why does strictures keep occuring

[chon]

My husband had a nissen sugery done on his stomach in 2001 a year later it was reversed because the surgeon had it too tight. After the nissen was reversed my husband has a severe abdominal pains.  we are in and out of the hospital.  The first gi dr he went to said the surgeon had caused some nerve damage to the area.  He has had to be diliated 6xor 7 times since his last operation. they first removed his gall bladder thinking that was his problem and then they diagnosed him with having gerd so the nissen was recommended.  my husband has since seen 3 more doctors to see why he is in so much pain.  they have done all kinds of xrays, ekg,blood work, ct scan, endoscopy, barium swallow you name it he has taken it.  All the test they do come out normal.  Two years ago he had passed out while having this abdominal pain.  we took him to the emergency room and they did all the test again and nothing they said he passed out because of the pain in his stomach because it was so intensed. after the reversal it seem every 5-6 mths we are back in the emergency room for severe abominal pains that wrap around to the back.  he was just put in the hospital for it 2 weeks ago and all the gave him was moraphine for the pain and sent him home the following day.  that weekend he complained that he was still hurting and very nausated.  the following monday he was driving to work and passed out again this time he was driving and hit a tree so they called in the heart dr and a neurologist to do some test on him.  while he was there they did a stress test, tilt table test and ct scan on his pelvic and abominal.  all the test came out fine except for the tilt table it showed he had something going on with his vagel nerve so the put him on toprol.  we dont know what is going on because this all started with his stomach but they say the vagel nerve is in the esophogus but goes down to the stomach.  we were also told he had a small lesion on the liver and a small hernia was discovered last may but they never said anything about the hernia this past week.  My husband is so frustrated because they can never find out why he is having this chronic adominal (abdominal) pain.  one dr that visited him in the hospital made it sound like it was all in his head.  today i get a call from his job saying he passed out again and his blood sugar was 65.  It seems like everything is starting to go wrong.  We just want some direction as to what to do or what to say to the dr's to help find the problem.  He is losing hope in finding a resolution for his medical condition.  I still say his passing out is due to the chronic pain and the neurologist seems to think so too.  Can esophogus replacement be done since he has to be dilated 2 times a year?  this new dr doesnt think that he needs to be dilated but the other dr we have seen says it has to be done...He is alway having fatigue, nausea and gags alot.  if it wasnt for this pain in the stomach or the spasming of the esophogus he would be fine.  please help

[Kevin Pho, MD]

Tough to say.  Clearly a comprehensive workup has been done as well as a multitude of tests.  

If the cause of passing out is due to chronic pain (and all cardiac and neurological disorders have been ruled out), then the pain needs to be better controlled.  One option would be a referral to some kind of pain management specialist to optimize the pain regimen.

The other issue is the low blood sugar.  One can consider looking at the pancreas - since various pancreatic disorders and masses can cause fluctuations in the insulin level - leading to low blood sugars.

You can discuss these options with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b