Myotomy and sleeve to bypass revision due to GERD

[Kikikiki 13]

Did you experience any nausea from your gerd? Also you say that you experience now no acid reflux but gastric juice reflux, can this still lead to Barrett’s oesophagus?

[Foxbins 625]

2 hours ago, Kikikiki said:

Did you experience any nausea from your gerd? Also you say that you experience now no acid reflux but gastric juice reflux, can this still lead to Barrett’s oesophagus?

No, I didn't have any nausea with my GERD. I vomited acid a few times but I wasn't nauseated beforehand. I don't know if gastric juice minus acid can still cause Barrett's.

I think I am an exception in that because I had a myotomy, where my esophagus was widened, the gastric juice can more easily flow up. Many, many people on this board have had revisions to RNY for GERD and I can think of only one other person who still had reflux after surgery, so that makes 2 out of many. The vast majority of people are cured. I know you are worried but Barrett's is no joke. If conventional treatment is not improving your GERD, if I were in your shoes I'd have the RNY. Like I said, I am way better than I was with the sleeve and statistically you would most likely fall in the group of people who are cured.

[Kikikiki 13]

15 minutes ago, Foxbins said:

No, I didn't have any nausea with my GERD. I vomited acid a few times but I wasn't nauseated beforehand. I don't know if gastric juice minus acid can still cause Barrett's.

I think I am an exception in that because I had a myotomy, where my esophagus was widened, the gastric juice can more easily flow up. Many, many people on this board have had revisions to RNY for GERD and I can think of only one other person who still had reflux after surgery, so that makes 2 out of many. The vast majority of people are cured. I know you are worried but Barrett's is no joke. If conventional treatment is not improving your GERD, if I were in your shoes I'd have the RNY. Like I said, I am way better than I was with the sleeve and statistically you would most likely fall in the group of people who are cured.

I have my appointment next month so the surgeon can see what’s happening inside... I’m scared. You suffered with your GERD for a few years didn’t you? It’s been a month for me and it’s making me feel awful daily

[Foxbins 625]

35 minutes ago, Kikikiki said:

I have my appointment next month so the surgeon can see what’s happening inside... I’m scared. You suffered with your GERD for a few years didn’t you? It’s been a month for me and it’s making me feel awful daily

Yes, my GERD started about 2 years after my sleeve, and was pretty well controlled with a PPI up until about 3 years ago. It got worse over the past two years. Are you taking a PPI, using antacids, making dietary changes, elevating the head of your bed?

[Kikikiki 13]

On 10/01/2020 at 11:59, Foxbins said:

Yes, my GERD started about 2 years after my sleeve, and was pretty well controlled with a PPI up until about 3 years ago. It got worse over the past two years. Are you taking a PPI, using antacids, making dietary changes, elevating the head of your bed?

Wow! That must have been tough! It’s been a month so far for me and it’s sent me into a deep depression with how awful it’s made me feel! I am taking PPI and antacids every day but just not getting much relief.... I find I have flare ups I guess you could say where some days it’s so bad I’m on the lounge all day barely moving then other days it’s still there but I’m ok enough to get things done if that makes sense... I have been watching my diet more now and working with a dietitian but no relief from that either... were your symptoms constant and daily, or did they only happen every now and then over those years you were suffering?

[Foxbins 625]

18 hours ago, Kikikiki said:

Wow! That must have been tough! It’s been a month so far for me and it’s sent me into a deep depression with how awful it’s made me feel! I am taking PPI and antacids every day but just not getting much relief.... I find I have flare ups I guess you could say where some days it’s so bad I’m on the lounge all day barely moving then other days it’s still there but I’m ok enough to get things done if that makes sense... I have been watching my diet more now and working with a dietitian but no relief from that either... were your symptoms constant and daily, or did they only happen every now and then over those years you were suffering?

I had daily regurgitation, everything I swallowed came back up, and needed to be swallowed again, sometimes 3 or 4 more times. I had heartburn a few times a week, and learned to have antacids in the car, in my purse, next to my bed, etc. I had acid reflux mostly at night, it would wake me up with acid in my throat and sometimes in my mouth, and then I couldn't get back to sleep because I was afraid it would happen again. Being vertical helps move the acid down into your intestines, so I encourage you to stand up and walk as much as you can. So does drinking lots of liquid--it dilutes the acid that's there and moves it downward. I drink loads of Crystal Light each day.

I saw my surgeon today, he did an endoscopy, everything looks good, no gastritis, no esophagitis. He offered to put me on tricyclic antidepressants because they can help esophageal hypersensitivity. I said no thanks. I'll try what I'm doing now, keeping a food diary, walking 3 miles daily, raising the head of the bed, and using melatonin at night to help whatever residual lower esophageal sphincter function I have left. I really don't want to take any pills and especially not tricyclics. Too many side effects.

[TipTop in TX 81]

Foxbins,

Thank you for sharing your journey. It has been so helpful.

[Foxbins 625]

First trip since the pandemic started. Strangely, reflux was better, I am wondering if it's because I forgot to pack the Iron supplement. I know the iron irritates my intestines but I didn't know it could influence reflux. I will have to experiment with taking it/not taking it to see if that's the cause. Also, I found out I'm sensitive to some kind of sugar alcohol--I had pancakes for Breakfast one day and the Syrup in a little pitcher on the tray was thicksomething er and not sugary-sweet like pancake syrup. I used a few tablespoons and was treated to the most amazing amounts of bloating, gas, and liquid poop. I spent the afternoon in the bathroom. I think the waiter just grabbed whatever pitcher was nearest in the kitchen and either it was "diet" syrup or they buy something augmented with sugar alcohols because it's cheap. I won't make that mistake again.

[Foxbins 625]

Okay, things are still better. Iron definitely irritates my stomach and makes it produce more Fluid. My doctor suggested "gentle iron" and I will give that a try, if it doesn't work I'm pretty sure heme iron will, but it is so expensive and not covered by my insurance. I have also started using cognitive/behavioral interventions before I go to sleep to help me. Only woke up one night last week with the crawly esophagus feeling and that is an improvement. Doing a taper on the PPI because why should I take it? My staple line is healed and my reflux is not acid. It will also help with iron absorption if I can get some acid back into the common channel. I'm decreasing 10 mg a week over 8 weeks.

[catwoman7 11,214]

21 minutes ago, Foxbins said:

Okay, things are still better. Iron definitely irritates my stomach and makes it produce more Fluid. My doctor suggested "gentle iron" and I will give that a try, if it doesn't work I'm pretty sure heme Iron will, but it is so expensive and not covered by my insurance. I have also started using cognitive/behavioral interventions before I go to sleep to help me. Only woke up one night last week with the crawly esophagus feeling and that is an improvement. Doing a taper on the PPI because why should I take it? My staple line is healed and my reflux is not acid. It will also help with iron absorption if I can get some acid back into the common channel. I'm decreasing 10 mg a week over 8 weeks.

I've been doing carbonyl iron for the last five years - it's considered a gentle iron, along with a couple other versions, and I haven't had any stomach issues with it.

and yes - heme iron supposedly doesn't give people stomach issues, either. I think it's mostly the ferrous sulfate (??) that people have G/I issues with

Edited October 25, 2020 by catwoman7

[Foxbins 625]

2 hours ago, catwoman7 said:

I've been doing carbonyl Iron for the last five years - it's considered a gentle iron, along with a couple other versions, and I haven't had any stomach issues with it.

and yes - heme iron supposedly doesn't give people stomach issues, either. I think it's mostly the ferrous sulfate (??) that people have G/I issues with

I've been taking carbonyl iron since January and it didn't bother me until after the bypass. Switching now to iron bisglycinate chelate.

[Foxbins 625]

137.8 today. I am happy that I seem to have stabilized around 136-138. My BMI is 21, so I'm thin but not scrawny. Only one episode of reflux this week at night, but I was sick too, with a splitting headache that wasn't relieved by Tylenol. I rooted through the medicine cabinet and found some Vicodin from a long-ago dental procedure and took one of those. I finally went to sleep but woke up feeling pretty crummy, no appetite and still a bit of a headache, so I rested most of the day. I got the gentle Iron yesterday, I will start next Sunday because I just reduced my omeprazole dose again and I don't want to change too many variables at once.

[Foxbins 625]

Okay, weight is 137.6, BMI 21. "Gentle" Iron gives me diarrhea every morning. I think it's kind of funny that most everyone else has Constipation with an RNY, and I have had to buy a new bottle of Spray N Wash because of liquid farts. My GP suggested taking iron every other day and I may try that next week. I take it at lunch, sandwiched between bites--eat about half my lunch, take the iron and my Vitamin, and eat the rest of my lunch--so the irritation isn't in the pouch but in the intestines. Reflux is still happening, about three times at night this past week. Sriracha, even in small quantities, is a definite food for producing reflux at night. Vinegar also seems to be a culprit. However, reflux seems to be improving with the cog/beh interventions and dietary management.