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Gastroenterology (Expert Forum)
Acid Reflux and Superior Mesenteric Axis Syndrome
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Acid Reflux and Superior Mesenteric Axis Syndrome
by Rickvin, Mar 30, 2004 12:00AM
After 6 months of tests and checks my father was eventually diagnosed with gastritis & acid reflux as well as food blockage due to superior mesenteric axis syndrome.
Often he feels spasms normally before meals, and after meals he has a feeling of indigestion. He has lost about 5 kg in the last 5 months as his diet has been almost 1/2 due to the indigestion problem after meals, causing him to reduce his food intake.
The doctor has said he would prefer my father to leave the problem and learn to live with it rather than go through surgery as this is a very rare problem. Has anybody come across this problem and if the person has had surgery to improve the condition? My father is 64 years this year.
Often he feels spasms normally before meals, and after meals he has a feeling of indigestion. He has lost about 5 kg in the last 5 months as his diet has been almost 1/2 due to the indigestion problem after meals, causing him to reduce his food intake.
The doctor has said he would prefer my father to leave the problem and learn to live with it rather than go through surgery as this is a very rare problem. Has anybody come across this problem and if the person has had surgery to improve the condition? My father is 64 years this year.
Doctor's Answer
by Kevin Pho, MD, Mar 31, 2004 12:00AM
, Mar 31, 2004 12:00AM
Conservative initial treatment is recommended in all patients with SMA syndrome; this includes adequate nutrition, GI decompression, and proper positioning of the patient after eating (ie, left lateral decubitus, prone, or knee-to-chest position).
Enteral feeding through a tube passed distal to the obstruction or total parenteral nutrition can be an effective adjunct in treatment of patients with rapid severe weight loss. Metoclopramide treatment may be beneficial.
Surgical intervention is indicated when conservative measures are ineffective, particularly in patients with a long history of progressive weight loss, pronounced duodenal dilatation with stasis, and complicating peptic ulcer disease. Duodenojejunostomy is the most frequently used procedure, and it is successful in about 90% of cases. This can be discussed with your surgeon
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Enteral feeding through a tube passed distal to the obstruction or total parenteral nutrition can be an effective adjunct in treatment of patients with rapid severe weight loss. Metoclopramide treatment may be beneficial.
Surgical intervention is indicated when conservative measures are ineffective, particularly in patients with a long history of progressive weight loss, pronounced duodenal dilatation with stasis, and complicating peptic ulcer disease. Duodenojejunostomy is the most frequently used procedure, and it is successful in about 90% of cases. This can be discussed with your surgeon
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Do we need to see a vascular surgeon or any normal surgeon might be good enough?
Thank you