REVIEWS
FEEDBACK FROM PATIENTS
In late 2020 I became aware of strange sensations in my throat, and across my chest. The best way I can describe this was that it felt like a prickling/creeping sensation up my throat and neck, accompanied by a strong feeling of pressure across my chest. These sensations were sometimes felt independently of one another, and I also had difficulty swallowing a few times.
I went to see my GP who sent me for an ECG, (as one symptom was chest pressure a heart attack had to be ruled out). The ECG came back clear, so I went back to my GP, but he didn’t know what was wrong. As this was during Covid I signed up to a virtual GP service, one of the doctors suspected I had chronic reflux.
This surprised me, as I didn’t have typical heartburn symptoms, however, the more reading I carried out on the unusual presentations of chronic reflux the more I thought this could be the cause. The virtual GP prescribed a PPI (Proton Pump Inhibitor) heartburn tablet, but this didn’t ease my symptoms.
I wanted to see a specialist quickly – and knew this would be impossible on the NHS – so I found a Gastroenterologist who specialises in reflux issues called Dr Rehan Haidry. He recommended an endoscopy to look at the structure of the oesophagus and a Bravo test to measure acidity levels, given I wasn’t experiencing the typical ‘burning’ sensation in my throat.
The Bravo test involves placing a tiny capsule – about the same size as a tic-tac – in the oesophagus for around 3 days to measure the levels of acid. When it came to the test I was given light sedation and a tube with a camera attached was fed down the back of my throat to implant the device and carry out the investigation. I felt a bit groggy afterwards, but I couldn’t feel the capsule, and there was no discomfort.
In recovery I was given a small device – about the same size as a Walkman – that I could wear discreetly under my jumper. The capsule in the oesophagus transmitted wireless signals to the device for around 3 days. I was instructed to press buttons on the device when I felt sensations. I also kept a written diary.
Afterwards I went back to see Dr Haidry who had reviewed the data and he explained the results to me. It showed that although I wasn’t feeling ‘heartburn’ there was a significant amount of stomach acid refluxing up my oesophagus, (particularly when I was lying down). The sphincter between my oesophagus and stomach was open wider than normal, which was likely the cause.
In order to try to resolve the problem Dr Haidry prescribed a different PPI treatment, and I put myself on a strict diet avoiding acidic foods and fatty dishes to try to reduce the acidity in my stomach. Unfortunately, these approaches did not help my symptoms.
I was concerned that doing nothing about the reflux could lead to a pre-cancerous condition called Barrett’s Oesophagus, so I began to research permanent solutions such as anti-reflux surgery. I decided to pursue TIF (trans-oral incisionless fundoplication) as Dr Haidry had advised that I would be a good candidate for this option, and it does not involve major invasive surgery.
The TIF procedure involves lengthening the oesophagus. Then the top of the stomach is folded and partially wrapped around the lower oesophagus. It is held in place with staples made of benign material which has been used inside the body for decades.
I decided to pay privately with Dr Haidry for the TIF procedure, as I still hadn’t had a first appointment with an NHS gastro, and knew it could be years before I was treated due to the backlog caused by Covid.
The procedure is done in the endoscopy suite under general anaesthetic. I stayed overnight after the operation and I did experience some pain immediately afterwards, but this was dealt with via a dose of painkillers for a few days afterwards. Also, during the surgery Dr Haidry discovered I had a hiatus hernia, the TIF surgery corrected this too.
I did struggle with the post-procedure diet. The diet consisted of clear liquid for 3 days (water, clear broth, etc), and then soups without lumps and pureed food, gradually building up to thicker textures.
I desperately wanted the surgery to be a success, and was very concerned that my symptoms may return if I didn’t follow the diet to the letter. In fact, I was very careful for far longer than recommended. It wasn’t until about 6 – 8 months later that I started to eat a more normal diet again and tried tea and coffee – which were previously huge triggers.
I can now drink tea and coffee again in moderation and I have a normal diet, it is truly amazing. Two years on I have virtually no symptoms at all. I prepare healthy balanced meals and eat out a couple of times a week. I know I have safeguarded my health and won’t develop a more serious condition like Barrett’s Oesophagus. I can’t speak more highly of Dr Haidry and I am so grateful that this procedure has given me back a normal life.
After having a hysterectomy and going into surgical menopause, Sue was determined to be ‘fit at fifty’. She was recently married, but had no confidence and was frustrated with her appearance. “I like my food and I did like a drink, but overall I was quite healthy. I ate well most of the time, I exercised regularly, I saw a PT and did high intensity exercise like weight lifting. I didn’t have any health issues, but I was significantly overweight for my height. Even looking at my wedding pictures upset me as I didn’t like the way I looked and I wouldn’t put on a swimming costume ever.”
Sue was just over 5ft and weighed 13 ½ stone putting her BMI at 36. She was fit and had no health issues, but had seen her GP many times about ways to manage her weight. She tried prescription weight loss medication, mail order slimming supplements and even went to a private doctor for £200 a month slimming injections: “The drugs work a bit while you’re on them, but there are always side effects and they didn’t give me permanent or significant weight loss. I blamed the menopause, but I was the one putting the food in my mouth. I started to think about weight loss surgery. I had a gut feeling that I didn’t want a body part cut off and taken away like in gastric bypass surgery. I came across a newer and safer technique called ESG – Endoscopic Sleeve Gastroscopy.”
ESG is a minimally invasive alternative to gastric surgery. Performed via a ‘camera down the throat’ technique means no incisions (or scars) on the abdomen and the stomach isn’t cut off or taken away. Instead a special device sews a line of stitches across the middle of the stomach, reducing its volume. “The doctor was very frank with me, he said that I had to do the work. If I continued to overeat then the stitches would stretch and I could find myself undoing any weight loss. I knew I had to commit to overhaul my lifestyle.”
Sue paid £10,000 to have the surgery privately. Having no health issues, like diabetes, meant she would be highly unlikely to meet NHS criteria. “The procedure was very simple. I went to the hospital (the Cleveland Clinic in London) in the morning, went down for anaesthesia and woke up an hour or so later. I had no marks or scarring on my body, just an IV drip in for the rest of the day. The recovery is very easy. I went home the next day which was a Thursday and I had the Friday off; I was back at work Monday morning.”
Sue noticed a difference in her clothes feeling too loose after just 4 weeks. The reduced size of her stomach meant she felt satisfied and full after small meals. “It forces you to eat smaller portions and your brain gets the message your full. You could ignore it and keep eating what tastes good, but you would feel uncomfortable so you don’t. I still had treats, but it would be one biscuit to get the taste, not four.”
Sue lost a stone easily in the first 8 weeks and remembered asking her doctor if she could break the no alcohol guidance. “Have a glass of champagne? You can have a bottle,” he had joked as he couldn’t believe how different I looked at my check up.
Studies have shown that the average gastric procedure patient loses 15% of their body weight over 6 months, but just 12 weeks after the procedure and Sue has already lost 20% of her body weight, quickly slimming down to 11 stone: “I was a size 18 in most shops, so I was thrilled to wear a size 12 Karen Millen dress to a wedding. It’s such a nice feeling to be able to go in any High Street shop and find clothes in my size that look good on me. My skin feels great and have more energy. I don’t feel sluggish anymore, I’ve changed my life
Sue’s BMI is currently 28 and she will only need to lose 7 more pounds for her BMI to be 25, which at over 50 years old is pretty incredible. “I’ve decided that to help me stay focused on the last leg of my weight loss journey, I am planning to renew my wedding vows on our holiday to Tanzania next year. I’ll be having a photo shoot on the day and replacing my wedding day picture as soon as I get home!”
Sue had the ESG procedure with Dr Rehan Haidry at the Cleveland Clinic, London.
I take Gaviscon sometimes and very infrequently Ranitidine 150mg, only if I go to wine tastings or know I might eat too much. Otherwise no problems at all. I am so happy, it has improved my quality of life no end! I couldn’t recommend it highly enough!
Before Stretta I’ve been nauseous and ill nearly every three months. I’ve had gallstones, and they’ve been removed last year, that might have helped too, but I am feeling great since Stretta.
Glad I saw Dr. Haidry, he is a pro and knows what he is doing.
Before I had stretta I had the following symptoms :
– waking up each morning with my nose congested, a sore throat and a bad taste in my mouth
– I felt lethargic most of the time. When wanting to do exercise, running out of energy quickly and getting out of breath easily and always with a runny nose
– regurgitated food and sick in mouth on a regular basis over any given week with frequent acid and wind
Post procedure:
– immediately after the procedure I was in a bit of pain but once the paracetamol had kicked in this was managed.
– I was back eating medium to solid foods with a week
– I felt immediate relief for 2-3 weeks after the operation which was amazing – due to the swelling no doubt
– after a couple of weeks, day to day routine was back to normal. I had held off training but soon for up and running with that again
– it was difficult to burp for the first 4 weeks or so which was amusing more than anything and actually reassuring in a way as it felt like it was ‘keeping it where it should be’
– chest was a bit sore initially internally upon long distance running but this was within a month of the procedure so probably to be expected.
12 months on
– occasionally wake up with sore throat. Usually if I have eaten something I shouldn’t have but in the round 70% improvement on prior to the procedure.
– Lots more energy and stamina.
– occasional reflux but literally a handful of times per week as oppose to several times per day
– still get a bit congested which is why I am keen on a stretta 2 but it’s nothing like what it used to be.
On the whole I would say a 70% improvement overall. Some days, it doesn’t even cross my mind whereas prior to the procedure I knew about it each day and looking back, it was quite depressing.
I am so pleased I did it and I wouldn’t think twice about a second one if the benefits built on where I currently am. “
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to contact Dr Rehan Haidry’s medical secretary Debra Hyams
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org