19 September 2023

Medical matters

The last few months have been spent sorting out a medical problem I have. Following an operation I had back in 2016 to have a stomach tumour removed, I now have a funny-shaped stomach which can cause me problems from time to time.

The diagram above shows the oesophagus tube at the top coming from the throat into the stomach. The tube at the bottom is the beginning of the intestines (duodenum) leading from the stomach. The little lines at top and bottom of the stomach are the valves or sphincters that keep the food inside the stomach for digestion. The red dot marks the spot where the tumour was growing into the stomach wall and the black line round that red dot is where they cut to remove the tumour. Instead of being bag-shaped my stomach is more like a crescent. I have titanium staples to close off the stomach wall where the tumour was excised.  I have as a result what they call a sliding hiatus hernia, where the top pointy bit of my stomach pokes through my diaphragm and gets stuck there. This can occasionally cause a bit of discomfort, but is bearable. 

My biggest problem is that I suffer from acid reflux, where the stomach acid rises up into the throat and can burn it. I have to watch how late I eat (usually not after 7pm) as I need the food to digest before I lay down to sleep. Also I have to avoid spicy or fried food. It is quite annoying that most restaurants these days seem to add chilli or curry to just about everything, so that it can be a nightmare what to choose when eating out. Alternatives are often deep fried too or doused in onions, which are also to be avoided, so I wish there were more options in restaurants for those requiring a blander diet. I have been on permanent medication (omeprazole) since the operation to reduce acid production, but in latter years  I often wake in the middle of the night choking on acid, as it rises up in my sleep. It is like vomiting while asleep. Usually in my half-sleepiness, I can grab a glass of water to neutralise the acid, but a few months ago, that did not seem to help and my throat and oesophagus were badly burnt and ulcerated. This resulted in a long series of tests to see if the tumour had returned but thankfully the good news was.... it hadn't. 

However the gastroscopy revealed the presence of the hiatus hernia, some polyps caused by long-term use of omeprazole and thirdly that, despite fasting 6 hours prior to the gastroscopy I still had food in my stomach. The consultant changed my medication from omeprazole to an orodispersible lansoprazole and decided to order a second gastroscopy for last Friday. The purpose of that was to stretch the pyloric sphincter - the valve  at the exit of the stomach that closes off the stomach from the duodenum. The consultant explained that when they had removed the tumour, they had cut through nerves in the stomach wall that tell that sphincter to open and release food. That was now a little compromised, which meant that food stays in my stomach longer than it should, as it takes too long to get through that sphincter. By stretching the sphincter, it would encourage it to open better. 

I was told to stop eating the night before the second gastroscopy, so my last meal was at 8pm on Thursday. I also had to refrain from drinking anything - even water - on the day of my procedure. Because I had opted for sedation during the procedure I had to have someone accompany me home afterwards in case I walked in front of a bus and was also supposed to have someone with me for 24 hours. Kay was working nightshifts at the hospital last week and weekend, so couldn't accompany me or sleep over. I got a choir friend to accompany me and a neighbour to be on high alert by phone if I needed her during the night.

My appointment was at 2pm on Friday.  I was less worried about not having eaten for 18 hours, but the journey by train and then bus into central London on a very hot sunny Friday was murder, as I was desperate to drink or even sip something. After I had been given a hefty whack of sedation, the gastroscopy was done, the pyloric sphincter was duly stretched by the consultant and I was given a written report to take home afterwards. Can you believe it, my stomach STILL had food in it, despite fasting for 18 hours! So hopefully that stretching procedure will help. I suppose having food sit around in my stomach that long means there is acid working on it too which makes me more prone to acid reflux especially when lying down in the night. I have had a gentle few days relaxing and on a bland diet, until the stomach recovers. 

Fingers crossed this will do the job. I see the consultant again in January for a catch-up.


Anonymous said...

Hope this procedure works. Sounds like you’ve been having no fun.

Tasker Dunham said...

I burnt my oesophagis, but only for a few days after one bout of chemotherapy. It was awful. I don't think I could bear having it all the time. I truly sympathize.

Susan said...

I have had stomach acid issues as well. To improve my digestion and ease the acid, my Functional Medicine MD recommended: Tri-Salts (Bicarbonates)by Ecological Formulas - 1/2 teaspoon with water after each meal and DGL (Deglycyrrhizinated Licorice Root) chewable tablets by Natural Factors - 1-2 prior to a meal). This works for me. Both products are available on Amazon. If I follow my diet carefully, I do not need these products. Like most, I'm not always careful and I like to eat at restaurants so the products come in handy.

RuthW in MD said...

My ENT dr. told me that I needed to sleep on a tilted bed to keep the acid reflux from atrophying my vocal cords any more. So I bought a set of blocks, abt 4" tall, called bed lifters, to use just under the legs at the head of my bed. I found that I can't sleep with slick sheets at all, or I slide down the bed and wake up with my feet hanging off the bed. But it has helped me not wake up to acid in my throat. Good Luck!

Anonymous said...

Oh no it sounds like you’ve really been through it. Fingers and everything else crossed for a good outcome

Yorkshire Pudding said...

You have explained this all so clearly - teaching me about internal matters of which I was wholly ignorant. Ten days have passed since you wrote this blogpost. I hope you are beginning to feel the benefit of the intervention you endured... Now I shall return to my starry celebrity world of red carpets, tuxedos and autographs.