Shoulder pain possibly related to Nissen and/or GERD?

[Richard Kaszeta]

This is one for Howard, if he's still reading here:

In 2001, I had a Nissen Fundoplication done, which resulted in the
near elimination of my acid reflux discomfort, although I still take
20mg Prilosec 1x/day, and rarely have any gastrointestinal discomfort
unless I badly abuse my stomach (large, repeated heavy meals with high
acid content), usually I'm fine.

However, starting in June I started having *severe* stabbing shoulder
pain, primarly in the left shoulder. After a series of X-rays, blood
tests, and a CT scan, my doctors and the radiologist are of the
opinion that the pain is referred pain from diaphragmatic irritation,
but my primary care provider does not think that a consultation with a
GI specialistic is warranted (since my last endoscopy two years ago
was fine), nor is a consult with a surgeon appropriate, and instead
has been treating the symptoms with painkillers (Vicodin). I'm hoping
that a better solution than Vicodin can be found.

Two questions:

1. Can this shoulder pain be caused by something wrong with my
esophagus, stomach, or the results of the Nissen? I've seen
references on Pubmed to some Nissens causing sliding hiatal hernias,
but I'm not knowledgable enough to determine the likelihood of this.

2. Should I be pressuring my primary care doctor more for a referral
to an appropriate surgical consult or a GI consult?