Howard: Had some tests today, here are my results--thoughts?
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From: skunker on 1 Apr 2008 13:20 Hey Howard, if you don't mind, I'd like to hear your educated opinion on my latest status and how it appears to be baffling my GI doctor: Background: Had Nissen fundoplication in 1994 (age 14). I'm now 28, but in late 2006 I started getting severe heartburn symptoms for the first time. This was immediately after I did some heavy weightlifting exercises. Since then, all went down hill and I was getting heartburn every 4 days, mostly in the evenings. I got scoped on 12/19/06 and was diagnosed with a hiatal hernia, GERD, and Barrett's (no dysplasia). Few months later I did a Barium Swallow as well as some xrays and everything looked NORMAL. During this whole time (12/9/06 - NOW) I've been on PPIs, but I have not been consistent in taking them and often went days without taking them because I thought I was getting better, etc. 1 month ago I had an esophageal manometry done and my GI doc said it looked normal. Today (4/1/08) I had an endoscopy done AND Bravo capsule placed. The endoscopy showed a "good" wrap according to my GI Doc and nothing looked out of the ordinary (the barrett's was the same, but he did not take a sample for biopsy). I guess all I can do now at this point is see what the Bravo reports. Am I now out of options if this does not show anything out of the ordinary? I still get terrible Gerd symptoms every few days....and I still can't sleep level. Thoughts on my progress? Thanks.
From: skunker on 1 Apr 2008 13:27 Forgot to mention in the above, I think it could be my diet. here's what I eat in a typical day: Breakfast: 1 cup of coffee, eggs, toast, banana Brunch: an apple Lunch: usually leftovers from the day before (beef stew, pork chops, meaty things with some vegetables Snack: Nuts, fruit, chips Dinner: Steak, Beef stew, chicken, Fish (i'm heavy on fish) vegetables and a carbohydate (potatos, rice, etc) I usually drink 2 glasses of tea a day and perhaps a soda every other day or so. I weigh 160 and I'm 5'9".
From: Howard McCollister on 1 Apr 2008 13:49 "skunker" <skunker(a)gmail.com> wrote in message news:da769ad5-645c-48c0-a47f-1f2844fae9b5(a)s50g2000hsb.googlegroups.com... > Hey Howard, if you don't mind, I'd like to hear your educated opinion > on my latest status and how it appears to be baffling my GI doctor: > > Background: Had Nissen fundoplication in 1994 (age 14). I'm now 28, > but in late 2006 I started getting severe heartburn symptoms for the > first time. This was immediately after I did some heavy weightlifting > exercises. Since then, all went down hill and I was getting heartburn > every 4 days, mostly in the evenings. I got scoped on 12/19/06 and was > diagnosed with a hiatal hernia, GERD, and Barrett's (no dysplasia). > > Few months later I did a Barium Swallow as well as some xrays and > everything looked NORMAL. During this whole time (12/9/06 - NOW) I've > been on PPIs, but I have not been consistent in taking them and often > went days without taking them because I thought I was getting better, > etc. > > 1 month ago I had an esophageal manometry done and my GI doc said it > looked normal. > > Today (4/1/08) I had an endoscopy done AND Bravo capsule placed. The > endoscopy showed a "good" wrap according to my GI Doc and nothing > looked out of the ordinary (the barrett's was the same, but he did not > take a sample for biopsy). > > I guess all I can do now at this point is see what the Bravo reports. > Am I now out of options if this does not show anything out of the > ordinary? I still get terrible Gerd symptoms every few days....and I > still can't sleep level. > > Thoughts on my progress? Thanks. Do PPI's improve your symptoms? If they do, and the Bravo doesn't show significant GERD, you may be getting non-acid reflux. With the Bravo capsule down, make sure you keep an accurate diary. I'm kind of a proponent of provocative testing....consider eating a pizza, drinking a beer, smoking a cigar...IOW try to reproduce your usual GERD triggers. A normal-appearing wrap may still be loose enough for function to be impaired. HMc
From: trigonometry1972 on 1 Apr 2008 20:43 On Apr 1, 9:27 am, skunker <skun...(a)gmail.com> wrote: > Forgot to mention in the above, I think it could be my diet. here's > what I eat in a typical day: > > Breakfast: 1 cup of coffee, eggs, toast, banana > Brunch: an apple > Lunch: usually leftovers from the day before (beef stew, pork chops, > meaty things with some vegetables > Snack: Nuts, fruit, chips > Dinner: Steak, Beef stew, chicken, Fish (i'm heavy on fish) vegetables > and a carbohydate (potatos, rice, etc) > > I usually drink 2 glasses of tea a day and perhaps a soda every other > day or so. > > I weigh 160 and I'm 5'9". I'll suggest you need to improve your diet. First, for anyone who has ever had GERD or has had GERD should quit the coffee, china tea, chocolate, and carbonated cola soft drinks and stay off them. The caffiene relaxes the LES and worsens reflux. Second, white bread, chips, potatoes, white rice, and banana have high GI indexes which canl raise your triglycerides, challenge your insulin secretion and gradually result in insulin tolerance leading to type 2 diabetes. Also such a diet will increases the odds of weight gain and I'll grant your diet is better than some out there in the world. At least in women according research any weight gain past about a BMI 20 increases the chances of GERD. A BMI of 20 is slim, often what the young weighed on leaving high school or did in the past anyway.
From: skunker on 2 Apr 2008 11:43
Howard said: > Do PPI's improve your symptoms? If they do, and the Bravo doesn't show > significant GERD, you may be getting non-acid reflux. PPIs generally don't help, but I'm not 100% sure. I have not been consistent with them because of the side effects. One thing is for sure in regards to the PPIs: While they may stem the acid burn for me, they do not prevent the feeling of bile/regurgitation I get. > With the Bravo capsule down, make sure you keep an accurate diary. I'm kind > of a proponent of provocative testing....consider eating a pizza, drinking a > beer, smoking a cigar...IOW try to reproduce your usual GERD triggers. Had coffee, pizza, and spicy deli sandwich yesterday, with a can of coke--I did OK...but had major feeling of regurgitation, but no acid burn. > A normal-appearing wrap may still be loose enough for function to be > impaired. That's what we suspected all along. If this is the case, what are my next options? |