Help! Anyone recognise these symptoms.

[perseus]

I was diagnosed with grade 1 oesophagitis, a gastro-oesophageal junction that was a "little lax", and a tiny hiatus hernia following an endoscopy in November 2003. All medical treatment seems to have failed, with the symptoms at best decreasing, before firing up again. I have stuck rigidly to the recommended diet, and cut out alcohol completely. My symptoms include a constant feeling of nausea, tiredness, and tenderness in the upper stomach region. Physical activity of any sort seems to worsen things. All blood tests including one for helicobacter have come back negative. I am now at my wits end, and so in desperation I am throwing it open to this forum. For info I am a male 42 years old charter airline pilot in the UK, and am otherwise "healthy". If anyone out there can help I would be very grateful.

[QDMQDMQDM]

It is unusual for oesophagitis not to respond to a high dose of a proton pump inhibitor such as omeprazole, lansoprazole, pantoprazole, rabeprazole etc.

Go back and see your doc.

QDM

[Loose rivets]

Perseus, sounds like you are having a pretty rough time of it, hence the open call to the forum.
I am putting forward unqualified opinion. I have been an airline pilot for 40 years.

As QDM says, back to the doc, but I suspect that you have beaten a well trodden path down that route for some time. I am assuming that you have faced up to all the more serious possibilities and had them checked out, you can't be doing with the burden of that kind of worry while flying.

Question. Are you sure that your stomach is contained below the diaphragm? You say that the hernia is small, but there should be a clear determination that there are no adhesions that leave the top of the stomach tacked at the wrong latitude.

Perhaps, and only perhaps, the tiredness should be divorced from the rest of the symptoms, inasmuch it would be logical to feel washed out while all the other factors are nagging at you.

The other possibility that comes to mind is, I have to confess, one of my hobby-horse beliefs. When a problem persists and causes long term distress, there seems to be a very counter-productive tendency for the body to auto-clamp various muscles, be they sphincter, blood vessel, or other. The cyclic wind-up can be circadian or random, and unbelievably painful, or not, perhaps simply causing other symptoms to mask what is going on. Relaxation techniques are usually not enough, the loop has to be broken with prescribed and if possible, specific muscle relaxants. Strangely, once you catch your sub processing at it, the need for drugs often seems to all but vanish.

Do keep the thread going.

LR

[Northern Chique]

If no success from QDM's suggestion, change doctors...

[perseus]

Thanks to all for your advice. I will pursue a couple of lines that have been suggested. I still think the hernia thing is relevant. (Thanks for the info regarding that Loose rivets. I suspect the stomach is a little too high, and for some reason causing me a lot of grief, especially nausea. Your comments on the tiredness thing also make a lot of sense.) A change of consultant is something I am looking very carefully at, this is not a criticism, I just feel a fresh mind could help. My AME is also a big help, and is doing all he can. If anyone has any more suggestions please don't hesitate to contribute. I will keep you posted as to how things are going. Once again thanks for your contributions.

[Loose rivets]

Probably of the items that I mentioned, the spasm is the most likely; I'll elaborate on why I think this is more than a remote possibility if you wish, but just for now I'll just mention that one very telling indicator is the sudden cessation of the symptom when just getting airborne for instance. Some of the data gathered, from an admittedly small sample of pilots, have indicated that muscular tensions, headaches and stomach pains, in some cases long term chronic symptoms, disappear completely during critical phases of flight. It seems that the level of concentration transcends any form of relaxation technique. I would guess that even if it is the inverse of this is true, and it gets much worse during these periods, it is all part of the same function and an indicator that you will be able to control it eventually.

[CoodaShooda]

I agree spasms are a good possibility...usually stress induced.

If you've spent time in the tropics, your symptoms also sound like an amoebic infestation.

[faheel]

For what its worth I was told I had a hiatus hernia about 5 years ago ( I was getting a lot of heartburn and pain some of which resembled an angina attack) needless to say I was pretty worried.

Anyway I found (via the net) a cure which was for me 100%
Try this, buy some fresh ginger, grate it up and squeeze out only the juice, take 1 teaspoon of juice when you get up in the morning, before you eat or drink.Do it for 3 weeks and voila' you are cured!

I cannot remember the internet site I got it from but they claim pretty much a 100% success rate and as I said it was for me.

Good luck

[missioncontrol]

I have had similar symptoms to what you describe for the last 7-8 years.

I have recently tried an alternative approach and went to seek advice from a herbalist who advocated "Chinese Herbal Medicine" taken in the form of a Tea.

This was after all atempts at conventional Western medicine had failed.

The results seem to be helping- I have noticed a dramatic improvement over the last few weeks. This solution is not cheap, but if it effects a cure then is better than suffering for years whilst trying the "Western approach". The Chinese have afterall been practising medicine successfully for thousands of years.

Hope this helps.

[flightmedic]

You don't mention which of the proton pumps you have taken (if any), but persistent symptoms in the presence of those drugs suggest something else is going on. The big worry would be a tumour, but you have had a recent endoscopy and that is clear. You also are helicobacter negative. There are then three other common possibilities. One is so daft you will kick yourself - you are eating food which is too hot and literally burning the stomach! The second is that you may be eating a lot of spicy highly flavoured food - common if you are eating passenger food a lot - and the third, and possibly the most relevant, is posture. You are tending to sit, and I bet slouch, at the controls for prolonged periods of time. Sit up straight, ensure your belts are not overtightened and get up to stretch a bit. With the modern ethos of locking pilots away you can't get even the little bit of exercise of wandering down an aisle and back.

[bdconnolly]

I would recommend you try alternative medicine, natural medicin rather than conventional. Seek an alternative specialist they can prescribe natural herbs and remedies which may be more useful. I know natural medicine always works for any problems I have had.

[perseus]

Thanks everyone for your suggestions. A second opinion from a truly excellent consultant has produced results. The suggestion is that I have ruptured my diaphram, and thus allowed part of my stomach to protrude upwards to where it should not be. Early indications are that surgery is going to be the answer. This has been a truly bad time for me, and I am at last seeing some light at the end of the tunnel. I will keep you informed, if anyone is interested. The lesson I have learnt thus far is to seek advice from anyone you can, and always get a second opinion.
Once again my thanks to everyone who has contributed, and also to those who sent emails.

[jayteeto]

I am going through a similar medical process. First things, I declared to the CAA and after endoscopy, they cleared my class one medical, which took the pressure off!! There is an operation that tightens the entrance to the stomach and is done by keyhole surgery. Cant remember the exact name, but Fundo.... was part of it. Only a few surgeons do the op, the leading man is based at Princess Royal Hospital, Telford.

[DX Wombat]

The name of the procedure is "Fundal plication" Hope that helps.

[air pig]

Glad to know that you are sorted out. Good luck and get back flying.:)

[flightmedic]

Nearly - fundoplication. To be fair, you did mention a hernia originally, and that is really the same thing. There are two types, a rolling (rare) and a sliding (common). I wish you well with the surgery. Remember my original comments about posture. Are you overweight by any chance?

[Loose rivets]

DX Wombat?? Was there not an AME in London of the same or similar name in the late 60's?

[Penktadienis]

Hi Flightmedic and other wing mates,

I've scheduled Fundoplication surgery on Monday. Will I be allowed for aerobatics ever more?

Cheers!

[flightmedic]

So long as you don't exceed 1g... ;)

The pressures created by aeros will not be much greater than those you can create yourself by straining. I'm not sure if anyone has ever measured intraperitoneal pressures in the centrifuge!