Aspiration pneumonia and achalasia surgery

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Thank god ive found this site with recent posts! Two years ago I started to suffer from heart burn, acid reflux, lump in throat and constant sickness of regurgitated food to the point I can barely manage anything other than mashed potato. 2 years of being told it's stress/grief/in my head/ young girl on diet(I'm 25).. I've lost 4 stone and been severely unwell, was admitted to hospital with aspiration pneumonia as food has been going into my lung, infection level of 217 so plenty fluids and antibiotics. Now I'm awaiting another endoscopy and manometry within the next 4 weeks before a surgery to either cut the esophagus open or en bloc esophagectomy. My CT scans show my esophagus is massively dilated and damaged and at my wits end. Has anybody had the en bloc esophagectomy? 

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  • Posted

    I had that robotic heller surgery. My serge on said he has done both surgery the one I mention and the POEM

    He said he had better results with the robotic heller that he dont do the POEM one . He said the POEM one that you will have acid reflux . By having the stomach flipped has kept me from having it 😊 I do eat those simethicone gas chews they do help

    Good Luck 😊

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    • Posted

      AH great thanks! I've never heard of those chews I'll have to have a look. I'm hoping it's just going to be that procedure but the doctor says he thinks my esophagus isn't working at all so will remove the whole thing which is the worse operation. 

      How are you eating now? Are things "normal" for you? And how long was your recovery time  smile 

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    • Posted

      Yes I can eat Noe food goes straight on down . I do spaz stillI got stage 3. I can't rat chocolate anymore i can't get past my throat it to thick makes me jabr hard time swallowing

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      I'm getting married next July and if this surgery doesn't work I will literally cancel my wedding I can't bear it any longer I just want to eat normally and gain some weight finally, Mine is stage 1. It's good to finally get a diagnosis but it's been left untreated for two years. I've been begging the doctors for help

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  • Posted

    It sounds scary to have the oesophagectomy, but when the oesophagus is really dilated and baggy, it may be the only real option.   There are lots of people who have had this operation that are connected with the Oesophageal Patients Association (OPA) who run a website, patient groups and so on.  90% of the cases are cancer-connected but there are people who have had the surgery because of achalasia.   Many of them achieve a reasonably good quality of life afterwards and are physically active.

    ?I think the aspiration of food into your lungs is a significant health risk, and this makes surgery of some sort prudent.

    ?For most people the surgery concentrates on releasing the muscle pressure on the lower oesophageal sphincter, the valve between the oesophagus and the stomach, thereby allowing food to pass through by means of gravity.   But it is important to have the manometry test to determine exactly where the problem has been occurring.   Many people also have a barium swallow test as well.   Sometimes people have a timed swallow test with various food consistency like marshmallows and so on.   On the OPA website under The Oesophagus and Achalasia you can download 'A Patient's Guide to Achalasia' which you may find helpful.

    ?I think the most important thing is to ensure that you are seen by an experienced Upper GI (gastro-intestinal tract) surgeon who has plenty of experience at dealing with these operations.   It is a matter of clinical judgement as to what surgery to perform.   Obviously nobody can advise you about the detail of your case, but it may well not be the case that you are at the stage of needing an oesophagectomy yet.   If an operation like a Heller's myotomy with a fundoplication can be realistically carried out, you would be far better off than the much more drastic surgery of removing your oesophagus entirely.   But that is a matter for proper diagnosis after doing all the tests.

     

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    Can anyone help me, my son zak has been having this problem for  3 months now, endoscopy test clear, today we had a barium swallow and said that looked all fine, my son never had a spasm at the time,  does this then give a correct reading, as he has these like spasms and needs to burp , he can eat his food but within a minute or two he spasms and can spasm through the day even when he wakes up before eating, it's like a wind bubble there and it can catch his breath, has anyone ever had anything like this?? I think we should still go ahead with a mamortry  test just to see, it's all so strange and just need help and advise, many thanks Lisa

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    • Posted

      s that will explore exactly what the diagnosis is.   Has he been observed at the hospital when he is having a painful spasm?

      ​We had a meeting a couple of weeks ago of around 30 people with achalasia, and the most frequent trigger for spasms was stress / fatigue, things that they might have eaten;  especially hot/cold water;  reflux; and some association with wind/colic.    It is generally thought that the rest of the digestion system running well ie not constipated, does help the general well being and tendency not to suffer the spasms.   But perhaps there is something like a stricture or small blockage that might impinge on part of his verve system?

      ​I suppose the issue might be whether it is something that causes both the wind bubble and the pain;  or whether the wind bubble actually triggers the pain.   I dare say that you have been trying various medication to help with the wind (eg gripe water?) and perhaps there is some kind of kink in his system feasibly?

      I do think it might be worth the doctors watching him eat whilst scanning him somehow or other.

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