Stretta for GERD

[theguyfromanotherforum]

Sheryl, are you familiar with this new non evasive procedure to treat Acid Reflux? The results seem very encouraging, but I am not sure if anyone does it here in Thailand?

 

I am also curious if GERD is only triggered by Hiatal Hernia (which I suspect to be in my case, but not 100% sure) would this procedure really help?

 

Any info on this?

 

 

[Sheryl]

It is not non-invasive, but rather minimally invasive - it is an endoscopic  procedure.

 

Not being done in Thailand AFAIK

 

The procedure is being very aggressively touted by the manufacturer of the device and you need to look carefully at articles about it because most of them are by that company or funded by that company. The procedure remains controversial and the only independent studies I have seen have either shown it to be about equal to conventional laparascopic surgery in effectiveness, or to be altogether ineffective - but there are not a lot of such studies and their sample sizes are small.

 

https://www.ncbi.nlm.nih.gov/pubmed/25459556

 

If the GERD is caused by hiatal hernia of more than 2 cm in size you would nto in any case be a candidate for this procedure.

 

Hiatal hernia can be diagnosed on endoscopy or by a barium swallow. conventional surgery has about a 90% success rate in terms of fixing the hernia and about 70% success rate in stopping reflux, success rate for reflux is lower since it can exist even without h.h.

[ThaiPauly]

I suffer greatly from GERD, especially at the moment, it's all the time every day, sometimes it's worse than others but it's a real bain in my life right now.

 

I had an endoscopy and a colonoscopy done at CMR last week and the doc said that he could find nothing wrong with me. He gave me a few pills Pariet and Ganaton  told me to change my lifestyle (which I am in the process of doing) and sent me on my way. I thought maybe that having read up on it a small operation may cure me?

 

I think I need to go back to see him again or should I take the report to another hospital? I don't really know what's best? The Doc is very popular and is always busy...maybe too busy, and the price they charge now....well price gouging is the only thing I can say about it, 10k more than their quote  and that was high enough, over twice what I paid 3 years ago when I had my last one done.

 

Any suggestions would be more than welcome

 

Many thanks

[theguyfromanotherforum]

11 minutes ago, ThaiPauly said:

I suffer greatly from GERD, especially at the moment, it's all the time every day, sometimes it's worse than others but it's a real bain in my life right now.

 

I had an endoscopy and a colonoscopy done at CMR last week and the doc said that he could find nothing wrong with me. He gave me a few pills Pariet and Ganaton  told me to change my lifestyle (which I am in the process of doing) and sent me on my way. I thought maybe that having read up on it a small operation may cure me?

 

I think I need to go back to see him again or should I take the report to another hospital? I don't really know what's best? The Doc is very popular and is always busy...maybe too busy, and the price they charge now....well price gouging is the only thing I can say about it, 10k more than their quote  and that was high enough, over twice what I paid 3 years ago when I had my last one done.

 

Any suggestions would be more than welcome

 

Many thanks

 

I suffer from non stop GERD. What are your symptoms as they vary greatly.

[ThaiPauly]

Severe bloating, pain that I cannot reduce without taking Gaviscon which has become my best friend laboured breathing

Burning sensation in my chest, soda water helps sometimes, but nothing takes away the underlying problem, whatever it may be but nothing "Cures" it. It has been going on 3 months now and has got steadily worse. I have had it before , but never as bad as this.

[Sheryl]

I suggest you see a cardioligist to rule out cardiac problem. Gastritis/GERD symptoms and those of angina/heart attack can be very similiar.

 

If you have gastritis would have shown on gastroscopy. Would usually also be indications if there was GERD.

 

There is no "small operation" that cures GERD. In the minority of cases where the GERD is due to a hiatal hernia, if conservation approaches fail there are surgical options but neither small nor always effective. In any case with a negative gastriscopy (I am assuming totally negative findings -- if you can, post the report) it is unlikely your pain is gastric in nature. See cardiologist and soon. If necessary go to ER. Do not tell them you have GERD (a self diagnosis) just describe the pain and its location.

 

If cardiac problem ruled out next step would be to consider possible gall bladder problem.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

 

 

[ThaiPauly]

Hi Sheryl,

 

I had what I thought was a heart attack 3 months ago, but after undergoing all the tests that CMR has to offer the specialist said my heart was in very good condition, which surprised me considering what my lifestyle used to be like, he told me my blood sugars were high though so my type 2 diabetis needs controlling better, I'm trying to do that, I have cut out alcohol completely and eat more fish than anything else, no caffine, plenty of water and fruit.

 

I just had a pm from a trusted old Moderator friend who told me to take a dose of bicarbinate of soda when I am in pain, so that will be helpful.

[Rally123]

^

 

Go get yer HP levels check with a stool sample test to confirm HP isn't your problem.

 

 

Quote

 

Background and Objectives:

Helicobacter pylori infection represents one of the most common and medically prominent infections worldwide. Gastroesophageal reflux disease (GERD) has a multifactorial etiology. The nature of the relationship between Helicobacter pylori infection (HP) and reflux esophagitis is still not clear. This study is designed to find the influence of HP on GERD.

Patients and Methods:

The study was conducted retrospectively at Sakarya Newcity Hospital between January 2006 and January 2009. Data were collected on patient's age, sex, weight, the grade of GERD and the severity of HP.

Results:

There were 1,307 women and 1,135 men in this review with a mean age of 39,54 (range, 17 to 70) years. Helicobacter pylori positive (1 to 3 severity) was frequently seen in patients with GERD. A statistically significant relationship was found between HP positivity and the grade of GERD. The Helicobacter pylori infection (1 to 3 severity) was found in 1,437 (82.5%) of patients with GERD in our series.

Conclusions:

Controversy still exists about the association between GERD and HP infection. Based on our findings, significant evidence suggests the potential role of HP infection in the development of GERD. Also, the current data provide sufficient evidence to define the relationship between GERD and HP infection.

 

 

[Sheryl]

Can you post the gastroscopy report here?

 

And where exactly do you feel the pain?

[ThaiPauly]

Hi Sheryl,

 

Unfortunately I do not have the means to post the report, but I have just had a very close look at the it and it says in very small letters that I have chronic gastritis, but the Doctor never mentioned it and as far as I am aware has given me no meds for it.

 

The only item on the list that was not normal was ANTRUM: hyperemia  and erythema.

 

Also a RECOMENDATION : Await for histopathology report, so they have done a biopsy by the sound of it, but none of this was mentioned.

 

Mostly the pain is in my gullet  about 6 inches down from my adam's apple, now I have to breathe deeply to get enough oxygen inside me, it's uncomfortable right now, but not painful.

 

I have my follow up appointment tomorrow so there will be an awful lot of questions he will have to answer.

If you think there is anything more specific I should be asking then I would be very grateful if you would let me know

Edited February 27, 2018 by ThaiPauly
Additional Information

[simoh1490]

I've been fighting GERD and its symptoms for about two years and I've only recently got things mostly under control. Diet is at the heart of the matter and for me it was a question of ruling out things one at a time - coffee and tea went first, hot chocolate works better; wine/alcohol had to go, not even so much as one glass a week remains! Under cooked food is out, nuts are also - part of my problem is that I also have a slow emptying stomach which doesn't help - trying to remain active after meals is helpful too, as is sleeping with two pillows not one.

 

Combizym with every meal helps a lot - Dexilant (PPI) is excellent to reduce acid. Whatever works for you for gas, I use air-x which I eat like sweets at times but still doesn't do a lot for the bloating. I recently had a health exam, part of which was a full abdominal ultrasound scan, the radiologist complained she couldn't see half the things she wanted to because of gas yet I'd not eaten anything for 12 hours....who knows.

[Sheryl]

OK so the gastroscopy was not negative. Quite the contrary, it found you have chronic gastritis. Hyperemia  and erythema = redness and swelling, signs of inflammation.

 

This plus your negative cardiac workup pretty much put the issue to rest, your pain is from gastritis - which can be extermely painful and mimic a heart attack in intensity and location of the pain.

 

Key issue with gastritis is to determine whether you have h. pylori present, this is a bacteria which usually accounts for gastritis.. Normally they test for that on the spot so I am puzzled why not. Ask him about this when you see him. If you have h. pylori you will need to take a combination of 3 drugs for about 2 weeks to eradicate it, and should then be re-tested for it as treatment is nto always successful.

 

You will also need to take a drug to inhibit acid production, either a PPI or somehting like ranitidine or cimetidine (usually PPI preferred). There is no getting around that and you will need to take it for a few months at least in order to let the stomach heal. Your symptoms will improve with this medication but be warned there can be a rebound effect coming off it. The pariet you were given is a PPI, but an unusually expensive one - if this is an issue for you ask the doctor if you can switch to omeprazole which is much cheaper (and if so, buy it yourself at a pharmacy, in a local brand like Miracid or meprazole GPO. Works fine).

[ThaiPauly]

Thanks Sheryl.

 

That gives me a good arsenal of questions for him tomorrow. I have been taking Omesprazole or Miricid for years already as I have always had a delicate stomach.

 

When you say "re-tested" do you mean another endoscopy?

 

I will report back tomorrow after I have seen him

[Sheryl]

It does nto have to be endoscopy, they can also test for h. pylori via a breath test or stool test.

[Rally123]

4 hours ago, Sheryl said:

It does nto have to be endoscopy, they can also test for h. pylori via a breath test or stool test.

Don't bother with a breath test. Very hard to find an hospital with that facility. The stool test is the cheapest and most common way to check.  Results given a few days after test. 

[theguyfromanotherforum]

9 hours ago, Rally123 said:

Don't bother with a breath test. Very hard to find an hospital with that facility. 

 

Ummm.... no.

 

Every decent hospital in Bangkok has it.

 

Although for the money spent, I would do endoscopy as it is better value for money, I find. 

 

 

[Rally123]

2 hours ago, theguyfromanotherforum said:

Every decent hospital in Bangkok has it.

 

Although for the money spent, I would do endoscopy as it is better value for money, I find.

The majority of farangs do not live in Bangkok. And why is an endoscopy, costing 10x plus more than the price of a stool test, be money well spent? An endoscope will not detect HP. Only a sample of gut bacteria will and the easiest and cheapest way is take a stool test. 

[faraday]

Just to add something on this.

 

I've had GERD for maybe 6/7 years. Had a Barium Swallow, & Gastroscopy, which confirmed I have a HH.

 

20mg of Omeprazole every day keeps it under control, but occasionally I take a 'Fisherman's Friend' mint sweet as it seems to help in settling my stomach.

 

However, on a couple of occasions, the FF's have caused  mouth soreness. Took me a few times before I connected the two incidents.

 

Hope this helps anyone.

[theguyfromanotherforum]

1 hour ago, Rally123 said:

The majority of farangs do not live in Bangkok. And why is an endoscopy, costing 10x plus more than the price of a stool test, be money well spent? An endoscope will not detect HP. Only a sample of gut bacteria will and the easiest and cheapest way is take a stool test. 

 

I actually wasn't aware that you can detect h pylori with a stool test.

 

Thanks for the info.

[farmerjo]

On 27/02/2018 at 10:47 AM, ThaiPauly said:

I suffer greatly from GERD, especially at the moment, it's all the time every day, sometimes it's worse than others but it's a real bain in my life right now.

 

I had an endoscopy and a colonoscopy done at CMR last week and the doc said that he could find nothing wrong with me. He gave me a few pills Pariet and Ganaton  told me to change my lifestyle (which I am in the process of doing) and sent me on my way. I thought maybe that having read up on it a small operation may cure me?

 

I think I need to go back to see him again or should I take the report to another hospital? I don't really know what's best? The Doc is very popular and is always busy...maybe too busy, and the price they charge now....well price gouging is the only thing I can say about it, 10k more than their quote  and that was high enough, over twice what I paid 3 years ago when I had my last one done.

 

Any suggestions would be more than welcome

 

Many thanks

I reakon it's to do with giving up smoking.

I have the same. 

[Sheryl]

For sure, if smoking, need to give it up. Smoking is a big risk factor for gastritis. So is excessive alcohol intake.

[ThaiPauly]

I have not smoked for a year and quit drinking when the doc told me to a fortnight ago, also had to give up coffee, fried food spicy food, garlic, cut down on dairy and lose the weight I put on when I quit smoking!!

 

If I do all these things he says I should recover

[simoh1490]

3 minutes ago, ThaiPauly said:

I have not smoked for a year and quit drinking when the doc told me to a fortnight ago, also had to give up coffee, fried food spicy food, garlic, cut down on dairy and lose the weight I put on when I quit smoking!!

 

If I do all these things he says I should recover

We share the same doctor at RAM and he's given us both the same advice, I feel like you and I are related now. 

You might want to try experimenting with lactose free milk to see if that helps you any, Rimping carries lactose free milk.

 

Also, try cutting down on the undercooked and hard to digest foods such as nuts and muesli. Try cocoa for breakfast first thing, thing, Tulip brand cocoa from rimping is 100% cocoa and is an excellent replacement for coffee/tea first thing.

 

[Rally123]

4 hours ago, ThaiPauly said:

I have not smoked for a year and quit drinking when the doc told me to a fortnight ago, also had to give up coffee, fried food spicy food, garlic, cut down on dairy and lose the weight I put on when I quit smoking!!

A doctor told me a similar thing and advised me to also give up alcohol and sex. I asked 'will I live longer?' He replied 'no, but it will seem like it'.    At the end of the day you only get one life. Do what you want and live life as you want. 

[Speedo1968]

Not sure of the posters medical reasons for having GERDS.

 

I had Parkinsons ( yes had ) and part of the additional symptoms was GERDS.

For GERDS it was just more medication on offer - I changed my diet and way of eating / tried to adjust my burn-out working lifestyle and GERDS was no more and never had since.

 

Good luck to the poster in solving their problems with GERDS, it is inconvenient but a treatable problem.

 

[faraday]

14 minutes ago, Speedo1968 said:

Not sure of the posters medical reasons for having GERDS.

 

I had Parkinsons ( yes had ) and part of the additional symptoms was GERDS.

For GERDS it was just more medication on offer - I changed my diet and way of eating / tried to adjust my burn-out working lifestyle and GERDS was no more and never had since.

 

Good luck to the poster in solving their problems with GERDS, it is inconvenient but a treatable problem.

 

Had Parkinsons'....?

[Sheryl]

He has more than GERD, he has chronic gastritis.

[ThaiPauly]

Now in hospital, all tests have been  carried out, including CT scan. They can find nothing wrong and have put it down to a stress disorder and it must be physycosymatic. I have seen the physciatrist but I am not holding out much hope that he will be able to help me, but I suppose I have to give it a try.

 

The Doc is only supplying me with painkilling injections as he says there is nothing he can give me.

 

Pain is now in lower abdomen, Gerd is not present right now.

 

Just thought I would update you guys following this topic.

[Sheryl]

I don't understand the "nothing wrong" part when you have previously posted endoscopy results showing chronic gastritis. I suppose you mean nothing else other than the gastritis?

 

Gastritis alone can cause quite bad pain, though it is usually not in the lower abdomen.

[ThaiPauly]

As you say Sheryll, nothing wrong other than what they know about and the gastritis is all about lifestyle changes.

 

As soon as I am out of pain I can go home, I hope that won't be to long