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Just Had PEOM and now suffering from Acid Reflux

Posted , 5 users are following.

rick_00446
rick_00446

Hi Guys, 

I'm a 26 year old male who had POEM surgery last week. I previously had ocassional issues swallowing, heartburn, acid reflux so I went to the doctor randomly and was diagonised with Alachasia and the doctors suggested POEM. I agreed and had the surgery. 

Now, I've been sent home with a month's prescription of PPIs which seems to be the common theme from all the discussions and papers I've read about it. 

Everytime I eat now I do have some acid reflux and I'm wondering if this will continue throughout life, or do these things subside after some months after POEM ? What has been your experience ? 

0 likes, 7 replies

7 Replies

  • rick_00446
    rick_00446

    Posted

    So I just realized that it's not acid reflux after each meal but belching. I do get acid reflux/heartburn early morning though.  

  • marilyn19717
    marilyn19717 rick_00446

    Posted

    Hi Rick I had dilation treatment for achalasia following a myotomy which failed after 30yrs. I too seem to be suffering from reflux even though on ppi's keep hoping it will ease it is 5mths since I completed my treatment. I think its trial and error diet, how to take tablets ect. Good luck for the future. Maz Maz

    • rick_00446
      rick_00446 marilyn19717

      Posted

      Thank you for your reply Maz. I'll absolutely be starting my trials and noting the errors. Hopefully things will be better soon. smile

  • AlanJM
    AlanJM rick_00446

    Posted

    The PPI medication may take some time to work at its optimum level, but it might need revision / alteration after some weeks.   It is probably part of the effect of the valve into your stomach working properly for food going down, that also allows reflux to come up.

    ?Try not to eat late in the evening, and think about sleeping whilst propped up and on your left side.   There are other remedies that you can take against heartburn like Gaviscon which is an alginate and creates a protective raft for a few hours.

    ?I think how long the reflux will last will depend on the state of your lower oesophageal sphincter.   In some ways, if you have indefinite relief from achalasia the reflux may be something that you have to put up with.   After a while, say a year or so, when things have been going well, you can always review the PPI medication with your doctor and see what happens if you reduce it or leave it off, but there will be a 'bounce' effect for a couple of weeks.   There are alternatives to PPI medication that suit some people (eg Maalox) but I would be guided by your surgeon's advice at the moment.   Long term exposure to reflux is not a good thing for your oesophagus, but relieving the achalsia is definitely the priority.

     

    • rick_00446
      rick_00446 AlanJM

      Posted

      Thanks a lot Alan for this answer. Today I had acid reflux that not only gave me heartburn but made even my jaw hurt. Thankfully it went away after an hour. 

      I do have some more questions : ?"I think how long the reflux will last will depend on the state of your lower oesophageal sphincter." Does the LES heals or strengthens after POEM, and prevents against acid reflux ? If yes, then how much time this take ? If no, oh well ! 

    • AlanJM
      AlanJM rick_00446

      Posted

      I think that achalasia can get worse over the long term, but I am not sure whether this applies equally with POEM.   I think that the anti-reflux medication for POEM would be required indefinitely - with POEM there is no fundoplication wrap to recreate the valve effect of the sphincter to combat the reflux.   But your surgeon will be the best one to advise you.

       

  • LisaMod
    LisaMod rick_00446

    Posted

    Hi Rick. I had POEM in late June. The reflux was horrible initially and improved after a few weeks. I was on PPIs for three months and then went off them. I have been told to sleep 40 degrees elevated for life and am and don't eat 2-3 hours before bed. I am taking extra strength Pepcid occasionally and Chinese herbs, NOW super enzymes (on Amazon) and probiotics often, which all help. Diet is the biggest predictor for me. If I eat small non-greasy or spicy meals, my reflux is minimal. I have realized the eating every two hours is best. Also a lot of liquid with meals causes reflux for me. I had an endoscopy after going off the PPIs, this is the the only way to accurately monitor the damage to your E and reflux, which showed mild irritation in my E from reflux. I just switched Insurances and need to find a new GI but the last one recommended going back on the PPIs, which I would rather not do. Basically, everyone is different and you will need to find a solution with your GI. There is no definitive answers for how many post-POEM patients have reflux but there are many theories. It's hard and lonely but we basically have to figure out what works for each of us. Good luck.

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