Lap Nissen Alternatives

[pastork]

I'm a 49 year old male. I've had GERD for five years. Originally I went to the doc complaining of chest pain. He sent me to a cardiologist who did a EchoCG and Stress Test. They showed my heart was in good shape. The only problem was cholesterol of 240. With heart problems ruled out I was diagnosed with GERD. Until 1 year ago it was somewhat controlled with one otc H2 blocker a day. I still suffered from persistent cough and wintertime wheezing, but the lower chest pain and nighttime bile disappeared. A year ago I saw an ENT about my persistent dry tickly cough. He scoped my throat and said he didn't see anything that wasn't consistent with acid reflux. He recommended upping my otc H2 blocker to twice a day. That brought the  cough to an end. I also got through the winter without requiring a steroid inhaler to control my wheezing.

However, I continued to suffer from low energy and fatigue. I figured it was just that I was out of shape, having no regular exercise program for the past 5-6 years. Five months ago I joined an exercise club and began working out 2-4 times a week, doing a half hour to 45 minutes on the elliptical cross trainer and once around the weight machine circuit, 10 to 15 reps on each machine with minimal weights, mainly going through range of motion. After a few weeks I began to experience chest pain after about 5 minutes of exercise that went away after another couple of minutes. It was similar to the tightness I normally feel with the adrenaline rush I get when my first responder pager goes off. My research told me the chest pain was probably related to acid reflux and since I could normally work through it in a few minutes I tried to ignore it.  I figured why waste $125 to have the doc tell me what I knew already - Acid Reflux, take my h2 blocker, watch what I eat and lose weight.  I did try switching from my 2x a day generic Pepcid ac to 1 a day Prilosec OTC for 21 days, but didn't get any help from that,  even combining Prilosec with Pepcid.  Over the next couple of months the pain grew in intensity and duration.

I finally made an appointment and saw the doc last week. He noted that my chest xray from last year had a shadow down by the diaphragm that, combined with my other symptoms, likely indicated a hiatal hernia. He said that eventually I will need Nissen Funoplication. However, he began by adjusting my meds, suggesting that I switch from  the H2 blocker to a Prevacid OTC 2x a day. He also prescribed Sucralfate 1gm 3x/day saying I should dissolve the tablet in a small amount of water so it could coat my esophagus on the way down to help alleviate my symptoms.

It's been ten days and the change in meds doesn't seem to be helping.  The worst attacks come when I exercise. I can no longer work past the pain.  I get on the cross trainer for 5-10 minutes and I can't go on. Just walking up the stairs can bring on severe chest pain. It feels to me like a balloon of stomach fluid forms above the diaphragm hernia and when I begin to exert myself the extra breathing activity squirts it up the esophagus. Is that a correct layman's description of what's going on? When the pain subsides, I'm left feeling weak for hours. Recently, it also has begun keeping me awake at night with the more typical heartburn burning.

What other alternatives are there to surgery? I am self-pay, so I would like to avoid that expense if possible.

[selmaS]

Hi....glad to hear u r feeling better and sleeping better.

I pray that continues for u : )

"selma"

[pastork]

The Prevacid combined with Sucralfate seems to be helping. Episodes of severe chest pain are getting less severe and less frequent over the last week. I've been sleeping better the past few nights without burning esophagus keeping me awake.

[selmaS]

HI..for those of us with a hiatal hernia...ne change in weight can cause a flare in symptoms....
and following a modified diet and lifestyle is important in addition to the meds.....tight clothes as well as exertion can affect the hernia

For an alternative to the Nissen procedure research ur area for a chiropractor that can manipulate the hernia down ...not all chiro's r able to do this....so do look carefully.

Previcid is a PPI which can take longer for effects to be noticed......and not all meds work for everyone, but do give it a bit more time and if u have additional issues let ur dr know...most PPI's can heal the damage from reflux so it may be beneficial for u to try it for a while....please see the Health Pages for more info on diet and lifestyle tips
http://www.medhelp.org/health_pages/list?cid=236

"selma'