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From: Bob G.
Date: 03/13/01
Time: 13:26:34
Jan: Based on my conversation today with Lorna (see "lack of propulsid" and "to Bob G" above), it seems there is no way of correcting poor motility. You may be a candidate for the kind of surgery I had, the partial wrap known as a Toupee. As Thistle explained above, people with low motility cannot have the normal Lap Nissen fundoplication procedure, where the top portion of the stomach is wrapped all the way around the LES valve. As my GI doctor explained to me, (and, again, as Thistle pointed out) the full wrap in low-motility patients could lead to blockage, where food would get caught up at the point of surgery. The partial wrap was designed to avoid this problem. And it seems to have worked for me. I do still have trouble with bread and meat but I expect this to go away with time.
The question, then, is why have surgery if it doesn't fix the motility problem? (And my GI doctor did indeed tell me that surgery wouldn't fix my motility problem.) Well, in my case I felt I had to stop the regurgitation (or, reflux) problem. Even though my doctor couldn't say for sure that the regurgitation had caused the low motility, I felt certain that that was the case (what the hell else would cause it?!) So my feeling was that I had to stop the source of the problem. If this didn't eliminate the problem, it would at least keep the problem from getting worse. I also was concerned about Barrett's esophagus. My endoscopy results indicated only minor esophagitis but I figured it was just a matter of time before that got worse. So I went ahead with the surgery. And now I have far less regurgitation. But I still have lots of belching and still have the motility problem.