please help my mom

[momspain]

my mom has had a hiatal hernia, barrets esphagus, and been on medicine Like prevacid,tagamet,prilosec, and others for 20 years or more. she had a nissen fundoplication 2 1/2 years ago. She is in worse pain since the surgery. She is  only 54 years old . she went back to the surgeon and they did a cat scan and said it was normal. She says she can barley eat anything without having pain what should she do? and what test can be done so she knows what to do to stop the pain in her chest in back . She says she feels full of gas and in pain almost every day>

[Cindee56]

Hi dear.  I'm so sorry about your mom.  I'm just answering this because my husband also has barrett's and he has the same symptoms.  He really cannot eat anything without feeling pain and throwing up.  He takes Nexium also.  His esophagus is all worn away.

We are now looking for another doctor.  I'm sorry I don't have an answer right now.  I can tell you what my husband does is drink those protein shakes and he uses Immodium if he gets the runs or a suppository if he's constipated to try to keep the bowels regular.  

[Jaybay]

Your poor mom.  I understand a Nissen's isn't exactly an easy surgery, and it sounds like the surgeon may have made the "wrap" a bit too tight.  If so, yet another surgery is required to either redo it a bit looser or undo it completely.  You mention that the original surgeon ordered the CT scan.  Much as I hate to say this, his own ego may be getting in the way.  Doctors are humans too, and sometimes they don't like to face facts if their work is less than curative.  Nissen's can be problematic that way.  It's not exactly a "one size fits all" kind of surgery and there's a certain amount of educated guesswork in determining how much of the stomach to wrap around the lower esophogus.

Another possibility is adhesions (scar tissue) that might be further constricting her stomach, esophogus or small intestines.  Adhesions don't show up on CT scans - or any other imaging studies for that matter.  I've had them all over my intestines for years and they never showed up on any tests.  It was always an exploratory surgery that diagnosed the problem.  Unfortunately, the stuff just grows right back with me, but that's a long boring story.

My husband was diagnosed with a severe case of Barrett's several years ago and so far has opted out of the surgery.  Aciphex twice a day seems to have kept his condition stable and his annual scopes with biopsies show no cell displaysia (precancerous changes in the Barretts tissue).  Until that happens, he's sticking with medical management.

If you mom hasn't been back to see her gastroenterologist about her post-op symptoms, she should do so.  That would be an excellent first step toward getting a referral to a different surgeon if necessary.  If she hasn't had an endoscopy done since these symptoms got really bad, it's probably time for one.  Don't let her give up.  A CT scan is not the be-all and end-all of diagnosis.  Obviously something is wrong, so she needs a doctor willing to do a more thorough investigation.

Best of luck to you both.  You're obviously a wonderful daughter - your mom must be very proud of you.  :-)