Tests Acid Reflux and Barium Swallow test and Endoscopy

The throat and ear problems are very likely due to aspiration of extra-oesophageal reflux whether acidic or not.

The bicarb test for acidity is very unreliable. Your pH test will provide an accurate assessment. If acid hyper-secretion is found, acid suppressants are called for - not because they reduce the reflux but reduce the harm refluxing acid can do to your oesophagus causing permanent damage (Barrett's Oesophagus) that can mutate to cancer.

There isn't actually anything much your consutant can do for reflux. The only option they can provide if you are unable to reduce your reflux through lifestyle changes is surgery: fundoplication.

What is fundoplication? is that a harmful surgery? 

Does this surgery help ? and is there a cost involved? as in how much? what exactly is it? and does it help 

Available on NHS.

The operation has been performed for 60 years, the last 20 laparoscopically - ie keyhole.

It takes the top of the stomach and wraps it around the base of the oeophagus. It takes about an hour and you go home the next day.

Read about it on the DownWithAcid org uk website and also see the NICE option grid in the appendices of the same book/site.

I had fundoplication 8 years ago and it gave me myl ife back.

And All my extra-oesophageal reflux issues I'd had all my life, went.

Oh nice one. So happy it was a success for you .You took the right choice of getting surgery done, I know alot of people are actually scared of surgery'.because sometimes it could have side effects, but I guess it really depends on whos doing the surgery too. Im sure the doctors or whoever is performing surgery want the best outcome for the patient. . Im guessing you are sedated during the whole time. , as long as they know what they are doing'. thats the main thing and that it is a success as it was for you . Kind of gives others hope sharing your story that not all surgery is scary and that it could benefit you in the future.   Thank you for sharing that'

I get confused as to what is surgery and what isnt, I actually thought an endoscopy was a surgery type of thing'. but not necessarily'. our waiting list here is like 4 months ; to be seen from a specialist if you cant afford to pay for it. and then from after that they put you on the waiting list again and that could take up to 4 months to be seen again as well'. unless you go private. private is always available' - but that costs money and sometimes people dont have that kind of money to spare'. Your Gp could mark it as urgent to be seen for a consultation. and some of them dont have the time or day cause they are "busy people"..Im glad i am being seen . but actually nervous about it too. 

Dear Barrets,

​What were your exact symptoms? Did you expierence LPR? 

​Because I understood dat de fundoplication is not effective for LPR?

​And how long did you experienced it before going to surgery?

Thank you Barretts, I am at the stage where I am hoping I will be a suitable candidate for fundalopiation surgery.

I have visited your website and thought it was great.

 

My symptoms included all those listed below, some of them all my life and I had the fundoplication 8 years ago when I was 59.

Most of my symptoms were from aspirated extra-oesophageal reflux, to which Jamie Kouffman gave the term LPR but has recently suggested the term "Resiratory reflux" would be better.

The worst symptom was the chronic reflux cough that would result in a coughing fit at least once a day when I would practically pass out, and make me sit up for a couple of hours between 2:00 and 4:00 am coughing and swigging too much cough suppressant.

I would perpetually have excessive phlegm in my throat.

I had catarrhal and asthma like symptoms. I had been tested for all known allergens and  been prescribed various inhalers for rhinitis and asthma.

I had an almost non-existent sense of smell, post nasal drip, bad breath and tooth erosion.

I had ear problems including excessive waxing, mainly on the right, which I used to have syringed weekly when I was a young child. The damage from that treatment is still evident today. And tinnitus. I had also had my tonsils and adenoids removed at the age of 4 in the hope it would help.

Dry, gritty eyes, articularly at night, was another unpleasant problem.

I had learned to live with these symptoms.

About 20 years ago, I mentioned to my doctor that the cough was worst when I was also experiencing severe heartburn. He suggested the refluxate was travelling the full column of the oesophagus and entering the respiratory system - which was quite a radical idea at that time.

Increasing doses of omeprazole over the years got rid of the acid hypersecretion and heartburn but did nothing to quell the cough. 80mg a day for a few years induced hypochlorhydria making me anaemic, on top of all the other symptoms, making me unable to walk more than 50 yards.

21 years ago I had been offered a Nissen fundoplication to deal with my acid reflux. It would have been open surgery and I was too scared so turned it down and relied on the newly introduced PPI drugs.

The fundoplication surgery is performed under general anaesthetic. I have a blog that may be found on my personal website, ChrisRob co uk, under the Barrett's tab which relates my experience of the surgery.

Fundoplication reduces the reflux from the stomach into the oesophagus. This also reduces LPR since there is no refluxate to breach the upper oesophageal sphincter.

Following my surgery, I was off all medications immediately.

My cough was minimised, I gained a sense of smell, my ears cleared etc. Within a few weeks, I was cycling 20 to 30 miles every day before breakfast.

Wow, what an improvement. I believe you must be one of the happiest persons on the world at this moment. Thanks for sharing this story. It's always good for getting hope from for the others. Especially because you hear LPR is difficult for surgery. I will also check your personal website.

Barretts, hope you don't mind me asking, if you were hypochlorhyric did your pH test  prior to surgery show acid reflux?

Definitely.

During the week or so prior to the 24hr pH manometry work up you come off PPIs. My heartburn was raging again.

My DeMeester score was a massive 179 when anything over 14.7 shows acid hypersecretion. And for most of the time, my pH was around 1.

Interesting about symptoms connected.  l was diagnosed with acid reflux, gall bladder removal helped that, though got usual nausea bloating belching years later, scope, diagnosis bit of gastritus, put on omprazole

But had allergic rhinitus diagnosed 30yr ago, coughing spasms where near choking, congestion, given rynocrom, helped, though still got time to time then tinnitus, sore sticky gritty eye stuff, increased asthma, also t and a out at 3yrs. Amazing about the connections, and also your results

guessing you were too breathless and unfit before to do strenuous exercise, brilliant result for you. Will check out your site. 

 

Your consultant said he would not see you again? I hope he recommended aanother consultant for you rather than brushing you off to the side' like he couldnt be bothered with you '. Their job is to try and help patients who are suffering and offer the best solution in hopes that the patient gets better'. Its quite annoying when they cant find the solution and then get a bit of an attitude  when they cant and they wonder why patients get fed up feeling the way they do . It usually is the case. Is a long wait. If they feel that your situation isnt severe enough then they prioritise it in that sense'.either mark you urgent or semi urgent or not urgent at all'. I waited 4 months just to see a specialist'. obviously I didnt have the money to see them straight away for a consultation. and just as well'. seems I would have only seen him for a measly 10minutes rather than a good half hour for $280 . . $280.00 for 10 minutes'. yeah not worth the consultation rather someone in there who actually listens to what you have to say rather than brush you off' etc'.

Wow im so happy for you '.seems like you definately went through a lot of pain and suffering and have come out better' as a result of the surgery'. and I dont blame you , I think anyone would be scared to take the surgery '. it is nerve wrecking as you dont know whether you will come out better, because they say surgery does have its risks, in your case Im glad that you took the chance'. because living with it can make you feel lifeless'. to the point where you cant do anything'. I mean In my situation yes I can walk around'. yes I can eat'. its a feeling of dry throat, and a feeling of something that is swollen inside my throat so and gagging or the feeling of nauseated after I eat, especially after I eat'. and the constant burping etc'. its Horrible'. Im so happy for you . You deserve to be better' no one should have to live like that'. thats a worse feeling ever. I actually thought having toothache or earache was painful and yes it is. but that usually eventually goes away '. can never compare to what acid reflux is. or whatever it is. It really does stop you in its tracks'. and sets you back. Every pain Iv had in the past has never amounted to what I have now. usually normal pains go away but this has lasted 7 months' - Horrible'.