Re: Thanks for help re my teenage son (more questions too!)

[Guest guest]

Sally, I agree with most of the others who have written and

also think you should have a 2nd opinion now. I don't recall

if you told us where you live. There maybe members here who

can refer you to a doctor with lot of experence near you.

Aspiration can cause pneumonia. Here is some symptoms I

picked up from a website:

Symptoms

Aspiration of tiny foreign objects are usually noted immediately with coughing, wheezing, respiratory distress, or total lack of air exchange. However, aspiration may cause only minimal initial symptoms and be forgotten until later symptoms related to local inflammation or infection develop

If you suspect he is doing this, please raise the head of his

bed. You can use blocks, bricks, whatever you have that will

keep his head higher as he sleeps. If he has any of these

symptoms I'd report them to a medical professional.

Hope this helps, and do let us know where you are.

Maggie

Alabama

[Guest guest]

Sally wrote:

Now a few questions from us

parents, who are busy researching, but

trying not to alarm our son with too much probing.

It is good that you are researching. That is one

way to know if your doctor is fallowing standard procedures. There are

different ways that doctors have, but some things, like doing a

manometry, seem to be wise no mater what else may be different.

He mentioned the other

day that he thought he might have food up his

nose as he could smell some food he'd had the day before-is that

possible?

This is very possible and I have had times where I

got a chunk of food stuck in my sinuses. It can be very irritating and

lead to sinus infections. There have been reports from this group from

people that have had chronic sinus infections. The food can get into the

sinuses, at night from regurgitating while asleep, or coughing up food

while trying to eat. If he is having problems at night, raise the head of

his bed by putting blocks under the legs.

It is also possible that the food he ate the day before is still stuck in

his esophagus. Food can be stuck in there for days. People fast before

surgery but often there is still food in the esophagus that must be

removed. Some surgeons don't even have the patients fast and just plan on

cleaning them out first.

Also,If he did aspirate

particles of food, what would the

effect be? How would we know that he had?

Generally, you cough after aspirating food or drinks, and sometimes it

can be hard to stop coughing. Food can damage the lungs and cause

pneumonia.

Lastly (for now) what is

manometry-should he have had it done?

Manometry is a way that motility studies are done, where they see how the

muscles in the esophagus move and how strong and coordinated they are.

Achalasia is rare and there are other disorders that look a lot like

achalasia but can be determined with a manometry. I don't think you can

be sure you have achalasia if you don't have a manometry. A tumor near

the LES can produce a barium swallow that looks just like achalasia and

the tumor may not show up on the X-rays, but it will produce a different

manometry result. He could just have a stricture which would also produce

a different manometry.

When you talk to his doctor find out how far above and below the LES he

cut and what kind of wrap, if any, that he did. This will give you

something to compare when finding out how other doctors do it. They don't

all do it the same.

The wrap question is important because it may be a factor in what is done

in the future, and why he is still having problems. Sometimes a wrap is

too tight.

Even though he seems to be coping, the extra pressure in his esophagus

could be causing it to become wider (dilated), or produce a pouch

(diverticulum). A TIMED barium swallow (ideally this would include a

barium meal and barium drink) and a manometry would help to know how he

is doing now. As a last resort, if the esophagus become to dilated the

esophagus is removed. One of your goals is to not reach that point.

Another test you may want to consider is a ph monitor. Strictures can be

cause by acid reflux. The could mean the LES is to loose not too tight. A

surgery for achalasia can by itself lead to acid reflux (GERD or GORD).

His pain may be acid reflux.

Do a lot of research and then get a second opinion, from someone that has

treated lots of achalasia patients, but don't rush unless you have too.

You may have to travel to get a good second opinion.

notan

[Guest guest]

> Thank you for your ideas, the main reason I have not pushed for

more

> treatment is because he is coping well at present (drinks seem to

> help the chest pain) He is not losing weight,and with patience can

> eat most of what he needs. I guess we are a bit scared of what the

> doctors will want to do next, especially as they did the Heller's

> without anything other than the Barium to go by-we did feel a bit

> rushed into drastic treatment.

> Now a few questions from us parents, who are busy researching, but

> trying not to alarm our son with too much probing.

> He mentioned the other day that he thought he might have food up

his

> nose as he could smell some food he'd had the day before-is that

> possible? Also,If he did aspirate particles of food, what would the

> effect be? How would we know that he had?

> Lastly (for now) what is manometry-should he have had it done?

> Thanks again for your help and advice!

> Sally

HI Sally- yes, it is possible to have food up your nose or in your

sinuses. I used to have quite a problem with regurgitation some time

ago, not to be gross, but I had to blow my nose in the shower in the

morning to make sure I got anything out. The hot steam helps open

your sinuses out.

He needs to start sleeping with the head of his bead elevated so the

gravity will keep food down. I also found at that time that I

couldn't eat after dinner and would drink just plain water -

figuring, if I did aspirate, it was safer than other fluids or food.

As far as the menometry - although I found it very unpleasant, my

understanding is that it's the only test that will definitively

diagnose Achalasia - I would insist on one before any other

treatments are recommended.

Ask, ask, ask - as you'll see from many posts here, and I can share

from some personal experience, there are even many

gastroenterologists who have never treated A. If yours hasn't, get a

referral to a specialist who has and don't take no for an answer!!

Good Luck

-

[Guest guest]

Hi Sally,

I echo much of what the others have said. You can get stuff up your nose from regurgitation - it has happened to me ! If it is still there and not got washed away with nose secretions then perhaps he could sniff salt water [ 1 teaspoon salt to 1 pint of cold boiled water] which might help to wash it out. I have heard of sinusitis after aspiration as well.

When you aspirate food you usually cough a lot. If it is just small amount then he might not cough much but it is usually a nagging cough. IF the stuff goes down further then he might get pneumonia and this will show up with fever and a cough.

Anti acid forming pills like Nexium and others do help to control this. He must sleep with his top half elevated as Maggie described to you. Often you need to go higher than the few bricks. Some folk use a wedge pillow.

Do get a second opinion from a doc who is familiar with achalasia.

Joan

Thanks for help re my teenage son (more questions too!)

Thank you for your ideas, the main reason I have not pushed for more treatment is because he is coping well at present (drinks seem to help the chest pain) He is not losing weight,and with patience can eat most of what he needs. I guess we are a bit scared of what the doctors will want to do next, especially as they did the Heller's without anything other than the Barium to go by-we did feel a bit rushed into drastic treatment. Now a few questions from us parents, who are busy researching, but trying not to alarm our son with too much probing.He mentioned the other day that he thought he might have food up his nose as he could smell some food he'd had the day before-is that possible? Also,If he did aspirate particles of food, what would the effect be? How would we know that he had?Lastly (for now) what is manometry-should he have had it done?Thanks again for your help and advice!Sally