6 replies to this topic

[sivart]

My daughter who is 21 is a T8 Para has just recently been diagnosed with GERD. She is being referred to a surgery for a consult for surgery. She has been a para for six years now from a ATV accident. My questions is this a common disease with para and Quad because of the spasmity ? or what. and does anyone have a good link to go to for more information. I have been searching the net thats how i found this forum. It is a great forum keep up the good work. Thanks any and all information is welcomed.

[PeterO]

Gastro Esophageul Reflux Disease... is a general description. That's a diagnosis that simply refers to disurruption in the esophagus and usually is easily maintained with some prescription meds like Nexium (Purple pill), Prevacid or Axid (over counter).

I would not recommend self medicating with over the counter without proper diagnosis and, after seeing some nasty things done by a rush to surgery with a cousin and a sister, would suggest getting additional opinions.

In my case, it was as extreme as the others with related more sever symptoms as Pre Cancerous Barrett's Syndrome, polyps and a hyatial hernia. An edoscopy is the way it is examined and properly diagnosed and I would suggest looking for a quality gastroentologist's opinion.

In my case, the symptoms mimicked chest/heart pain and, during an actual heart attack had doctors in the ER confused. My symptoms started at an early age, but then again I've had multiple back surgeries since 1983.

Pain meds and especially anti inflamatory meds were attributed to the primal cause. I've since learned to live with pain and reduced medicating to almost non. It took some getting used to it and pain management counseling helped.

The norm dose of Nexium is 20 mg. I was put on 40 mg 2 x a day and after nearly a month or so, symptoms subsided. This is very unconventional and was fought tooth and nail by my insurance carrier. The doctor insisted and suplimented what they wouldn't pay for with medical samples he had.

After 3 months, I had a repeat endoscopy that showed dramatic improvement. I've been medicated this way now for 5 years plus (started 1st year on Prevacid, then changed to nexium). If I reduce now and then, I feel it start to return. Going back to the increased dose improves in a few days.

I understand that kidney and liver tests need to be done periodically if on prolonged doses, but in my case, because of the cardio vascular meds I need to take, I have that testing done frequently.

To me, the two "pretty purple pills" are like candy in my mix of 21 pills a day I take... sigh...

Good luck! Hope this helps!

[kewlcatkez]

sivart, on Mar 27 2008, 09:21 PM, said:

My daughter who is 21 is a T8 Para has just recently been diagnosed with GERD. She is being referred to a surgery for a consult for surgery. She has been a para for six years now from a ATV accident. My questions is this a common disease with para and Quad because of the spasmity ? or what. and does anyone have a good link to go to for more information. I have been searching the net thats how i found this forum. It is a great forum keep up the good work. Thanks any and all information is welcomed.

Hi,

I get oesophageal reflux. My Sphincters very floppy and lax due to my genetic connective tissue disorder. Also since paralysis, it seems worse. However it could be just effects building up over time, the medications I take which cause more reflux etc. As I take anti inflammatories, this is quite possibly the case.

With regards to your question, the SCI/D's role in the GERD (GERD or GORD using the British acronyms) depends upon the level of injury. Just as digestion slows after paralysis, sphincters may also become more 'floppy' and increase the incidence reflux. What I would say though, is that the incidence of GERD/reflux in SCI/D could be due to the increased ruse of Anti inflammatory medications, pain medications etc. Almost all medications list digestive/reflux factors as side effects. GAßA antagonists such as benzodiazepines ( Benzos). Interestingly, Baclofen is a direct agonist of GAßAß receptors, and has been shown to help with the symptoms and control of some GERD. Other medications to avoid (where possible and under the care of your dr) are: Anticholinergics
Aspirin, Prostaglandins, Theophylline, Tricyclic Antidepressants, Calcium channel blockers (Only where safe to do so, as side effects may be of less risk than failing to take these medications).

With regards to symptom control, there are some foods which can provoke or worsen a GERD "attack" or flare. This is by no means exhaustive, but foods include: Fried/Fatty
Caffeine (Coffee, Tea, Chocolate), Spices (Peppermint, spearmint, garlic, onions, cinnamon, herbs), Alcohol, acidic foods, Tomato/tomato juice, and Citric Foods.

With regards to treatment, Zoton ( Lansoprazole) & Omepraxole are the drugs of choice now here in the UK as they pose less side effects to those with conditions such as congestive Cardiac Failure, has less negative effect on the U&E's potentially, and in clinical trials reportedly were at the top. Of course, there also may be the case that reps put spins on these things.
It depends upon Consultant/DRs or in some cases the Trust's preference as to which one is prescribed.

Combining Zoton or Omeprazole with gaviscon does seem to work for a lot of people with Gastroesophageal Reflux Disease.

if Omeprazole isn't working, perhaps asked to change to Zoton? Omeprazole can also be increased to dosages above the 'set' suggested ones under the direction of your dr and by combining it with other Proton Pump Inhibitors.

Also, as the capsules are big, this is one time when its ok to split open the capsules in order to swallow. The actual drug inside the capsules, both Omeprazole and Zoton ( lansoprazole) are digested and broken down by the stomach. To combat this, the capsules contain little grains/granules/ and you can open a capsule and take with a glass of water, apple or orange juice or yogurt.

Surgical intervention is not recommended for people with a Connective tissue which I have, unless absolutely no other options. I also would urge caution with regards to having surgery to 'correct' GERD. This is based on the information from studies which has found the following:

""However, a large number of the surgically-treated patient -- 62% -- were also taking medications. The authors interpreted this to mean that surgery was not effective in preventing the need for medication. The authors of the new study concluded that surgery should not be recommended with the expectation that it would prevent the need for further treatment with medication. The implication of the study-though the authors were careful to avoid the implication--was that surgery was ineffective at relieving the symptoms of GERD in the long-run.""

Source: http://www.medicinen...rticlekey=17300

For further info:
http://seniorhealth....a/GERD_surg.htm

Information with regards to the procedure, available for the "patient" can be found here: http://www.gerdsurgery.info/

Ultimately, my thoughts are that if there is an underlying issue which is leading to the GERD, then surgery is less likely to be successful in the long term. In my case, my connective tissue is faulty so a solution would likely not last. Also the effects of my paralysis on my intestinal tract, medications etc and there are other factors to consider.
In your daughter's situation, her paralysis, any medications she is taking long term and other factors may mean that any surgical 'solution' is less than an 'easy fix'.

I do hope that she has some resolution of her symptoms soon,

I hope this helps someone,

Take care,

K

[PeterO]

""However, a large number of the surgically-treated patient -- 62% -- were also taking medications. The authors interpreted this to mean that surgery was not effective in preventing the need for medication. The authors of the new study concluded that surgery should not be recommended with the expectation that it would prevent the need for further treatment with medication. The implication of the study-though the authors were careful to avoid the implication--was that surgery was ineffective at relieving the symptoms of GERD in the long-run.""


________

As you see above, surgery is not the solution! I very strongly agree!

My sister recently went through the radical surgery... senslesly and will continue to suffer.

7 years ago, I watched in horror as one of my cousins went through the same suregry with a cancerous polyp. They removed part of the esophagus and, the result was spreading cancer. She suffered tremedously for two years in the hospital.

My case was identical. The cancer treatment was radiation and chemotherapy. The healing process was with the therapy I described above and I will say this much... I've gone trough 3 wonderful endoscopies with clear results and only as stated above, medication and modified diet.

She's on the money! The use of anti inflamatories seemed to be my downfall. I have avoided those as much as I can. I've stopped using them for 3 years now and realized that there needs to be a balance between all of my maladies and I need to work closer with my 9 doctors on where to compromise my comfort and survival.

leave it up to them alone, they all seem to have separate agendas and not always in the common interest.

[longhaul]

Hi Welcome. I have found that sitting and bad posture have a lot to do with GERD if she were able to use a standing platform after eating that might help. Don't lay down for a couple hours after eating don't eat to late at night and check to make sure she isn't sensitive to certain foods. Sleeping on the left side is said to help also. GERD sucks big time I hope she gets rid of it. See Ya

[sivart]

Thanks for all of your advice! The only medicine she takes is Balcofen and Ditropan. The dentist is the one that pick up of this the enamel on her teeth is being eaten my the acid. We just had the acid test done and her acid levels were high in the esophagus for 48 hrs. Will keep you posted!

[PeterO]

Well that sounds encouraging!

Sounds like diet modification, eating and resting habits and maybe something like nexium might do the trick.

Before you see the doctor, go to their site:

http://www.purplepil...purpleplus.aspx

Fill out a registration and you can print out a coupon to bring to the doctor for a free sample test. (FYI, the pills are about $18.00 ea USD and the sample test is worth taking!)

From what I've heard from others that tried it, early detection, treatment and diet modification can resolve the problem in a week or two. In my case, it was neglected and ignored by simply taking mouthfuls of Tums and other antacids to stop heartburn and the overlying problem was ignored.

good luck!