Risk

I went to see a surgeon yesterday about a possible Nissen Fundoplication to correct a GERD problem

According to the Dr., Nissen Fundoplication requires I have a BMI no higher the 25. My BMI is in the low 40s. I weighed in yesterday at 250lbs. At my height, I’d need to lose approximately 100lbs, something both the Dr. and I see as unrealistic.

However, he said he would do the surgery if I lost 35lbs, brining my weight to 215lbs. But even if I do, my BMI would still be in the 30s. For years I have tried to bring my weight down to below 220 through diet and exercise and just couldn't do it. So the risk would still be high for the procedure to fail.

Do you think the risk is still too high even at a BMI in the low 30s?  Does the BMI take into account muscle weight vs. fat weight? When considering this type of surgery does fat vs. muscle weight matter?  My body type is rather muscular.

[Ratnakar Kini, MD]

Hi,
What symptoms you have?
What medications you are on?
Do you find relief with medications?
I would like to know these details before I can comment on  fundoplication and BMI.

[Compito]

Clearing my throat, coughing, choking on mucus and asthma-like symptons.  Been on a number of different medications started with Omeprazol switched to Nexium, now on Kapedex.  Relief is marginal. When I start taking a new medication, regarless of which one it is, after a few days it seems to have a positive effect.  But it doesn't last.  After about a week I regress.

When I came off these medications so my Dr. could do the study (Motility I think it was called, one of three he did), I developed a burn and nausea where there was none before when I was on them.

So at the very least if I did not have the surgery, at least these symptoms would be controled.  However, it leads me to another question.

What are the long term effects of taking the proton pump inhibitors and other like medications that either nutralize stomach acid or prevent it from being created?