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Esophageal stricture


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#1 warmheart

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Posted 27 April 2010 - 06:46 AM

Hi everyone,

Has anyone here had an esophageal stricture? If so, what happened next? Thanks in advance.

Hugs,

warmheart

#2 kaykay

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Posted 27 April 2010 - 08:52 AM

My GI dialated mine, it was much worse for about a week after the procedure then it has been much better. It was done in March of this year. I hear some people go in almost weekly for it but with my health plan I couldn't afford that. I also take max dose of the PPI which seems to help.

hope you find some relief soon.

#3 Jeannie McClelland

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Posted 27 April 2010 - 09:48 AM

Hi Warmheart,

I had strictures dilated twice as part of endoscopies and once when I had the fundoplication. The first time left me with a pretty sore throat for several days. Since the fundoplication has fixed my GERD, I haven't had any more strictures.
:emoticon-hug:

If I had a choice between getting a stricture dilated and going on a roller coaster, you know, I'd chose the dilation!

Warm hugs,
Jeannie McClelland
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International Scleroderma Network

#4 warmheart

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Posted 27 April 2010 - 10:23 AM

Thanks Kay-Kay and Jeannie,

Glad to hear the treatments worked for you both so well. It turns out I do have a stricture and it's 6 or 7 inches long. So tomorrow I have to go in for an endoscopy; can't have any sedation because I don't want to bother a friend to come into the city and drive me home. At least this way once it's over, it's over. My last endoscopy was many years ago now and it wasn't too bad as I recall (no nasty surprises and it went quickly), so I hope this one isn't too much more of a production.

Meanwhile my primary care physician told me not to eat anything that could get stuck and need to be fished out in the emergency department. Oh dear.

Hugs,

warmheart

#5 mando621

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Posted 28 April 2010 - 12:44 AM

Hi Warmheart

How did they find a stricture without endoscopy? I have been having more trouble swallowing lately and I have an EGD with possible dilation scheduled for Friday. The doctor didn't do anything to check for strictures, I think he will be looking for those during the procedure. Did they do ultrasound or MRI?

Do the strictures actually show to the eye?

Thanks.
Mando

#6 Shelley Ensz

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Posted 28 April 2010 - 10:32 AM

Hi Mando,

I may be wrong (I often am) and I have no medical training at all (which is why I may often be wrong!) but I'd guess they might have found Warmheart's stricture by doing a barium swallow. And that her endoscopy will actually be not to diagnose but to stretch the stricture out.

My husband has had esophageal strictures, and he regularly had them stretched for a few years, until things settled down. Since then, he has had a fundoplication surgery which settled everything down and no further stretching has been necessary. (He doesn't have scleroderma, he just had bad heartburn and stuff, many years ago.)

Now Warmheart can let us know whether I'm right...or just trying to oxygenate the universe by flapping my lips.
Warm Hugs,

Shelley Ensz
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Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#7 warmheart

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Posted 28 April 2010 - 02:16 PM

Hi Mando, hi Shelley,

The more oxygen the better, if you ask me! :D

Mando, to answer your question, the radiologist found the supposed 6 or 7 inch stricture by doing a barium swallow. I looked up the length of the entire esophagus, and it's only about 10 inches! But the endoscopy didn't show any stricture, only that most of my esophagus is narrower than normal. It wasn't that way in the past, so I don't know what caused that, but it meant I didn't have to have it dilated after all. I don't mind my swallowing problems, I'm so used to them by now. I just wish at least they could keep me skinny! It doesn't seem very fair. :angry: But I should be grateful that I can keep my weight up.

I had a dilatation done once years ago just after I was diagnosed, just to see if it would help my swallowing (it didn't!). It was done in the hospital GI unit, but I sat on a chair with no medication at all, and the gastroenterologist took the dilator (it looked sort of like an enormous turkey baster) and plunged it really quickly down my esophagus and then up again. :barf: Probably the same way they did it 100 years ago. So it was interesting to hear that the way they prefer doing it these days is with a balloon dilator during an endoscopy.

Anyway, it looks like I do have Barrett's esophagus (no big surprise there), so the doctor today took a whole bunch of biopsies and I'm supposed to get the report in a week or two and then have an appt. with her.

I thought I could get away with not taking my PPIs even though I knew better. NOT!!! Hopefully someone else will read this and learn from my mistake.

Hugs,

warmheart

#8 warmheart

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Posted 29 April 2010 - 01:12 AM

P.S. Shelley, your husband has been through so much!!! I hope things keep getting better and better for him now that he's had his transplant. Your post on his philosophy of happiness should be required reading for everyone, everywhere--seriously! He must be an amazing person.

And as usual, as far as the barium swallow goes, you were right as usual. :) Fortunately the radiologist wasn't. :VeryHappy:

Hugs,

warmheart

#9 relicmom1

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Posted 29 April 2010 - 02:12 AM

I have an esophageal stricture and have had it dilated numerous times. Not only does the food go down slowly, it literally gets stuck. When it gets stuck it is extremely painful. So far, I have been able to bring it back up on my own when it has happened. Let me also say that you are a very brave person to have an endoscopy without sedation!!!! I have a terrible gag reflex and would not be able to do it without sedation. The last dilatation I had has been a little over a year ago. I am slowly beginning to have problems again and will probably have to have another one in the next few months. I also take Prevacid 30mg twice a day for the GERD. Good luck on your procedure and please let us know how it goes!
Peace :)
Barbara aka relicmom1

#10 warmheart

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Posted 29 April 2010 - 11:05 AM

Hi Barbara,

I'm sorry you've had so much trouble with your esophagus! Luckily it turned out I don't have a stricture, so I don't have to have a dilatation. Food sticks in mine constantly and I have to force it down and keep it down, but it's almost never painful. As far as the endoscopy goes, the worst part about it was the anticipation. That and maybe when my throat started to numb from the lidocaine, but the nurse was wonderful and kept me calm. Actually I had my first endoscopy without sedation too but I was more scared this time because I knew it would end up taking longer and I didn't know what to expect. But even with all the biopsies it was still pretty short, or at least it seemed that way.

It just occurred to me today that the gastroenterologist guessed that my esophagus was narrowed from birth, but it looked normal on x-rays before I got scleroderma, and then today I realized that since I had scleroderma it was very obviously dilated--the classic scleroderma esophagus. On barium x-rays it looked like a big white water balloon. So what I'm wondering is whether scarring could cause that kind of narrowing. Does anybody know about this sort of thing?

Barbara, if you do have to have another dilatation I hope it goes smoothly--please keep us posted!

Hugs,

warmheart

#11 mando621

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Posted 30 April 2010 - 11:00 AM

Hi,

Well, I'm sort of recovered from the endoscopy this morning. I mostly was recovering from the anesthesia and slept much of the day. The GI doctor didn't think I had a stricture because he used a balloon to dilate and there wasn't much resistance from the esophagus. The doctor dilated slightly, but he didn't think that was why I was having trouble. He did find my stomach inflamed and took biopsies, so I have to go back to get those results in two weeks. I had been taking prilosec twice a day for a few weeks before this endoscopy, so I'm not sure whether to keep that up? I guess it is time to go back to my general practitioner and talk this over with her.

At least the endo wasn't a problem, but instead of being 15 minutes for the procedure, my hubby had to wait an hour for me. Since they started right away when I got into the procedure room that makes me wonder why it took so long. I had anesthesia that worked well since I don't have a clue what they did.

Mando.

#12 warmheart

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Posted 01 May 2010 - 01:40 AM

Hi Mando,

Glad to hear you've recovered! I'm glad you didn't have a stricture. As far as PPIs go, your doctor will probably tell you to keep taking them. I was told in the past that it was extremely important to take them forever, basically, and not to stop. I stopped when mine went over the counter and I couldn't afford to buy it, and my primary care doctor at the time put me on a different one that didn't work well at all for me. So I got discouraged and stopped taking PPIs altogether. Stupid.

You were probably there for an hour because most of that time you were waking up in the recovery room.

Hugs,

warmheart

#13 relicmom1

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Posted 01 May 2010 - 02:25 AM

Warmheart, I don't know which PPI you were on but I'm on Prevacid 30mg twice a day. Since the over the counter brand is only 15mg, my insurance continues to pay for the 30mg. And when when it went OTC, it also became available in generic form, for which my co-pay is smaller. My doctor has to get an authorization every 6 months for it though, but that is their policy on ALL PPIs. They, in their infinite wisdom, do not think you should have to take it forever like we do.
Peace :)
Barbara aka relicmom1

#14 warmheart

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Posted 02 May 2010 - 02:14 AM

Hi relicmom,

I'm currently on omeprazole 20 mg. twice a day, and still have heartburn pretty much 24/7 so I guess it'll probably have to be increased. It didn't matter for me whether it was covered because my primary care physician didn't want to prescribe PPIs before now; her reasoning was that if I thought I needed them I could get them OTC.

But then she gave me a script when she talked me into going for the barium swallow the other day; I was expecting a huge copay but it was just the standard drug copay--a nice surprise! She didn't have to get an authorization, either. The generic is a big horse capsule that's not easy to swallow (kind of ironic, when you think about it), but that's fine because I really don't have trouble getting it down.

Hugs,

warmheart