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PPI use after Nissen

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Posted 11/23/2011 8:30 PM (GMT 0)
I'm just wondering who out there has had to go back on PPI after their Nissen fundoplication. If so, was it temporary, or is it a sign that the Nissen didn't work?
Posted 11/23/2011 8:52 PM (GMT 0)
mamakay-
Welcome to Healing Well!

Unfortunately some people don't get total relief with the reflux surgeries. Not just nissens though. I don't know any specific percentages or anything, I just know 2 of my surgeons have said this is a possibility. They usually don't have to be on high doses though.
I recently did have to go back on them temporarily because my nissen was torn apart by an esophagus stent to help my torn esophagus heal. We didn't know it had ruined the wrap until a couple months after the stent was removed.


Take care,
Bill devil
Posted 11/23/2011 11:58 PM (GMT 0)
I am still rather new post surgery, only 11 weeks, so hope this is just a temporary complication. I have a history of hypersenstivity in my esophagus as well so it may just be reacting to changes and not necessarily related to acid. However, that being said, it doesn't take much acid to cause me pain. Most people who reflux the levels of acid that I did wouldn't have felt any pain. I am hoping that I just need to get over the hypersensitivity somehow and if there is acid leaking up, control that through diet and not drugs. I tried PPIs, tricyclic antidepressants, neurontin, none of which worked so I chose surgery. Now I am scheduled to meet with my doctor again to see what I need to do at this point. I am convinced the surgery has helped a lot, but disappointed that I may have to still rely on low dose PPIs or other drug therapy. Yet, it is all worth it to stop the pain.

Thanks for listening.
Posted 11/24/2011 4:53 PM (GMT 0)
I'm not in the Nissen club, but I think those who are would tell you that it's still very early days. And there is also the problem of acid rebound when coming off ppis - it may be that you need a very very slow withdrawal. With hypersensitivity issues, it can take a very long time to retrain the nerves and the brain. Perhaps if you are still having trouble six months after surgery you could have some tests to see if there really is any acid escaping, just for peace of mind. Meanwhile, give the recovery process some time and perhaps consider something to help retrain your brain's responses (which may be due to overexcited nerves rather than any anxiety) - acupuncture, hypnotherapy??

St John's wort is good for nerve pain but it may not be safe to take alongside your ppi (reduces efficacy) - one to ask the doc about.

Zinc is very important for neurotransmitters as well as wound healing, so maybe consider a supplement too? You may be able to get a liquid one or chewable if need be.

You may wish to search the forum a bit more for other post wrap experiences - they do vary, so hang in there!

MMM
Posted 11/24/2011 4:57 PM (GMT 0)
https://www.healingwell.com/community/default.aspx?f=45&m=2265828

Have a read of Jesper's comments on the above thread too.

MMM
Posted 11/24/2011 10:09 PM (GMT 0)
I appreciate the advice. All good stuff to talk about with my Dr. And on this day of Thanksgiving, I give thanks for being on the road to recovery and the wonderful support I have through my family and people like you in this forum. Right now my husband is cooking up a fantastic thanksgiving meal which I will savor in small quantities. I think back to where I was a year ago, and though I haven't reached the light at the end of the tunnel yet, my quality of life is improving. I have been told more often than once that a positive attitude helps in so many ways in the healing process. So, I strive forward with hope and believe that this will all eventually be behind me. Happy Thanksgiving!!
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