Help please!

[Steve101]

My wife had surgery for oesophageal cancer 5 weeks ago. T2 N0. M0. All went well at first. Then she developed pneumonia and aspirated bile. She had abdominal pains. Her condition deteriorated and she had sepsis and was rushed into ICU. She was there for 17 days. 10 on a breathing tube and 7 with a tracheotomy. The good news is that she has beet the infection and is now in step down. It also turned out she had a herniated bowel that they had to operate on (whilst in ICU).

However, the swallow test she had before going into ICU showed that the stomach wasn't emptying, they have inserted a balloon once to dilate pyloric sphincter but that hasn't made a difference. They have repeated the swallow test since coming out of icu and it still is not opening. She has an NG tube and that is draining off bile, so the sphincter must be opening to allow bile to pass up to stomach. So why won't it open to let the stomach drain. I'm really worried. The surgeons are at a loss to know what is happening. Any thoughts and help would be much appreciated.

Thanks

Steve

[Hidden]

I suffered the same 5 days after the op (4 years ago) But recovered in the end.They dilated my opening in my stomach to empty food.It was an awful time but got better quite quick.I am sure it willl be sorted as it puzzled my team for a few days.

[Steve101]

Thanks Griff for the reassurance.

[Steve101]

I read a post yesterday on this site, about a person who took antibiotics and they found out by accident the antibiotics also helped the passage of food through the stomach. I'm trying to find th epost again, but unable to find it, anybody know where it is?

Thanks

Steve

[2Chrissie4]

Hello it sounds like she has Pyloric Stenosis and the surgeons have already tried the first treatment and that is stretching the Pylorus Sphincter. They can try using Botox next (I have had this that is why I mentioned it) and as a last ditch resort they can operate on it (which is a quick operation) and cut through the sphincter called a sphincterotomy where they make a lengthwise cut through the sphincter and therefore openinch the Pylorus up. Good luck and hope she gets better soon.

[Steve101 in reply to 2Chrissie4]

Thanks Chrissie

I have just heard that my wife is going down to theatre to have the botox! So you were right.

I still have some concerns though, as the pyloric sphincter is allowing bile to pass into the stomach, but wont open to empty the stomach. Am I being silly but that does not make sense to me. My wife is being fed through a feeding tube in the duodenum, and I read a posting on this site where someone was getting bile reflux into the stomach. The thoughts were that the feeding tube was allowing no where for the bile to go but escape back into the stomach. They halved the feed through the duodenum and the bile reflux stopped!

There are worrying times.

This is such a good site, really helps to chat to people that have been through it.

Thanks

Steve

[2Chrissie4 in reply to Steve101]

Forgot to mention in my prevous post just now. I have to use a Jejunal feeding tube every night for a feed with a pump because I cannot eat or absorb enough nutrients by mouth. So I understand the problems that your wife has. Please message me if you want more information. Let me know how things go with your wife. Give her my regards and hope that she gets better soon

[Steve101 in reply to 2Chrissie4]

Hi Chrissie

I am getting very anxious. My wife had the pyloric sphincter stretched and Botox injected. The surgeon showed me the pictures and the new stomach is looking healthy and the pyloric sphincter is open. They are now measuring what my wife is drinking and what is coming back up the NGO tube. One thing that is different is that bile is no longer refluxing into the stomach, I know it is only hours after operation but there appears to be as much coming back up the NG tube as my wife is drinking. You would think that as the pyloric sphincter is open it would just drain.

I have two thoughts:

They have not given my wife any motility drugs - would this help to get the system moving?

I have read a post oh here where the feeding tube was causing the duodenum above it (closer to stomach) to back up. That person halved the feeding tube dose and the bile reflux stopped and they were able to eat again. I mentioned this to my consultant and he just dismissed it.

Chrissie - if you are able to share your experiences with me that would be really helpful. Are you going to be on a feeding tube for the rest of your life?

Thanks

Steve

[Steve101]

Chrissie - I meant to ask did the botox work for you?

Steve

[2Chrissie4 in reply to Steve101]

Yes, the Botox worked but there are drawbacks to having the Botox in this area. The Botox wil relax the sphincter to a point that it will allow reflux from the gallbladder to flow back up through the stomach into the oesophagus and what is worse the throat and mouth. That is the downside to Botox. I now have to take a capsule similar to Omeprazole every morning and evening as well as a liquid medicine called Antepsin (there is a supply problem with this medicine in the UK). What is good about Antepsin is that you can take up to 8 doses in 24 hours and is brilliant at controlling acid reflux and bile reflux. There is nothing that can be done for this kind of reflux especially in my case because of previous surgery on the stomach and gullet I:e Oesophagectomy.