Question about ERCP and S.O.D.

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NYCman

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I've heard of some people having a ERCP done, and the doctor finding S.O.D. Sometimes the docor uses his instruments to tighten up while he's already down there. What is the difference between this procedure, and a Nissen Fundiplication?
 
While they are both gastrointestinal, they really are two totally seperate things.

I haven't had any experiences with ERCP and S.O.D., but from what I've read, they involve the bile ducts, gallbladder and pancreas. During the ERCP, a sphincterotomy during an ERCP involves cutting of the sphincter or muscles at the juncture of the intestines and the bile and pancreatic ducts.

What I do have experience with is the Nissen Funcoplication. It is not done Endoscopally, but rather laproscopically (sp?). They make 5-6 incisions across the abdomen to insert their equipment. They then go in and stitch the stomach around the base of your esophagus. They may also repair a hiatal hernia if you have one. The result of this surgery is to have the stomach contract around the esophagus and keep acid/food from coming up. Basically acting as a "new" Lower Esophageal Sphincter for one that has malfunctioned.
 
Thanks MountainReader, I have mildly incompetent L.E.S.

I recalled reading that some get the Nissen done and they actuaally end up feeling worse. Gas all the time, and things like that, right?

I also read of someone whose liver and pancreas levels were normal, but the ERCP showed S.O.D. I wonder if there are any drawbacks to getting this S.O.D. "cutting" procedure done.
 
In response to the concerns with the Nissen Fundoplication, there are some potential side effects. If your LES is only mildly incompetent, it may not be a good next step for you. The Nissen is a serious surgery. You have to chew food well for the rest of your life to keep food from getting "stuck" above the wrap. It is really unpleasant when this happens, but eventually the food does go down. Also, gas cannot come back up. This means that gas can get trapped below in the stomach resulting in Gas Bloat Syndrome. This is a syndrome specific to those who have had the NF. Another side effect I've had is some occasional intense nausea. I also have days where I feel just fine.

For those considering the NF, I would personally recommend it if their LES is really not working. It has been very helpful for me. I was having major breathing problems from acid irritating my lungs and flaring my asthma. I couldn't get my asthma under control because I couldn't get my reflux under control any more. My Manometry results showed that over the course of the last 3 years my LES functioning, which wasn't great to begin with, had gotten worse. For me the reflux had become life threatening, per my Pulmonologist. The NF was literally a life saver for me.

I hopoe someone else can respond on your SOD questions.
 
I would only consider S.O.D. as a potential culprit of my problems if I take Nexium, and Nexium has no benefit to me. I was just worried because I had heard of some negative things regarding the Nissen, and I wanted to make sure that it wasn't a procedure used to fix S.O.D.

Thanks.
 
I have heard that it makes it very hard to burp and that can be very painful. I have a hard time burping as it is which I don't understand if my LES valve is so floppy to allow so much acid up.
 
It is definitely good to begin more conservative.

With the Nissen, many have trouble burping. No problems there at all for me. Can't vomit though.
 
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