why can't they just fix the stupid valve?

  • Thread starter Thread starter melkon
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melkon

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Sorry to rant, but I'm just so annoyed that there isn't some kind of relatively simple surgical fix that would replace/augment the blasted LES. It just doesn't seem like that complicated of an area anatomically. I see amazing surgical techniques pioneered all the time - organ transplants, pacemakers, artificial hearts, lasik eye correction etc. The current surgeries for GERD seem more complicated/risky than necessary. If surgery had less risk and better long-term outcome projections I'd go do it tomorrow.

This maddening GERD is so common I just don't know why they haven't figured out a simpler way to fix it mechanically rather than requiring lifeling medication (which in my case has pretty much stopped working). Why don't they just implant a little ring at the base of the esophagus that you could control with some kind of remote switch - you know you'd just set it to OPEN during a meal, then CLOSED afterworRAB?
 
Your concern is certainly well taken.

I think though, that the LES is a bit more complicated than one might think. The operation of such must be exact. Too weak and you get GERD and too strong, and that can cause other problems. It has to be just right. When surgery is done, it gets really complicated.

I am sorry that you are not able to experience relief. Maybe there are other options that you'd like to try? If so there are many on here that can help with many ideas and angles.
 
In my opinion, it is all about the drug companies. Acid reflux/GERD is a multi-billion dollar business for the drug companies and they can sell to the Dr.'s that a little purple pill can fix it all, no need for extra research on alternative or surgery cures.
 
I have two thoughts on this. My boss did have a surgery to fix his GERD and while he no longer refluxes, he also cannot vomit. So if he gets a stomach virus or food poisoning, he just has to deal with it. No way to get it out that way, unless he has his stomach pumped.

Before I pose my other thought, I'd like to preface it that I have GERD and was on Prevacid for the last 9 years- I've done the routine of having the upper endoscopy and the discomfort of acid indigestion, the horrid pain of having an eroded esophagus, and the myriad drugs that just didn't work.

So my other thought is why we- as patients- aren't doing more to find out why we have GERD to begin with. It's becoming so prevalent, as mentioned by the OP, and yet...you rarely hear anyone try to find the root cause. In my case, the root cause was that I had an allergy to dairy products. Not an intolerance, like lactose intolerance, but an actual allergy. After 9 years on Prevacid, I was seeking treatment for an unrelated illness (Hashimotos Thyroiditis) and my doctor put me on a food elimination diet to determine if I had allergies. My acid reflux went away. When we added milk and other dairy products back in, I began refluxing again, burning in the stomach, etc. I no longer eat or drink dairy products and I have weaned myself from taking 30mg Prevacid Rx twice a day, to once a day, to switching to 15mg Prevacid OTC once a day to taking it once or twice a week. I should be done with PPI's altogether within another month or so.

Not everyone is going to solve their GERD by finding they have a food allergy, but it wouldn't be surprising if some people had a similar cause for their GERD as I did.
 
I agree that the drug companies like having a huge market of sufferers dependent on their pills. I wouldn't care that much except the drugs don't always work that well, or at least not indefinitely, and they have side-effects too as well as often being really expensive. I just don't see why something that's basically just a little on/off valve can't be mechanically tweaked to allow us to get our lives back. I guess any internal surgery is going to be a bit complicated by definition, but when you think of all the routine surgeries out there I just don't know why this problem doesn't have a simpler fix.

I also agree that as patients we often don't know exactly what's causing the reflux. I've had lots of tests over the years, but I still don't really know why my LES doesn't work right, or even if that's the root problem. I've had chronic daily heartburn for 15+ years and I really have no idea why. The doctors don't seem that interested in finding out, they just want to get you out of their office with a prescription in hand so they can move on to the next appointment.
 
I have mixed feelings about this.

For most people, acid reflux can be controlled with diet, exercise and lifestyle changes. There are various homeopathic approaches that work for many people. Medication should not be the first thing we turn to.

I also agree that it is best to try to find the underlying "causes" for why our acid reflux is flaring. It is a hard thing to do in many cases. Especially, if it isn't obvious. Many doctors are all about the prescriptions to address the symptoms. Others look at a few other common "causes" and leave it at that.

That said, I have relied on reflux medications for many years. I tried many lifestyle changes initially and continue to practice many of them, but have been unable to find an underlying trigger. On the flip side, I've been able to rule out many things, such as food allergies, over the years. I eventually ended up on PPI's twice a day. After years, they stopped working. I was put on all of the PPI's on the market and ended up with a pretty nasty long-term side-effect from one of the most popular PPI's on the market. PPI's really should be used for short-term treatment. For many of us, we've been on it for many years and there hasn't been a lot of research on the side effects of this. There was a recent study that did indicate that long-term use can make bones more brittle.

Eventually, my reflux literally became life-threatening. The acid was irritating my lungs and triggering my asthma to the point I needed emergency treatment. At that point, I opted for the "fix" of surgery. I had a Nissen Fundoplication where they wrapped the upper part of my stomach around my esophagus. When the stomach contracts, it keeps the acid from coming up into the esophagus. This is an extreme and serious treatment for the reflux. It doesn't work for everyone and for all practical purposes is irreversible. There are a couple other surgical approaches, but from what I've read, they don't work for everyone either. (BTW, I can't typically can't vomit and it can be very uncomfortable when dealing with a "sour" stomach, but I did have one stomach bug that was so bad that it did make its way up. Everyone will be a bit different here.)
 
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