GERD with Cramping, V/D

  I have had diagnosed severe GERD for years now and since I had cranial sugery in 9/96 additionally I have had vomiting.  The vomiting has  recently increased, after a period where I hadn't had it in a couple of months.  I have been vomiting every day and haven't been able to keep anything more than breads down.  I haven't always had cramping, nausea and diarrhea with GERD.  I am on Prilosec and Carafate.  I have tried Propulsid and other drugs like Propulsid but I have a neuro disorder and these drugs end of giving me a stick man syndome, so I am unable to take them.  The vomiting has been occuring from immediately after a meal to up to 3 hours or more afterwards.  My primary physician says nothing more can be done.  I do know about the surgery, but he hasn't thought enough of it to bring it up to me.   The neuro disorder hasn't a name yet...to some it appears as if I have MS..but the tests are negative.  Also I had a virulent virus about 3 weeks ago I believe that could be one reason for the increase in the vomiting etc.  I also choking/swallowing diagnosis since the surgery in 96.  I believe that cutting the Vagus nerve was the reason for this.  Suggestions?  How do I get my primary to understand the discomfort I am in instead of him just saying that he isn't sure of how to help me anymore?  Complatency is becoming common with my doctors...
  Thanks in advance for your response
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Dear Jeanne:
Swallowing disorders (dysphagia) are relatively common in persons with various neurological disorders. There are a multitude of reasons for dysphagia. The nerve supply to the throat, esophagus, stomach and bowel is very complex, and may be disrupted at many levels of the nervous system. However, the intestinal tract has both external (the vagus) and internal nerves which act independently. It would be uncommon to have dysphagia originating in the esophagus because of vagotomy (cut, or removed vagus nerve).
Because of the complexity of the swallowing function, several tests should be performed in order to determine which part of throat or gastrointestinal tract is involved. Such tests include a video-swallowing study of the muscles in the mouth and throat, barium esophogram, and sometimes assessment by a physician specializing in speech and swallowing pathology. If the problem is not in the throat, the function of the esophagus can (and should) be assessed by an esophageal manometry study, where the pressure and motility (contractile function) are determined.
Lastly, as you probably know, reflux disease can cause swallowing difficulties. Most commonly, this is because inflammation of the esophagus disturbs normal motility. However, adequate therapy of GERD with prilosec or prevacid should alleviate this problem. If complications of GERD occur, such as strictures of the esophagus, medical therapy alone would not be sufficient. The complications of GERD can be assessed by various barium studies and gastrointestinal endoscopy.
At the risk of sounding bias, I would recommend that a gastroenterologist specializing in esophageal motility disorders be consulted.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution, please call 1-800-653-6568, our Referring Physicians Office and make an appointment to be seen with Dr. Tamir Ben-Menachem of the Division of Gastroenterology, one of our experts in the treatment of feeding difficulties and motility disorders of the GI tract.
HFHS M.D.-tbm
Keyword: dysphagia
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