Trouble swallowing!

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Hello all. I am new to this forum. To give a little history, back in 2009 I was diagnosed with a small hiatal hernia, GERD and esophagitis. And started having issues swallowing. So I was sent for a esophageal manometry which showed low LES pressure but relaxed with water swallows but also showed out of the 10 swallows I did take, that 3 of them were successful and 7 had failed. I was started on numerous different medications which started to help with the reflux but then it came back after awhile. So I was switched to another medicine all in all was on a few different PPIs. Which in the end started to fail me. I eventually just thought it was going to be a way of life and dealt with it as I could. 

Well my swallowing issues have been getting much worse lately so I went back to the dr and had an EGD done 3 weeks ago. He found the hernia, esophagitis and I now have Barrett’s Esophagus. He also performed a dilation at that time.

Back in 09 I was told the the Nissen Fundoplication wasn’t really an option for me bc my motility issue of swallowing was already bad enough. 

I don’t go back to the dr for another 4 weeks for my follow up after the scope. 

Has anyone had any similar issues that can maybe give me some insight on what to expect or what my options may be?

I believe the only test I have not done yet was the barium swallow not that I can remember anyway. This all started at 16 years old.

Thanks!

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  • Posted

    There is good information about Barrett's oesophagus on the Action Against heartburn website, or through Barrett's Wessex.

    It sounds like you have the swallowing problems akin to motility issues or achalasia, but also have reflux causing soreness and possibly damage to the lining of your oesophagus.

    The option for the motility issues are normally to open up the lower oesophageal sphincter, but that in turn makes reflux more likely.   

    Not everyone responds well to PPI medication.

    I think it would depend on the details of the manometry tests, but it is feasible that an experienced Upper GI surgeon may be able to operate to repair the hiatus hernia and resolve the reflux problem with either a fundoplication or a Linx bracelet.   These are magnetic collars that create a valve effect that the sphincter should achieve normally, but it is also true that use of this may be exacerbate your swallowing.

    It is a long term priority to try and resolve the reflux by finding alternative medication or by surgery.

    The Barrett's oesophagus should be monitored under a surveillance scheme to check for dysplasia.   This is often dealt with by radio frequency ablation to reduce the risk of cancer.

    Also, in the longer term, much will depend on the state of your oesophagus and how much the short term measures can help to preserve it in good working order.   Although you will want to avoid an oesophagectomy, these operations are done, by specialist surgeons, and it is possible to achieve a reasonably good quality of life afterwards.

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    • Posted

      Thank you for your response and the info. I guess I just have to sit it out and wait a few more weeks till my appointment. It just gets frustrating. But I am hopeful my new GI will be able to get this figured out and help me. I just feel like I’m screwed either way because if I opt for a surgery to correct the reflux I run the risk of it making my swallowing worse. Or if I opted for the surgery to fix the swallowing issue, it could make the reflux worse and in turn cause more damage to the esophagus and progress Barrett’s.  

      I guess one of my questions is; is it possible that a hiatal hernia can cause problems swallowing foods and sometimes liquids?

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    • Posted

      I think a hiatus hernia can have an effect in many different ways with how reflux can affect things, but it really is a matter for your own doctors to diagnose the causes and relationship of the underlying causes.
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