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for background please see previous discussion on Failed POEM, hopefully this information will help some others understand what may be going on if they have the symptoms of a failed POEM.
Once you have Achalasia according to my doctors you lose the ability in the esophagus to feel whether you have acid reflux or not although you may have pain in your stomach from over production of acid. When they did my original POEM on April 15th of this year (2016) there were no signs of esophageal acid erosion or esophagitis. This past Friday due to having all the symptoms of failed POEM and the Barium swallow test results that showed the same results as the one I had before the surgery they performed an EGD and it showed that:
1. I now have a hiatal hernia
2. I now have a large ulcer in my esophagus
The surgeon is saying that this is causing my sensation of not being able to swallow and my regurgitation. He is also saying that this may necessitate them going back in to do a fundoplication which makes sense to me and which I would prefer that they do. In the mean time they have prescribed the following
1. Carafate – one tablet crushed in water 4 times a day for 90 days
2. Pantoprazole 40 mg twice per day before meals for 90 days
3. Ranitidine 150 mg once per day before bed
Additional Instructions - Eat six small meals per day for the rest of my life.
They are saying they will see me in 30 days so see if there is improvement. I have the suspicion that if I actually improve they will use this as an excuse to avoid doing fundoplication and to keep me on PPI’s for years which I am not okay with.
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