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Re: Qustion on HM w/wrap

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Barb wrote:

>

> When someone has a Heller Myotomy w/Dor Fundoplication, would the wrap

> usually loosen or tighten in years following the procedure? ...

>

In the short-term tightening is the problem, but years latter being

loose is the main problem. Being loose can cause more acid reflux which

can cause scarring in the esophagus. That scarring causes a stricture

that results in swallowing problems again. Reflux may be one of the main

causes of long-term failure. Of course you also risk reflux without a wrap.

notan

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Notan,

I am SO glad to see you back on the board!! Wish you the best for your continued

recovery!!

Your knowledge is more helpful than the GI specialist. My current specialist is

having trouble explaining my condition, did not seem to have good notes from my

testing!! I think it is time to find a specialist who understands this condition

and is approachable for questions and follow-up. With so few with A experience

our selection is limited.

I was told at my last endoscopy, while I was still under conscious sedation (my

husband heard this), that my wrap may be loose. So, over time I guess my wrap

will only become looser? At my follow up appt 3 months later he had not notes to

this effect and no indication to his findings. What a waste. I am desperate to

find a qualified, reliable doctor.

Thanks for your expertise!!

BC

> >

> > When someone has a Heller Myotomy w/Dor Fundoplication, would the wrap

> > usually loosen or tighten in years following the procedure? ...

> >

>

> In the short-term tightening is the problem, but years latter being

> loose is the main problem. Being loose can cause more acid reflux which

> can cause scarring in the esophagus. That scarring causes a stricture

> that results in swallowing problems again. Reflux may be one of the main

> causes of long-term failure. Of course you also risk reflux without a wrap.

> notan

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My surgeon told me I could expect to have surgery last twenty years. That's how

long he has being doing this procedure.

Achalasia is a rare disease and it takes time to gather enough people to do

research to know how long surgery lasts. That is probably why you are having

problems getting answers. Doctors simply do not know for sure. The surgical

techniques and instruments and diagnostic equipment used today are not the same

ones used even 15-20 years ago to compare results. Today surgeons are even using

robotic assisted surgery.

By a lose wrap do you mean a partial wrap? I don't think there are any studies

published now that compare the types of wraps. I know there is a study

collecting data in Seattle right now.

>

> When someone has a Heller Myotomy w/Dor Fundoplication, would the wrap usually

loosen or tighten in years following the procedure? Would a patient have more

complications with a loose wrap? I get the opinion the specialists do not have

answers and that is why they cannot answer questions. This group explains this

condition more than any doctor I have seen. Thanks to all!!

>

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My doctor said my wrap could be loose. I took it to mean could be floppy, not

tight enough. I was wondering if some of my pain could be from food getting hung

up in wrap instead of going into stomach. Doctors do not offer much info and I

have found some do not keep good records and cannot explain some testing that

was done previously, like an endoscopy. I just want to find a GI specialist who

understands this condition and can follow me as a patient and I not have to

explain every procedure/testing that has happened since being diagnosed at every

visit. If they have a profile on their computer they should be able to read and

have some idea of the patient's history. I have started to keep a brief history

report and take it with me at all appointments, basically I am doing their job.

I feel like a new patient at every appointment. Do others feel like this?

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Notan, thank you!! I wish I could find a specialist who had even 1/2 the

knowledge of you. So far I have been unsuccessful in finding someone who

understands this illness, much less explain it.

Any suggestions of the BEST in the Mid-Atlantic area on the east coast? Thanks.

Barb

-

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The wrap is from outside i.e outer wall of the esophagus. So there is no

question of food getting hung up in the wrap. Loose means that there is reflux

and this could be the reason for pain. If you are seeing the same GI, then

he/she should have all the details which you gave on your first consultation. It

would be a good idea to ask the surgeon who did the HM to send the report to

your GI. Since there is no centralised database, the information may be patchy

but your primary physician should still have all the requisite info

achalasia

From: bagwoman52@...

Date: Thu, 29 Sep 2011 00:08:26 +0000

Subject: Re: Qustion on HM w/wrap

My doctor said my wrap could be loose. I took it to mean could be floppy,

not tight enough. I was wondering if some of my pain could be from food getting

hung up in wrap instead of going into stomach. Doctors do not offer much info

and I have found some do not keep good records and cannot explain some testing

that was done previously, like an endoscopy. I just want to find a GI specialist

who understands this condition and can follow me as a patient and I not have to

explain every procedure/testing that has happened since being diagnosed at every

visit. If they have a profile on their computer they should be able to read and

have some idea of the patient's history. I have started to keep a brief history

report and take it with me at all appointments, basically I am doing their job.

I feel like a new patient at every appointment. Do others feel like this?

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