Mrs. Dash without onion or garlic? [Heart Medication]

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From: H McCollister on 18 Jun 2008 11:08

In article <4858bc92$0$17153$742ec2ed(a)news.sonic.net>,
"Bob Noble" <bnoble(a)sonic.net> wrote:

> >
> > Congratulations on the betain working for you. Funny, I can consume
> > tons of vinegar, and do every meal. I don't think I have a high or low
> > acid problem, but rather a sensitivity to foods that relax the LES.
> >
> > Bob
>
> No Bob, that's not how it works.
> You more likely have a relaxed/defective les all the time that certain foods
> agitate more than others.

Some people have a low LES resting pressure, some have a normal resting
pressure but suffer from TILESR (transient inappropriate LES
relaxation). Those inappropriate relaxations come from certain triggers.
Classic triggers are alcohol, nicotine, caffeine, full stomach, and
certain spices - garlic among them.

The betaine thing....well, I'm in favor of whatever works to keep
someone asymptomatic of GERD. Even the placebo effect.

HMc

From: Bob Arnold on 20 Jun 2008 14:38

From: christophe on 20 Jun 2008 15:20

Howard writes: " Some people have a low LES resting pressure, some
have a normal resting
> pressure but suffer from TILESR (transient inappropriate LES
> relaxation). Those inappropriate relaxations come from certain triggers.
> Classic triggers are alcohol, nicotine, caffeine, full stomach, and
> certain spices - garlic among them."
So would surgery still be helpful for this 2nd group of patients? How
would this condition be diagnosed? I have heard others argue that
anxiety also causes these transient and inappropriate relaxations.

I'm doing pretty well post fundoplication. I only had a 270 wrap and I
am almost eating anything I want 6 weeks post op. I still get
occasional gas pains, but that's about the sum total of my problems at
this stage. The earlier post fundo symptoms - which seemed to mimic
reflux - are all but gone. What is your view on partial wraps?

From: H McCollister on 21 Jun 2008 10:06

In article
<7715171c-3758-4c6d-9ac7-9c6ef88d1266(a)j1g2000prb.googlegroups.com>,
christophe <chris_pham(a)optusnet.com.au> wrote:

> Howard writes: " Some people have a low LES resting pressure, some
> have a normal resting
> > pressure but suffer from TILESR (transient inappropriate LES
> > relaxation). Those inappropriate relaxations come from certain triggers.
> > Classic triggers are alcohol, nicotine, caffeine, full stomach, and
> > certain spices - garlic among them."
> So would surgery still be helpful for this 2nd group of patients? How
> would this condition be diagnosed? I have heard others argue that
> anxiety also causes these transient and inappropriate relaxations.
>
> I'm doing pretty well post fundoplication. I only had a 270 wrap and I
> am almost eating anything I want 6 weeks post op. I still get
> occasional gas pains, but that's about the sum total of my problems at
> this stage. The earlier post fundo symptoms - which seemed to mimic
> reflux - are all but gone. What is your view on partial wraps?

The condition and function of the LES is part of the manometry
evaluation (both conventional manometry and impedance manometry).
Fundoplication would work fine in either LES situation.

I think anxiety gets blamed for many, many physical ailments in today's
world - likely far more than is physiologically possible. Having said
that, I honestly don't know how anxiety would affect the LES. I do know
that there are MANY anti-anxiety medications out there. Anxiety should
be every bit as manageable as reflux.

Partial fundoplications have higher failure rate than a full wrap.
Furthermore, it's been shown that even patients with poor motility
ultimately do well with a complete fundoplication. In my view, there are
very, very few reasons to ever do a partial fundoplication for GERD.

Other than the higher failure rate, there's no downside to them. They
tend to work well, right up until they stop working.

HMc

From: christophe on 22 Jun 2008 04:07

On Jun 22, 12:06 am, H McCollister <nos...(a)nospam.com> wrote:
> In article
> <7715171c-3758-4c6d-9ac7-9c6ef88d1...(a)j1g2000prb.googlegroups.com>,
>
>
>
> christophe <chris_p...(a)optusnet.com.au> wrote:
> > Howard writes: " Some people have a low LES resting pressure, some
> > have a normal resting
> > > pressure but suffer from TILESR (transient inappropriate LES
> > > relaxation). Those inappropriate relaxations come from certain triggers.
> > > Classic triggers are alcohol, nicotine, caffeine, full stomach, and
> > > certain spices - garlic among them."
> > So would surgery still be helpful for this 2nd group of patients? How
> > would this condition be diagnosed? I have heard others argue that
> > anxiety also causes these transient and inappropriate relaxations.
>
> > I'm doing pretty well post fundoplication. I only had a 270 wrap and I
> > am almost eating anything I want 6 weeks post op. I still get
> > occasional gas pains, but that's about the sum total of my problems at
> > this stage. The earlier post fundo symptoms - which seemed to mimic
> > reflux - are all but gone. What is your view on partial wraps?
>
> The condition and function of the LES is part of the manometry
> evaluation (both conventional manometry and impedance manometry).
> Fundoplication would work fine in either LES situation.
>
> I think anxiety gets blamed for many, many physical ailments in today's
> world - likely far more than is physiologically possible. Having said
> that, I honestly don't know how anxiety would affect the LES. I do know
> that there are MANY anti-anxiety medications out there. Anxiety should
> be every bit as manageable as reflux.
>
> Partial fundoplications have higher failure rate than a full wrap.
> Furthermore, it's been shown that even patients with poor motility
> ultimately do well with a complete fundoplication. In my view, there are
> very, very few reasons to ever do a partial fundoplication for GERD.
>
> Other than the higher failure rate, there's no downside to them. They
> tend to work well, right up until they stop working.
>
> HMc

That was a brilliant answer. Thanks very much.
I really don't know why my specialist opted for the partial
fundoplication. I had no obvious motility problems at the manometry
and, as you said, the research seems to suggest that total
fundoplication seems to work whether a patient has motility problems
or not.
The specialist (at the post op consultation) did say that even though
it was a partial wrap, it was a very good one. He said it is also
tight (which took me some time to get my head around). More
encouragingly, like you, he was quite up front about the long term
results of the two wraps. He said the partial wrap had higher failure
rates at 5 years. If I get 5 years feeling like this, I'll be happy
provided it can be re-done.
I really appreciate your contribution here. I'm not really a pushy
person and didn't push for second opinions before surgery. [Perhaps, I
should have.] Anyway, I'm glad that you think the wrap will work well
for a while.
This leads me to my second line of questions, namely,
In your experience, how long do partial wraps last on average? Can
they last indefinitely? Is there anything I can do to preserve the
wrap? How easy is it to do a redo after a partial wrap?

Occasionally, I still have the odd problems with swallowing and only
yesterday was standing over the toilet almost gagging, spitting up
heaps of saliva. However, that was 5 minutes of discomfort in almost 2
weeks of eating almost anything I want! I guess this suggests that the
wrap is still functioning at least. Even though I feel great, I've
still got to concentrate and eat relatively slowly. One of the nurses
suggested that I should have half a cup of warm water before eating. I
think I'm going to have to resume this practice.
Thanks again and best wishes,
chris

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