Base of stomach formed right angle constriction (not pylorus) and causing aspiration. Any one else experienced this and is there an op ?

After oesophagectomy in 2007 I have now started to have bad reflux and aspiration leading to aspiration pneumonia at Christmas. Medics thought it was narrowing pylorus but endoscopy showed this to be OK - problem is that stomach has been pulled up and now forms a right angle or S bend at base causing constriction. Anyone else had this problem and know of a treatment ?I am permanently on Clarithromycin antibiotics to act as a prokinetic which help a lot but am concerned that I will develop a resistance to antibiotics.

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  • When the surgery is undertaken, there is probably some degree of movement and the position of the stomach over time, not least because the process involves a major change to the digestive organs in and around your chest. The (smaller / re-fashioned) stomach does stretch, sometimes in ways that probably cannot be precisely predicted, ad sometimes I think that this can have an effect similar to how you describe your situation.

    Surgeons will not want to rush in and try another procedure to correct the positioning, but something of the sort would no doubt be possible. Good surgeons tend not to do something complex if something simple will do the trick. So they are probably investigating and trying the easier things first. It sounds like a sensible investigation so far.

    There are centres in the country where they are more experienced at correcting these unwelcome developments, and there will be lots of expertise that could be brought to bear on this problem. One of the most frustrating things for a patient is when the doctors watch and wait. But they do so because of experience and judgement and it may take a time before this is resolved.

    Please give our helpline a ring on 0121 704 9860 if it would help to talk things through in greater detail.

  • Thanks Alan, I agree watch and wait but this has been going on for over two years with 17 hospital/consultant appointments, numerous endoscopies and GP visits, culminating in aspiration pneumonia as I mentioned. I have a further consultation on 21st June (the day of the strike!) and depending on outcome will contact helpline. (The first two years after op were fine apart from usual problems which we all seem to experience.)

  • The helpline (0121 704 9860) is definitely a good idea then!

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