Prokinetics, four esophageal reflux, and a LES, Saint Joe limitation

Posted by cblue @cblue, Feb 16, 2023

From what I can read prokinetics has your use in gastroparesis, and a few other limited applications, I realize nobody here is a doctor, so I’m just getting opinions from other patients. But one surgeon is telling me to not have surgery but to take prokinetics one of the only ones that seems not to be banned in the US (due to serious, cardiac issues, including cardiac arrest, and all of the details or matter) heart issues, serious heart issues,) the only one that I’m aware of is known by several names. I think the old name was raglan now it’s metrochloropromadide (There’s also a few other names. I don’t know if I’m spelling that right there is a ODT formulation witha shorter name.) there’s a black box warning for tardive dyskinesia another movement disorders. They are considering this instead of a 180° fundoplication. One surgeon feels all need to be fundoplication. I am wondering if anybody knows anything about this or is having any experience with this for treating Gerd and I am aspirating into my lungs, which is why it Hass to be treated. I’m reaching here cause I suspect nobody knows anything about this but any information would be appreciated

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cblue | @cblue | Feb 16, 2023

Ps Sorry about the spelling errors above. I don’t know what the Saint Joseph was. I use voice texting and it changes words. To clarify, I wanted to know if there were any experiences good or bad and what kind of limitations or side effects experienced if they used it even for Gastro paresis I guess l

rits | @rits | Feb 16, 2023

Sorry I don't know anything about what you are asking. However like you, I aspirate into my lungs. During the test I took last month, the first swallow of Barium went directly into my stomach and then immediately came back up and went into my lungs. I aspirate when I eat which leads to coughing snd choking because some food is going into my windpipe instead of all of it going into my esophagus.

Do you know why you aspirate? I'm trying to understand why my lungs are not being protected. Millions of people have gerd but the reflux does not go into the lungs. Will the drugs or surgeries you are considering protect your lungs?

cookierockwell | @cookierockwell | Feb 16, 2023

I also have GERD and aspirate into my lungs. I keep getting pneumonia from it.

My previous gastroenterologist put me on metoclopramide, but I only took it a few times. Reading about the side effects just scared me off it. I have a new gastroenterologist now, and when I asked him about it, he said I shouldn't ever take it, and that he never prescribes its.

As far as surgery, I'm having an endoscopy today to dilate my upper esophagus, which my gastro says not to count on it helping, that there's only a very small chance. If that doesn't work, we'll be considering surgery. Gastro says to get the Nissen fundoplication, and surgeon says just get the POEM myotomy. We'll see.

Best wishes to you that you get some relief soon.

cblue | @cblue | Feb 17, 2023

Sorry, I wasn’t clear to others but thank you cookie that’s exactly what my issue is but it was very helpful your post. Thank you.

judithfraser000 | @judithfraser000 | Feb 18, 2023

I had a negative response to metrochloromide.

marecpa | @marecpa | Feb 19, 2023

I also aspirate into my lungs and I found that PPI’s actually make the regurgitation/aspiration worse, along with severe leg edema. I was on 40mg twice a day and had to stop. After Bravo study to determine if I’d be a candidate for surgery (I am) gastro doc put me back on a different PPI in am and kept H2 blocker at night and the symptoms of increased regurgitation/aspiration and edema returned. I had to stop PPI and go back to H2 blockers only. H2 blockers do help but evidently not enough for lesions to heal. If you are on PPI and H2 blockers work for you, maybe ask about switching.