Morphine reduces LES pressure

April 27, 2012

I knew this all along. The original pdf states Ca channel blockers are largely

ineffective and have many adverse side effects.

One promising pharmacological treatment is to reduce the dose of Ca++ and add

morphine to increase efficacy and reduce side effect profile. This has been my

long-term experience with a MSIR and Gabapentin regimen that has been markedly

more effctive than dilations, HM, botulinum, tricyclics or Ca channel blockers

alone.

And, yes, opioids titrated to effect will increase life function, allowing

achalasians to eat, live, work, drive and socialize much better on them than

without.

Steve

http://www.ncbi.nlm.nih.gov/pubmed/8381758

April 28, 2012

Steve wrote:

>

> I knew this all along. The original pdf states Ca channel blockers are

> largely ineffective and have many adverse side effects.

>

I would think it is common knowledge to anyone that has been in this

support group long-term and follows these things. A key phrase in your

statement is " largely ineffective " which should not be taken to mean

never effective. They are for some people effective. Sometimes that

effectiveness drops over time but that does not mean the good time is

not worth pursuing. Also, the " many adverse side effects " are often

minimal and not even noticed, but for those that get head aches they

could be very noticeable and for those with low blood pressure they may

not be advisable. Some people are going to focus on the first part of my

last sentence and some are going to focus on the last part, they should

focus on both.

>

> One promising pharmacological treatment is to reduce the dose of Ca++

> and add morphine to increase efficacy and reduce side effect profile.

> This has been my long-term experience with a MSIR and Gabapentin

> regimen that has been markedly more effctive than dilations, HM,

> botulinum, tricyclics or Ca channel blockers alone.

>

I am glad it works for you. I wasn't aware that Gabapentin (Neurontin)

was a calcium channel blocker. I looked it up and see that it is. Years

ago in this support group there was a discussion about speculation that

Neurontin might be helpful with the achalasia neuropathy (NCCP) but two

members went to a medical achalasia convention and asked a doctor there

about it and didn't get an encouraging response. Were you prescribe it

specifically for achalasia? I wonder how the CCB effects compare to

other drugs that are normally used as CCBs. It would be an interesting

choice because of the other effects with neuropathy if they actually

work for achalasia in spite of the unencouraging doctors response.

>

> And, yes, opioids titrated to effect will increase life function,

> allowing achalasians to eat, live, work, drive and socialize much

> better on them than without.

>

Heller myotomy did that for me so opioids are not going to help me.

Perhaps you meant, " allowing " SOME " achalasians to ... . " I know I am

being picky here but I think opiods do have a place in treating

achalasia, for some people, and I would hate for the discussion of it to

be dismissed because in overstating the positives of it we sound like we

are pushing an agenda. Steve, people are not going to trust your opinion

when you sound like you are pushing your personal agenda. It is a

natural response when faced with ignorance and bias to overstate things

to make a point. Kind of like shouting and like shouting it may cause

people to decide to stop listening.

Jerry

April 28, 2012

I took nefedipine for years. Â It was the one medication recommended by my

otherwise useless doctor in Uruguay that actually helped me swallow sometimes.

Â I continued to take it after my surgery. Â I had no side effects that I am

aware of, but of course, other people's experiences may differ.

________________________________

From: notan ostrich <notan_ostrich@...>

achalasia

Sent: Saturday, April 28, 2012 10:08 AM

Subject: Re: Morphine reduces LES pressure

Â