed it a few months to get a holiday first) but eventually in early 2009, I had my surgery. My blog of that is on my https://sites.google.com/site/robichris/barretts#TOC-The-Laparoscopic-Nissen-Fundoplication-operation - personal website here.

For me, it was the best thing I ever did. It gave me my life back. So many symptoms I hadn't even thought of as being due to reflux disappeared overnight. I became drug free. The high dose of PPI over that long time had https://sites.google.com/site/downwithacid/home/complications/hypochlorhydria - induced hypochlorhydria and I had become anaemic unable to walk 50 yards without getting out of breath. Within a few weeks I was back on my bike building up to cycling 30 miles a day before breakfast.

Unfortunately, due to 5 hours violent retching due to norovirus, my wrap loosened, the https://sites.google.com/site/downwithacid/home/reflux/lpr - reflux symptoms returned and I knew I needed a repair. So three years ago, I had a https://sites.google.com/site/downwithacid/home/reflux/reflux-reduction/fundoplication#TOC-Collis - Collis - https://sites.google.com/site/downwithacid/home/reflux/reflux-reduction/fundoplication#TOC-Nissen - Nissen revision (which you may also read about in my https://sites.google.com/site/robichris/barretts/refundo - personal blogs.

I have collected many stories from patients who have had the Laparoscopic Nissen Fundoplication which I intend to print out to make available to prospective patents like yourself but haven't got around to it yet. (Just aren't enough hours in a day sometimes.) Most had very positive outcomes. Just a couple who didn't.

This paper published in 2015, https://www.ncbi.nlm.nih.gov/pubmed/25487547 - "20 years later: laparoscopic fundoplication durability" followed up nearly 200 patients who had had the operation 20 years ago and concluded: "Long-term results from the early experience with LF are excellent with 94% of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up. However, 18% required surgical revision surgery to maintain their results. There is a relatively high rate of daily dysphagia but 90% of patients are happy to have had LF."
And I have links to a number of other studies that showed similar results:
"Nissen Fundoplication has a positive impact on quality of life and is effective in reducing symptoms of heartburn, regurgitation, burping and difficulty lying down associated with a hiatus hernia. There is however an increase in the incidence of flatulence associated with the procedure. In spite of this, 94% of patients would recommend the procedure to someone else."

"it is not clear the real incidence of redo antireflux surgery, because of small sample size or are single center studies. In the 90ís, Lafullarde reported an overall reoperation rate of 10% after LF. More recently, reoperation incidence is reported to be resembling 5%. A systematic review performed on elective LF documented an overall reoperation incidence approximating 0.6%. In the nationwide study from Denmark, an incidence near to 5% of redo antireflux surgery was reported in 2589 patients."

All the best
Chris

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk


Posted By: Mtmurray
Date Posted: 25†Jan†2017 at 1:53pm
Rich,

I had a 4cm hh and 3 small islands of NDBE. I decided to have a fundo. My surgery was done 5/5/16I was regurgitating food and had periodic heartburn. I have not had either since my surgery. I had a second egd done December 2nd. It showed my NDBE had regressed to gastric muscoa. It was the best decision I have ever made. best wishes on your decision!


Posted By: Northbriton
Date Posted: 07†Feb†2017 at 4:49pm
1st day home after Fundo.. No where near as bad as I thought it would be. So far so good. Very little pain and eating Yogurt (carefully) as well as drinking lots of water in little sips. Blessed relief I will no longer have heartburn and associated problems. I will post again in 6 weeks and let you know how things are. I was diagnosed after nausea and weight loss with Barretts and Schatzkis Ring as well as a hiatus hernia. Posted on this forum and Chris gave me hope that I don't have to put up with the horrible life because of symptons and the fear that I may develop cancer. Found a great consultant surgeon who was happy to perform the operation. In and out in 12 hours and so far just a little discomfort. I hope I will soon have my life back!


Posted By: chrisrob
Date Posted: 07†Feb†2017 at 6:47pm
Good News. Best wishes for a full recovery soon.

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http://www.barrettswessex.org.uk - www.barrettswessex.org.uk


Posted By: jcombs99
Date Posted: 07†Feb†2017 at 9:12pm
North
    Good for U go on the soft food 4 a long time let it heal or scar up .Post after ur next EGD that will time u what going on .Every case is different I love my ppi's BUT when they don't work Refundo time .



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