Dyshagia .. hiatus hernia .. stricture of unknown origin

Reflux reduced but acid still creeping plus last 9mths difficulty swallowin. Went doctors aug16 (still no meds taken; bloods, blood press., cholest.. all good. Referred to hospital 260816 and considered emergncy so kept in for tests Advised my oesoph like a funnel .. narrow at bottom, stretched at top. Failed 2 endoscopies as food lodged in funnel. Had ct and barium meal. They suspect dysphagia/alchalasia "due to stricture of unknown". Obviously this is inconclusive and worries me big time but, for what its worth, im showing no visible signs of C and feel great. Got discharged 270816 from Hosp, they wouldnt do 3rd endoscopy, next procedure is on list for PET scan and take 1 20mm omeprazole each day. My acid does seemed to have reduced, still probs swallowing but im not happy taking ppis (want off them asap .. but got to give medical system a chance).

Im a bit up in the air at the moment. I gave nhs a try; got took in as emerg and got tests done. Then day before august bank holiday i get discharged on ppis , on a waiting list for PET scan, no further endoscopies planned yet ive got "a stricture of unknown origin" - scary and at no time has anyone mentioned treating my hiatus hernia which is the source of the reflux problem. In hindsight i should have engaged with medical system a lot sooner and any advice anyone could offer would be appreciated.

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  • Update ... out of the blue .. nhs called .. im back friday for endoscopy. Fingers crossed

  • Yes, fingers crossed - hope all goes well for you.

  • Cheers magnus

  • Thinking of you Garysreflux ...... I have a very large hiatal hernia and waiting for a date for surgery. Joannie

  • Thanks for your support. Wishing you an early op date. G

  • One thing they might give you is a high resolution manometry scan, something that might well pinpoint where the problem is occurring. There is an explanation about this in 'A Patient's Guide to Achalasia' that you can download from the OPA website. opa.org.uk/pages/achalasia....

    towards bottom of page.

    The food being stuck does suggest a motility problem. Achalasia is where the muscles do not contract and relax properly to propel the food down into the stomach because of the nerve endings not sending the right signals. Taking soft and fluid food, and trying to relax often helps a bit. Do not eat anything if your food has not gone down below chest level, and eat 'little and often'. Overloading your oesophagus will make things worse.

    I would not worry about taking PPIs for the moment, unless you have an adverse reaction. They have been around a long time, the side effects are probably overdone for the general population and it is more of a question of having a review after a couple of years to see whether they are still required.

    It would be sensible to investigate this stricture first, since that can cause a lot of problems, swallowing-wise. It may, or may not, be some form of achalasia. If you have the chance, do ask about having your hiatus hernia repaired, as the long term effects of exposure to reflux are not healthy.

    Achalasia is not cancer, but the Upper GI specialist centres will be the people to see as they are the same specialists for that part of the body.

  • Thanks ever so much for taking the time to respond to my post. I'll take your comments on board; they were a great help. Cheers. Gary

  • OPA_AlanM . Thank you for the information on the Manometry scan. It's something I have been waiting for as my last pre-operative test/procedure. I do eat little and often. I have also cut out wheat and gluten in my diet and making my own Gluten Free bread. It absorbs in the gut much easier.