My brother-in-law was recently diagnosed with a precancerous tumor in his throat. The various doctors that he has seen, locally and at the Mayo clinic, feel that this was caused by acid reflux from a hiatal hernia. He will have surgery to remove the tumor and fix the hernia. The treatment that shocks me is that they have told him he needs gastric bypass surgery. I don't understand this at all and he hasn't had the answers to my questions. Does doing bypass eliminate the reflux issues? Is this the only procedure that will do this? He is about 80lb overweight(at least in terms of what I think is reasonable - probably more if you look at the charts with the current bias toward super skinny). In any event, if losing weight were the issue there are other, less radical methods, even surgeries, than the gastric bypass. I'm worried that the doctors are getting swept away by the trend to have weight loss surgery and are suggesting a possibly unnecessary procedure.
Does anyone have any insight or experience on this?

Ilene, I know two women who have had this surgery, one about 15 years ago, and one earlier this year. In the first case, the woman lost weight gradually and kept it off for all the years I knew her. In the second case, the woman is still eating the wrong things, but is losing some weight. I know there is a risk factor associated with this surgery, so if he is to have it, I would suggest that he makes sure the surgeon has done many. Perhaps ask to speak to some of his/her patients. Personal opinion, I think Weight Watchers would be a better place to begin, if he is committed to losing weight. My husband lost 50 lbs. by a combination of exercise and my learning how to cook tasty no and low fat meals (I hide my rich, chocolate ice cream in the back of the freezer - grin). Several of non-surgical options here. I think you are right to be concerned.

Both I and my DH have had gastric bypass surgery for weight loss. However, this surgery is not always done for weight loss. It helps those who suffer from chronic acid reflux and can save their lives. Weight loss will most likely be a side effect of his surgery, but sometimes a modified surgery is done for acid reflux patients so they do not lose a great deal of weight. I'm almost positive that his doctor recommended the surgery not for weight loss but for the chronic acid reflux.

The procedure that helps with reflux disease is called a LAPAROSCOPIC NISSEN FUNDOPLICATION. I just had it on June 1.... Not fun, for the first 6 weeks afterwards, but a big help. This compbined with proton pump inhibitors made me almost 100% cured of the issues.

Ok Brian,
Can you give us more info on this surgery. I'm living on Maalox and Prevacid but not a happy camper. I'd like to sleep on my right side again and dump the meds. How long was the surgery, who does it, what were the complications etc. Any info would be appreciated.

Thanks,
Eileen

With this surgery they basically take the fundus of the stomach and make a collar out of it that surrounds the pyloric sphincter that controls the opening where your esophagus attaches to your stomach, and then they pull the collar tight to strengthen this area and prevent acids from moving upwards out of the stomach. You don't want this done by just anyone. Here in So Cal there are only two guys that have done hundreds of them, and it isn't something that you want someone doing for the first time. It sounds simple, but it is complex. The first month afterwards you are on a liquid diet while things are healing, and there are side effects during this period that are less than pleasant, but they go away. Since having it done, I am still on a PPI, but my nighttime heartburn etc. is gone. Remember that acid reflux leads to Barrett's and Barrett

Just a note of interest....I had some ongoing problems with continual acid reflux during the past year, took maalox, rolaids, etc. at first, then doc prescribed some Acidphex(?) that worked well but gave me severe diarrhea so I stopped, then he gave me Zantac which didn't really work, then finally Prevacid. However, about the same time he gave me Prevacid, I decided to take his advice along with my husband's ENT who both said I should cut out caffeine. I had been told that before but paid no mind since I have drank coffee for many years and only developed the acid reflux within the past year, so I figured caffeine couldn't be the culprit. So I quit caffeine, and never really started taking the Prevacid, and my acid reflux disappeared! I know it is not that simple for a lot of folks, but it was worth a try and actually worked for me, and I'm glad because I was starting to worry that I would end up with Barrett's and I'm paranoid to begin with since my husband got cancer.
Michele

Reflux is aggrivated by many things including caffine. Diet is a big issue too. Treating it with OTC things like Zantac and Rx meds is a multi-billion dollar indiustry in the US today. Radiated H&N patients frequently have issues with it.

Brian,

How odd, I had the Laproscopic Nissen Fundoplication July 13. I seem to be following your path in many regards! I have had reflux for about 40 years and especially after treatment, it got worse. Further complications were created when the scar tissue from the PEG caused my stomach to attach to the abdominal wall and then to top it off, the surgical clips left from the PEG placement were stabbing my stomach because it was so tight against the ribs. They ended up not being able to remove the clips but everything else turned out fine. I have only taken 3 Nexiums since July 13 and I was up to 2 a day. I have eaten things and combinations I haven't had for decades and I have yet to have any heartburn or indigestion. It really is a miracle, to me.

Maybe you should keep me posted on any future treatments so I can mentally prepare myself!

Ed

Apparently this just isn't that uncommon in radiated patients. The really extreme gas and bloating after the surgery was a real surprise and definately unpleasant. I swallowed enough Gas-X pills to fill up a dump trunk in the first three weeks. Liquid diet for the first 3-4 weeks felt like the old days right after cancer treatment, and I lost some weight, but pretty much back to my normal post cancer diet now. It definatly has helped me, but perhaps not to the helpful extent that you sound like. I would still do it again, and am told that as I get further out from my surgery date things will continue to improve....

I hope you don't follow in all my issues, I don't like to whine, but there have been plenty of others that make life difficult that I haven't mentioned. I won't bore you with the details...or get people started watching for things that may never enter their lives

Thanks all. This is terrific info and it now turns out I may need something like this also. I haven't kept food down in 2 weeks. I'v been treated for reflux since right after my radiation and have had endoscopies to kep things open. Up until 2 weeks ago I wasn't doing too badly keeping down my soft diet but ow I'm miserable. They did another endosopy last week and added reglun (?) to my growing list of various meds. Still having trouble even with boost. Sounds like I may be a candidate too!