Advice

[souljacs4]

Can anyone tell me what the best procedure would be to close off the oesophagus to stop acid I have been told I need this done but there are a few procedures to choose from one with a bead wrapped around oesophagus and then some look like major surgery also can I get list of surgeons anywhere.

[Milk0]

I think it depends on the level of acid coming up. Also what size you are. I had to have a gastric bypass. No other operation would of been as successful. But before anyone has gastric surgery they and there family need counciling. I never got any. It's a different world now. The way you look at every day food changes. Eating becomes hard work and mind numbing. On the plus side it did solove the massive acid reflux problem I had instantly. But if I could of done it without this operation I would of. Hope it's been a help.

[souljacs4 in reply to Milk0]

Thank you

[chrisrob]

To prevent acid reflux, the gold standard treatment is fundoplication where the top of the stomach is wrapped around the lower oesophagus. It has been performed for 60 years, the last 20 of which laparoscopically. A recent paper following up 20 years of Laparoscopic Nissen fundoplication (LNF) found 94% of patients were satisfied.

There are now a number of alternative treatments being offered. The LINX "bracelet" is a ring of titanium magnetic beads on a wire that is placed around the lower oesophagus. A recent paper showed that after 5 years 85% of patients were satisfied.

Apparently, Dolly Parton had the device fitted in 2013.

LINX has been heavily promoted in US as, whenever a new clinic offers the treatment, it makes news that a new cure for reflux is being offered. It has also been promoted by exaggerating negative points about LNF and by stressing LINX is reveresible so if it doesn't work you may have it removed and go for LNF instead. But it's twice as expensive as LNF. (Would you buy an expensive car that may not work and then pay the salesman to take it back and then buy the cheaper model that does work?)

40 years ago, people were clamouring for Angelchik (an artificial wrap made of gel filled silicon rubber) but 20 years down the line, they were all clamouring to have it removed as complications had set in.

There are other treatments available that are performed endoscopically but do not have such a good success rate. Stretta uses radio frequency energy to cause scarring tightening up the lower oesophageal sphincter but only 72% were able to reduce their acid suppressant medication by more than 50% after 2 years.

Endoluminal gastroplication (TIF, Esophyx, MUSE) uses a "stapler" inserted by endoscope to perform a plication at the end of the oesophagus tube but this too only has around two-thirds satisfaction rate.

I am presently attempting to research and compile details of the various treatments here: sites.google.com/site/barre... but it won't be ready for a couple of weeks.

[souljacs4 in reply to chrisrob]

Thank you very helpful

[Hidden]

The Linx bracelet is relatively new in the UK. I know that Majid Hashemi at University College Hospital London has done some operations with it, and Ken Park at Aberdeen. It is primarily being aimed that patients for whom medication does not work sufficiently. It is done laparoscopically (ie keyhole) like may other surgical procedures these days. This is the kind of issue you need to talk through with your trusted surgeon. There is some more general information about Linx and other options here: nhs.uk/Conditions/Gastroeso...

I think it might all depend on the advantages / disdvantages of a medical device rather than surgical options.

[pferries31]

Hey Alan, Ken Park is my Surgeon. Nice to hear of our Surgeons being known. He performed my Oesophajectomy in 2012. I still have quite a few issues and always wonder if this is it now. Due to get a CT scan soon and see what that brings.

[gutlesswonder]

Hi souljacs4

Have you really exhausted all the possibilities of medication/diet/posture/stress etc etc ?

The GI Tract is not simply concerned with alimentation; it is our second brain and the largest endocrine organ --any surgical alterations have profound implications for every aspect of our total existence. Do nothing lightly.

Chrisrob has the right ideas.

[souljacs4 in reply to gutlesswonder]

Thank you