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From:  "John Messmer, M.D." <jjm23@p...>
Date:  Mon Mar 10, 2003  8:25 pm
Subject:  RE: [vocalist] Has anyone had fundoplication?

If you ask gastroenterologists, they will say the surgery has two possible
results: too tight or too loose. Maybe they're just jealous of their
surgical colleagues.

A fundoplication just reduces the refluxing quantity. If one's problem is
acid and acid damage, one might still need to take acid blockers. If it is
too tight (and this is hard to judge in surgery) one may have difficulty
swallowing food that is not adequately chewed. If it is too loose, there
may still be reflux.

My usual recommendation is not to fool with mother nature until and unless
there is failure of other options. One should lose weight down to normal
(that is, lean) first, reduce carbonated beverages, reduce fatty meals, try
acid suppression and/or antireflux medication and of course, don't smoke.
Then if it is intolerable and one is willing to risk the possibility the
surgery may not work and may substitute another problem for the first, go
ahead. Choose a surgeon who does this procedure regularly, preferably
several per week and with a couple years experience.

As to antireflux meds: currently only metoclopramide is available. Despite
the potential side effects of muscle spasm and rigidity, I have used it for
about twenty years and have found it to be quite safe. Another med,
cisapride, is off the market in the US (maybe elsewhere also). There is a
med called tegaserod (Zelnorm) which is being marketed for irritable bowel
syndrome, but which may have benefits off label for reflux.

Never approach surgery as though it's just some simple procedure like
piercing your ears. Things can and do go wrong.

John

John Messmer, M.D.
Assistant Professor, Family and Community Medicine
Penn State Hershey Medical Center



> -----Original Message-----
> From: lvandekirk [mailto:lvandekirk@y...]
> Sent: Friday, March 07, 2003 12:12 AM
> To: vocalist-temporary@yahoogroups.com
> Subject: [vocalist] Has anyone had fundoplication?
>
> Has anyone had the surgery that fixes GERD, i.e., fundoplication? I
> am considering having it as it seems far better to have the malady
> FIXED rather than medicating the rest of my life and, even worse,
> barely eating or drinking. I have been diagnosed with GERD in the
> last two months, and now realize I've probably had it for years.
>
> I'm particularly interested if anyone has had the laparoscopic
> version of the surgery, how long it took to comfortably sing again,
> whether the surgery really fixed the problem, what drawbacks there
> are after having it done (I keep reading things about difficulty
> swallowing).






  Replies Name/Email Yahoo! ID Date  
23259 Re: [vocalist] Has anyone had fundoplication?lvandekirklvandekirk Thu  3/20/2003  
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