Oesophageal Patients Association

Are there early signs of needing a stretch?

Hi there all of you that have had a stretch. What were the symptoms before you had it done?

As I have noticed recently that I am getting some pain (only mild) when I swallow dryish things like toast or biscuits. Haven't had a problem up to now, it's 19 months since my Ivor Lewis and I'm due back for a check up/scan in January. I was thinking that it may be at the joint where they stitched me back together but is this "normal". I have to add that I have still got a 'dormant' tumor in the same sort of area that they blasted with chemo and radiotherapy last June and thats what they will be looking at in January.

Any ideas? I will be speaking to my specialist tomorrow in any case but just thought I would scan any others for ideas.

Cheers

Colin

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Dear Colin

The stretch is usually for dealing with scar tissue or some other reason for the oesophagus becoming too narrow, and very often it is at the surgical joint. The food does not go down from the 'oesophagus' into the stomach properly - or at all. In my own case, the food had been resting too long before going through into the stomach and a 'pouch' had developed, but mine was not an oesophagectomy case so you should not take much notice of me in that respect. I think that people who have stretches often would have had the problem before the stage that you are at now, but I stand to be corrected.

I think that you are right to speak to your specialist as soon as you possibly can because they will always pay great attention when a patient notices any changes. I always think that it pays to be on the safe side with these things and if possible I would ask for the January investigation to be brought forward. On one hand it is not all sorts of food that seem to be causing the trouble; on the other if something is creating a swelling or constriction, the sooner you can get it sorted out the better. Which does not mean that it will be serious, just that living with uncertainty is best avoided if possible.

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Thanks for that Alan, I will be having a word with them tomorrow in any case and see what they say.

Cheers Colin

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Hi, I am interested to hear that with you too a pouch had formed. After Endo and Barium it is evident that a large j shaped pouch has formed well below the exit of my pull up ( 5 yrs post Ivor Lewis) which is uncomfortable and pressing on my diaphragm. I now have a 4 week wait to see my consultant to find out what can be done. If you could shed any light on what might be possible to remedy the dysfunction I would be most grateful.

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I am sorry to hear that. Does it keep that shape all the time or only when it is coping with a load of food? I realise that you may not know the answer though.

It will be a technical surgical issue as to what can be done, and I will try and find out.

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Thank you so much for this. The pouch has been worsening / drooping and now J shaped after being noted during endoscopies and a stretch proceedure last year. Re the shape I have only seen it on a Barium picture... full of the stuff! Well below the exit spincter! I have reduced portion sizes even further and find that I can no longer get comfortable to sleep at any angle. I am getting a stitch like pain right under my breast bone and have been aware of the pain when walking sometimes. Sounds like a right catalogue of woes.... I am a very positive post Ivor Lewis/cancer patient and still determined to thrive! Hate even having to list all this!

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Is there a point where food is being blocked from passing through, perhaps just below the bulge? Are your diaphragm muscles intact, or do you have anything like a hiatus hernia, to your knowledge?

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My surgeon contact says that it is a difficult situation, but it can happen, and it can sometimes be due to pyloric obstruction. Obviously a surgeon would need to have all the details before being able to say anything. Options are limited. You will have to wait to see what the surgeons say when you see them, but if you are still in doubt, please contact me again at that stage..

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Hi Colin

I was having a few problems a couple of years ago, but it turned out that my oesophagus was plenty wide enough. It was just food catching on the scar tissue, I have had no problems since. I hope this helps.

Kind Regards

Steve

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Thats what I am hoping for but you never know, thats why I was canvassing opinions but will still get it checked out.

Cheers Colin

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Hi Colin,

I had this problem with food sticking and a bit of pain at the new join, I had 3 stretches in total, in a period from about 12 months to 26 month after surgery.

All clear after the last one and problem has not returned since, now 5 years out from surgery.

Very quick and easy endoscopy procedure, so nothing to worry about.

Best regards,

Davec

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Hi there Dave, thanks for that. It's what i am hoping for but as I had notice of another tumor that is in the same sort of area but not changing I was getting a bit concerned. I will know more once I have seen the specialsts, it's just that not knowing bit beforehand that gets me down. I hope to get to see one soonest and will post a note soon after.

Cheers Colin

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Hi Colin, I had swallowing problems, mentioned it on my first 3 month visit, they put a camera down my throat straight away. It was scar tissue causing the problem and I was told to eat smaller mouthfuls and chew longer, never had a problem since:) Doctor was happy with what he had seen and put me on 6 monthly visits.

All the best

Mark

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Thanks Mark, it looks like I have been fairly lucky till now then as this has only come on recently. It did feel a bit tight for a few days then this pain started. Today however is better so I will try your method anyway but still get it checked out, Just need to pin down the specialist now.

Cheers

Colin

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I had the Ivor Lewis Oesophagectomy done 7 years ago and needed 6 dilatations of the join within the 1st year then everything was ok until recently when i started having problems swallowing again. It turned out that i needed another dilatation. Since i had that done in June i have had an OGD again but i didn't need another dilatation as yet but i have been told that i can phone up and book one if my swallowing gets bad again.

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Hi there Christine,

just replied to Mark on this subject so I won't repeat all but just to say thanks for the reply and if I can get booked in to have it done it may not be a problem after all. It's just that when you feel these changes, you don't know straight away what it is likely to be. It's like my ribcage, which I hadn't noticed until I was in the gym the other day, I have a bit sticking out on my right side where they cut me open. I guess the ribs didn't join properly. I didn't notice it and now I know why I have a few twinges if I sit in my armchair like I used to do, it comes on gradually but is eased by changing to a different position.

However well done on 7 years and counting, lets hope for many more for all of us.

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