sphincter muscle
in [Heart Medication]
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From: tdonline on 28 Oct 2005 15:16 I have read on boards where some people have reflux but their LES pressure measured out 'normal'. Can this be? Does this mean the LES is fine most of the time other than inappropriate relaxation? Does it mean their LES is only mildly demaged? Is this medically possible? And if so, what would be the reasons? Do people with reflux and normal LES pressure recover from GERD/LPR and lead life without strict management issues? It's really depressing to think I'll be sleeping on a slanted bed the rest of my life...
From: jmc on 28 Oct 2005 17:52 Suddenly, without warning, tdonline exclaimed (28-Oct-05 8:16 PM): > I have read on boards where some people have reflux but their LES > pressure measured out 'normal'. Can this be? Does this mean the LES > is fine most of the time other than inappropriate relaxation? Does it > mean their LES is only mildly demaged? Is this medically possible? And > if so, what would be the reasons? > > Do people with reflux and normal LES pressure recover from GERD/LPR and > lead life without strict management issues? It's really depressing to > think I'll be sleeping on a slanted bed the rest of my life... > I don't know, but I have symptoms of what my doctor colorfully calls a "floppy LES" but when I did the barium swallow, the test was normal. I absolutely can't sleep on a slanted bed, but aside from the recent antibiotic issues, the med I've been taking has controlled it well. Hopefully someeone else can answer your last question, as unfortunately I cannot. I'm afraid to come off the meds, as my reflux manifests as severe chest pain when untreated, and since I have heart issues as well, it'd be nice to know that the chest pain is "simply" reflux, and not something worse... jmc
From: Howard McCollister on 29 Oct 2005 01:02 "tdonline" <trinhd90(a)gmail.com> wrote in message news:1130527010.738918.230940(a)g49g2000cwa.googlegroups.com... >I have read on boards where some people have reflux but their LES > pressure measured out 'normal'. Can this be? Does this mean the LES > is fine most of the time other than inappropriate relaxation? Does it > mean their LES is only mildly demaged? Is this medically possible? And > if so, what would be the reasons? > > Do people with reflux and normal LES pressure recover from GERD/LPR and > lead life without strict management issues? It's really depressing to > think I'll be sleeping on a slanted bed the rest of my life... > Yes, pressure measurements of the LES can show its resting pressure to be normal, yet the patient can have transient inappropriate LES relaxation and severe GERD. The only people who commonly recover from GERD (other than those who have anti-reflux surgery) are those in whom obesity is a major contributing factor. Weight loss in that case can eliminate GERD. Otherwise, the other management issues you mention are pretty much life-long requirements. HMc
From: Howard McCollister on 7 Nov 2005 11:05 "jmc" <NOnewsgroupsSPAM(a)NOjodiBODY.HOMEus> wrote in message news:3sfkt8Fo8dpjU1(a)individual.net... > > I don't know, but I have symptoms of what my doctor colorfully calls a > "floppy LES" but when I did the barium swallow, the test was normal. > Barium swallow is a completely pointless test for GERD. The information it returns is, at best, incomplete, and at worst misleading. Very high false negative rate. A waste of time - ordered by doctors who don't understand the pathophysiology of GERD. The only way to diagnose GERD is with ambulatory pH testing. The only way to diagnose the *complications* of GERD is by EGD. The only way to diagnose the motility function of the esophagus (including the "floppiness" of the LES) is by direct esophageal manometry. HMc
From: jmc on 7 Nov 2005 13:59
Suddenly, without warning, Howard McCollister exclaimed (07-Nov-05 4:05 PM): > "jmc" <NOnewsgroupsSPAM(a)NOjodiBODY.HOMEus> wrote in message > news:3sfkt8Fo8dpjU1(a)individual.net... > >>I don't know, but I have symptoms of what my doctor colorfully calls a >>"floppy LES" but when I did the barium swallow, the test was normal. >> > > > > Barium swallow is a completely pointless test for GERD. The information it > returns is, at best, incomplete, and at worst misleading. Very high false > negative rate. A waste of time - ordered by doctors who don't understand the > pathophysiology of GERD. > > The only way to diagnose GERD is with ambulatory pH testing. The only way to > diagnose the *complications* of GERD is by EGD. The only way to diagnose the > motility function of the esophagus (including the "floppiness" of the LES) > is by direct esophageal manometry. > > HMc > > > Howard: Thanks for the info. I'm stuck with the UK health system for now, but am planning on getting everything reevaluated upon my return to the US. jmc |