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Nutcracker Esoph.



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Hi everyone. I haven't been around for a while due to band & personal problems, but I need to tell you all what's going on. All of the sudden, after weeks on a good fill, it got way too tight & I had to keep having my fills taken out. I had chest pain, top of the stomach pain too. Also, feeling that food kept getting stuck in my throat. Nothing helped the fills loosen up, not liquids, not anything.

Since didn't want to go to Mexico from Long Island to get this all checked out, I coordinated w/Dr. Ortiz to get everyting checked here. His friend here Dr. Gabriel who's in NYC works with a gastroenterologist(sp?) My own doc is a gastro, but he doesn't know much about the band. Anyway, I went to the doc. in NYC, and he did an endoscopy which showed esoph. & stomach irritation. Same with an upper GI. They also noticed esoph. spasms. Prescribed Nexium. (This whole time my band was unfilled) Dr. Ortiz said I NEEDED a motility test, which no one else could figure out why it was necessary. But since my own gastr does it, he did and found out that I have very very strong esoph. spasms, a condition called Nutcracker esoph. If left untreated it can lead to greater esoph. problems. Sounds weird, huh? The treatment is calcuim channel blockers & continuation of the Nexium. I've just started on them last week, & had a loose fill, (1.3cc's). They started me on the low dose of the channel blockers & might have to go stronger) The funny thing is that even before the motility test, Dr. Ortiz was telling Dr. Martinez that I had nutcrackers). They have 3 other patients who have this condition. It is managed through medication and not, I repeat not, having a tight fill. Was it there before the banding? No one knows. But they do know that it can be excaberated by stress, which I have had plenty of; very sick husband w/major hospitalization, money issues, etc. Drs O & M have both told me that band-wise, I will not be able to have tight restriction at this point. But I WILL have some, and that I have to make the band even more of a tool than it was, not the whole cure. I will never again be one of those people who can only eat 2 oz. of food & be full. I was assured & double assured (I called them again after hearing about Michelle's erosion) that this has nothing whatsoever to do with erosion or slippage).

I did not post this to scare. I wanted to tell everyone anyway since I've been gone so long between having my band filled & unfilled & depression over the other problems. I also want to tell you to have any esoph. issues checked out because if you have esoph. problems they have to be taken care of.

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Wow Karen! Thank you so much for posting this. I'm so sorry to hear that you are going through such a stressful patch! I'm sure the added stress of the band issues is not helping your situation, what a mess! The more stressed you get, the more stress you get.

Of course you didn't post to scare, but to get and give support! http://www.csmc.edu/5938.html so it looks like you feel stuck all the time? What a bad thing, and you poor dear!

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Nutcracker esophagus is often found in MO patients in general, so it's not something the band would cause.

I wonder if it resolves as we lose weight?

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Vines, I already saw that site. Thank you so much. Funny, they say the Calcium channel blockers don't do much good, but both my docs think it will. In certainly don't want to go on the anti-depressents they describe; they make you gain weight! Time will tell.

You are right, Sue. However, I did lose about 50-60 lbs. before it manifested. I think it was on its way anyhow, because when I was filled under fluoro in Mexico it was noticed that my esoph. did move faster than most (the barium moved down fast), but at that time much less than what tests show now. Funny, the local barium swallows I took when this first sharting happening showed nothing, and that radiologist certainly didn't pick up on anything. They did my swallow lying down, which I thought was very strange.

When I did the swallow at a different site as part of the upper GI series most recently, I stood up for the swallow & then lay down for the rest of the x-rays. That radiologist said it was quite noticable & he also diagnosed reflux, as did the doc who did the endo, of which I have absolutely no symptoms (I did have it pre-banding so I know what it feels like). In any event, I am taking nexium as well.

Personally, I think that stress was the biggest contributing factor. I actually felt my esoph/stomach clench up when I walked into my husband's hospital room for the 1st time back in August. That's when all this started. Maybe if I lived on Valium, I'd be fine. Non-functional, but fine.

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I wonder if that's what they were looking for when I had to bring a tuna salad sandwich to the lab. I'm not even kidding! My pre-op was to bring a "salad type sandwich. It was the first time in my life where they told me to eat as fast as possible, then I had to lay still under x-ray machines to see how food moved. Odd.

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Lisa, it might have been nutcracker esophagus...or just a test for the motility. I have had trouble for MONTHS/YEARS/SINCE A YEAR POST-BANDING feeling like the food in my esophagus is bouncing up and down...FINALLY, the Mexican surgeon happened to have me doing a barium swallow at the right time and we watched that. And then we watched while one swallow just sat there going nowhere.

For some of this stuff, timing is everything.

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I was wondering where you've been Ms. Karen. I hope things heal up for you really fast. Your DH has had a lot things going on this year too.

Take care, hugs!

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Thank goodness they figured out what it was so you can start treating it and get better. Hope it resolves itself with some treatment.

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Thanks for posting this Karen. This clenched it for me and I went back on my Prilosec and it's helping with my funny band/tummy feelings. De-stressing also helps!! Oh, and Aloe Vera juice, which heals anything from top to bottom...good stuff. Let us know how it's going for you.

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