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How To Prevent Lung Damage?

Posted on Mon, 30 Jun 2014

Question: Dx w/GERD,had Nissen to prevent further aspiration causing asthma. Still taking ppi cannot get off. After 4 years post surgery I'm aspirating again flaring asthma. Had multiple cardiac work-up resulting neg. changed diet, bed, trying to loose wt. I'm 5'3 148# what else can I do to prevent lung damage I'm very frustrate.

Answered by Dr. T Shobha Deepak (4 hours later)

Brief Answer:
Will require further evaluation

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms,

Before attributing the persistent symptoms to Asthma following anti reflux surgery it is important to document reflux.
Has any Upper gastrointestinal contrast study been done after surgery to document reflux?
Further management will depend on this investigation. Technically correct done anti reflux surgery for right indication should help in improvement of symptoms.

I would like additional information
1. Has upper gastrointestinal contrast done to document reflux?
2. How often do you have asthma attacks?
3. Are the attacks mild or severe enough to affect day to day activity?
4. Has allergy workup done to rule out allergen as known cause for asthma?
5. Has 24 hours ph study of oesophagus been done?

Do get back to me with these details

Take care
Best Regards
Dr T Shobha Deepak
MBBS, MD

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Shobha Deepak (16 hours later)

Upper GI was done 2 days post-op, however, 1 week post-op follow-up visit I was back on ppi. The surgeon was concerned that the surgery was not for me. He said you cannot get off mess. I've lasted about 4 yrs after the surgery, but not sx free. Ph study was done resulting in severe GERD, although prior to bring dx w/ it I did not experience any sx at all. Poss. Silent GERD? I've been under care at LLUMC for both GERD and asthma. I've not been in inhalers for over a year but one because of aspiration and throat burning, on back on it. Please advise Thank u

Answered by Dr. T Shobha Deepak (7 hours later)

Brief Answer:
Re-investigation required

Detailed Answer:
Hi
Greetings
From the description given , it appears that Nissen fundoplication done was a loose wrap, which could possibly explain the cause of your symptoms.

At this juncture you wil require further evaluation to assess for reflux and if present severity of it. I would suggest you to get re-investigated in consultation with your physician
1. 24 hour ph study
2. Milk nuclear scan for evaluation of gastric emptying time
3. Upper GI contrast study for assessment of severity of reflux

If the reflux is sever and you are symptomatic , one should consider redo surgery.

Take Care
Best Regards
Dr T Shobha

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Shobha Deepak (13 hours later)

Thank u for your time and advice

Answered by Dr. T Shobha Deepak (20 minutes later)

Brief Answer:
Wish you a happy life

Detailed Answer:
Dear Ms

WishingYou a very happy and healthy life.
Take care
Best Regards
Dr T Shobha Deepak

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D