Question:
GERD when drinking but not when eating

Hi! I'm 10 months post-op. I had a proximal RNY with transection. I've had no problems up until 5 months post-op when I started experiencing GERD. I've been on Prevacid 30mg, twice daily with no relief. I am currently on Protonix 40mg, twice daily. I had an endoscopy performed back around 5 months and it only showed signs that my esophagus was irritated--DUH! I already knew that it was. I can eat 1/4-1/3 cup of food at meal times with no pain or discomfort. And yes, I wait 30 minutes before and after eating to drink liquids. But when I try to drink more than 2 ounces of any liquid within 30 minutes, I experience a burning sensation in my chest, throat and even my ears. What could this be? I thought fluids were supposed to pass through our pouches without any problems? My GI doctor says that if my GERD doesn't improve, he may put me on Zelnorm. I'm really concerned!!! I'm stationed in Hawaii with my husband on military orders. I'm really close to hopping on an airplane and flying to Virginia to see the surgeon who performed my WLS.    — Donness O. (posted on October 22, 2005)

October 22, 2005
Here is a couple of thoughts I hope may help. Have you considered a stricture? Maybe a call to your original surgeon would help. If not ask to see a gastroenterologist. I wish you the best of luck and hope you find the cause of your pain.
   — scharlier

October 22, 2005
Although you will ultimately need to consult with a doctor about this problem, what you are describing seems to be more of a sign of some delayed emptying of your pouch. Consequently, even waiting 30 or more minutes, you still have relatively little excess volume to accommodate more than 2 ounces of fluid. However when you drink more than this negligble amount, it would seem as if you are then causing food and fluid to back up into your esophagus which could be the cause of the irritation. Anecdotally, some of us have found that when we are placed on acid-blockers we experience greater problems digesting food (and longer periods feeling full, which in terms means longer periods needed to wait between eating and drinking) given how little gastric juice is produced in the pouch in the first place. This effect could explain why you have not experienced much relief from taking the Prevacid. When I had experienced comparable problems early after my RNY surgery, it turned out that two factors were contributing to my pain. First, I was in high ketosis, so the ketones were in my saliva and irritating the pouch, and after eating saliva was being produced (and swallowed) further filling me. And, secondly, I had allergies and a bad head cold which resulted in my pouch taking quite a bit of post-nasal drip (which in turn caused tremendous stomach upset and discomfort). Of coures, even knowing the source of my discomfort, didn't make me feel any better physically, but I tried to take some solace in knowing that it wouldn't last forever. Good luck.
   — SteveColarossi

October 22, 2005
Id hop that plane so very quickly and get that taken care of ASP... most general doctors do not know much about us GBCers.... good luck Flo
   — Flo

October 23, 2005
I am ten months out of surgery, and I still cannot eat mor than a few ounces at a time. I also can't drink within an hour to an hour and a half of eating and vice versa. Everyone is different. My surgeon automatically puts everyone on Prilosec after surgery and for the rest of our lives. I have trouble eating foods such as chicken, beef, and eggs. I get symptoms that sound like yours if I do. I suggest keeping track of what and when you eat and drink, and seeing if there is any correlation. You really should go have a follow-up with your surgeon, anyway. Thank you for serving our country!
   — Novashannon