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The Ask A Doctor message board provided a medium for sufferers of Heartburn and Gerd to ask questions about medical and surgical options for heartburn and receive answers directly from experienced Gastroesophageal surgeons.
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From: S. Carvajal, M.D.
This is a very complex problem and difficult to sort out. There's a lot of conflicting results leading to confusion. The full answer to your problem cannot succinctly be answered. The first question to answer is whether the wrap is functioning appropriately. This requires a 24-hour pH while off all anti acid medications for 10 days. Furthermore, I would recommend a esophageal manometry to make certain that the lower esophageal sphincter pressures are normal. If you have your complaint during those 24 hours without evidence of significant acid reflux, the wrap is presumed to be competent. He then need to concentrate on what the cause of the pain is. In your case, this would likely be gastritis. Bile gastritis is uncommon when the pylorus is competent. If a prior pyloroplasty has been done, bile gastritis is more common. Initial treatment for a bile gastritis is prokinetic agents. There are surgical remedies for this problem as well. What's most important is to realize that your symptoms may not actually represent heartburn and reflux disease. If your doctors aren't able to help you, I would encourage you to obtain a second opinion from a national expert.