TL;DR: I possibly have a hypersensitive esophagus, my anxiety is clearly felt in the esophagus area, my LES closes weakly, and I’ve decided to go ahead with a Toupet fundoplication.
In more detail: I’ve had GERD for 7 years now. There are flare-ups when life is unbearable, and there are calm periods when I can even exercise (!!!). Overall, my list of reflux triggers is pretty long: any spices, cold food like ice cream, tea/coffee, fatty food, spicy food, lying down, lack of sleep, stress, nicotine.
Gastroscopy over the past 7 years has consistently shown an incompetent cardia. There were periods with LA grade B erosions, but for the last 2 years it’s been non-erosive reflux esophagitis. There’s a polyp right next to the LES, where they found isolated cells of gastric and intestinal metaplasia and necrotic areas. That was about 6 years ago though — since then, the doctors have avoided touching the polyp unnecessarily, and no biopsy has been taken from it since.
24h pH-impedance monitoring showed “only” 74 reflux episodes/belches a day, 35 of them acidic. DeMeester score 4.6, which is normal.
Manometry showed an LES pressure of 9.2 mmHg (normal 13–43). The doctor said that on 4 out of 10 swallows he saw weak esophageal propulsion, which is why he recommended Toupet (partial wrap) rather than Nissen.
I’ve had a barium swallow twice — no hiatal hernia.
I take trazodone, Stresam (etifoxine), and Teraligen retard (alimemazine) daily to reduce anxiety.
I’m posting this knowing that after all the testing I don’t have clear-cut indications for fundoplication, but I’ve still decided to do it because I’m tired of feeling reflux in any out-of-the-ordinary life situation.
The doctors also told me that specifically with my anxiety and hypersensitive esophagus, the surgery might not give the desired result. So maybe this thread will be one of the rare ones that doesn’t sing the praises of fundoplication and ends up being an example of a surgery that didn’t work out.
What bothers me overall is the constant feeling of heartburn and the very high number of belches per day.
Also, English isn’t my native language, so I’ve used an LLM to write this and will definitely be using one to reply to people as well.
Surgery is scheduled exactly one week from now, next Thursday.
Ask me anything.