Complications post laproscopic nissen fundoplication

Hello,

I am new to this site and I was hoping for some advice from anyone who can help. I am 28 years of age and 5 weeks post op to correct a hiatus hernia, after suffering heartburn and acid reflux for 6 years. However, since the op, I have been in and out od hospital on a drip 3 times due to severe stomach cramps and constant retching and feeling sick. The doctors at the hospital take x-rays and inform me that my stomach is full of air. They put me on a drip and pile me with drugs until i feel ok and then send me home saying they can do nothing more. Once I am home, I go straight back to feeling sick and having diorrhea and the process goes round in circles. Has anybody else experienced this 5 weeks post op and if so, are there any tricks to combat it and how long does it last? I am still unable to go to work and I am takinf sickness tablets 3 times a day with no relief.

Simon

Hi Simon,

Welcome to the Healing Well Wrapped Club! I'm so sorry to hear that you're dealing with post-op complications. 

First, it sounds as if you're getting lots of bloating, which is a very common complication during the early stages of recovery.  Some suffer from it more than others.  I believe it's dependent on how tight or loose your wrap is.  Also, post-op swelling can make bloating worse as well. 

As Alcie said, some here have had more bloating once they start eating more normal foods.  If this is the case, you might want to back off on your eating and consider going with soft of liquids for a while longer.

The vagus nerve is often irritated during the surgery, and it can play a big role in discomforts post-op.  That irritation can also cause the diarrhea you're experiencing.  That was a problem that I had as well, although it was intermittent.  It didn't disappear completely until sometime after the year mark. 

Unfortunately, you're in the midst of a very uncomfortable recovery, and knowing that with time it will subside doesn't help that much.  It sounds as if you're already taking anti-nausea meds, so that's good.  Have you considered trying a different one?  Perhaps another composition would work better for you.  I tried Zofran and Compazine suppositories, and the suppositories were more effective for me.

Alcie is right when she says retching and vomiting can damage your healing wrap.  That's why it's so important to treat the nausea. 

I so wish I could give you some magic trick to get this all behind you.  Unfortunately, we all heal differently, and we just have to travel those paths to recovery.

I assume you've discussed all this with your surgeon.  I would be interested in hearing his/her take on the subject.  Several people on this forum have suffered nausea during recovery.  Hopefully some will be by soon to share their own experiences with you. 

I also agree with Alcie's warning not to do a dilation at this early stage.  Although 5 weeks must seem an eternity to you, it's really very early in the recovery.

I don't know if you'll find it helpful, but here's a link to a document discussing a study of post-op Nissen patients, that comes to the conclusion that nearly all complaints resolve after 3 months.  Here's the link: 

http://www.sages.org/sagespages/document.php?user=FrantzidesConstantine&document_id=144&title=postoperative-gastrointestinal-complaints-after-laparoscopic-nissen-fundoplication

I'm glad you've joined the forum...it's a great resource, and will also provide you with lots of support as you go through this difficult recovery.

Very best wishes,

Denise

 

Hi Simon,

Is there any way to get another surgeon to consult on this problem?  I'm sure you're not alone with this frustrating situation.  It's a complication that can happen when the wrap is too tight.  I believe sometimes swelling can exacerbate the problem.  Do your doctors think this will resolve in time?  The linked article said that most often the problem subsides by 3 months.  Here's hoping that things are better sooner than that. 

Wish I could be more helpful!  I wonder if you should back off further on the eating, and stick with even blander foods.  You're suffering enough that it might be worth the effort to try a bland and very smooth diet for a while to see if you get any relief. 

Best wishes,

Denise

(Oops...sorry about the wrong name!)

Post Edited (dencha) : 3/17/2012 8:11:10 AM (GMT-6)

My problem is the reflux is not completely gone after my surgery, and I have a ton of gas. I am 3 1/2 months out from surgery. Last time I saw the surgeon, 6 weeks ago they did an upper G.I. The radiologist told me I had a huge air bubble in my stomach. The sugeon later told me that is why I might be feeling as if I have reflux, the pain and pressure from the air trapped. She is thinking of stretching my esophagus a bit to see if it will allow the air to come out as a belch here and there and relieve some of the pressure. If your wrap is too tight, it can create this, but in most people it moves through as a ton of G.I. gas. It does that to me, but I think a lot of air stays trapped in my stomach causing discomfort. My G.I. doctor says absolutely do not stretch the esophagus, especially since I am still experiencing some reflux. I am at a loss as well, but mine does not come with nausea - just a yucky feeling of pressure. I try gas-x and other things, but my GI said that is like a placebo, because really it is trapped air in my stomache and won't help. I need to see my surgeon again, but she is an hour away and I just get so tired of making that trip for her to recommend one thing, and my local G.I. to discount it - the surgeon does take his concerns into consideration, so I remian in limbo. She is a good surgeon, my G.I. told me I am the only one of his patients that have had issues after going to that surgeon. Speaking of beer Simon, I just tried one last weekend to gear up for St. Pats, and the next day it was as if my stomach had so much air in it from the carbonation that it was a tight balloon ready to burst :-(. Be careful with that until you get this issue resolved!!

Hi Virgogirl,

I know it's hard to be suffering from bloating, but you're still at an early stage of recovery.  If you're bloated or having discomfort, beer is the very last thing you should be drinking.  Beer can cause bloating in people who haven't just had their upper GI tract revised.

Your GI doctor is correct in telling you that esophageal pain can cause feelings of reflux.  The esophagus is a "dumb organ" and it interprets all pain as reflux. 

Like Simon, it would be helpful for you to back off your eating and go back to more bland an soft foods for a while.  Baby that stomach.

No surgeon or GI doc can make you heal faster.  You can facilitate it by making careful choices with your eating.  Your upper GI tract has undergone a major revision and it's totally understandable that your stomach is complaining loudly.

Baby that stomach of yours, and you'll begin to get some relief.  This is not a forever thing.  Relax into your recovery and let it tell you what it needs.  If you fight it, you're only going to extend the agony.

Best wishes,

Denise

Hello, I am new to this site. I had the lap nissen on Jan 25 2012, after months of trying to find a Dr. that wouldn't require me to have the Gastric Bypass. If I would have did both operations in one, it would have been a deadly combination. I had a large hernia in my Esoph and my stomach was half way through it and my liver and diaphram was swollen. I was so sick.

I had my first nissen in 2002 using mesh. It went great, no problems and little to know pain. I remember when it ruptured in May. I was constipated for a while before the violent vomit. One day I a sharp pain like I had been stabbed in my stomach then I vomited bowel. That was the first time I have thrown up in 10yrs.

Well, this time its been a nightmare. I was re-admitted to the hospital within two weeks after my discharged in Jan. My Esoph had swollen shut. I could only get down liquids. I spent days in the bed with little to no strength, I barely could hold up my head. In the meantime the Dr. was only saying, "I beat you up pretty badly, It's gonna take all of 6 to 8 weeks to completely heal". Know that this doctor is no stranger to this procedure. He was a partner to the surgeon that operated 10yrs ago. He was very thorough and got me everything but a pain free day. I had complete confident in this man. After hunting for a physician so long, and being turned down so much. I deemed him the one. lol

Since the second hospital stay I've had diarrhea up to 11 times a day. I am on zofran as needed for nausea so I want hack my head off and its always a mild cramp in my abdominal area. The dirrhea comes when it wants too. Most days I don't eat any food because I don't have a taste for it, but I try to keep sipping on juice to stay hydrated. This thing is really doing me in. I've lost 80lbs since December and I don't feel healthy and I am always cold, sick at the stomach and weak. What could this be? The Dr. did'nt use mesh this time. He used the linning for a Pigs heart or something like that to make the wrap.

Could my body be rejecting the foreign body? 

My family Dr. order a stool collection and is sending me to a GI Dr., but I've never seen a Doctors office like this. I takes almost a week to process a freaken referral or to get your test back.  I look forward to read your comments.  

Hi all,

Just a quick update, I am feeling much much better now than I have for ages, however I am still struggling with food and liquids. I can the majority of the time eat fine, although I do get the feeling of something getting stuck with most foods. This feeling only lasts a minute or 2 and then goes but it is very frustrating. I am also struggling with liquids, nearly every drink i have tastes differently than before the op and I almost dislike every drink. I also cannot drink without only being able to take small sips still and sometimes it feels like drinks are getting stuck and filling my throat with liquid. I have tried drinking beer again and I can still not drink any gassy drinks such as beer or fizzy pop. I can barely get the neck of a beer bottle down me before i feel like my stomach is going to explode. Has anyone else suffered with this nearly 4 months post op?
The wedding is 7 weeks away and still I can't eat or drink normally. I've already had to cancel my stag do which was gutting enough. lol. How long will the jacuzzi stomach last too?

Simon,

I've had a very hard time with my Nissen fundoplication as well. Six months later, I still have a lot of pain.

I was diagnosed with Crohn's Disease in 1998. It's not possible that that it's a post op reaction to your Nissen. It's an autoimmune disease. The surgery could have brought on a "flare" - stress can tweak the Crohn's, for sure.

I was VERY sick when I was diagnosed with the Crohn's. It definitely can cause trouble with nausea and appetite, amongst other things. It sounds as though you are having a "classic" symptoms. When you get the right medication to help your gut heal, much of the nausea and lack of appetite will resolve.

You are truly dealing with a lot right now. Message me if you have any questions about the Crohn's - I am quite the expert on it now. Also, the Crohn's community on this forum is EXCELLENT.

Best,
Leslie

I had a Nissen Fundoplication in 2001. I"m hoping that it will indeed help to protect me from cancer of the esophagus because it certainly hasn't been of much help. I still take Nexium every day. The most helpful thing that I have ever taken is Pure Encapsulations - G I Fortify. It is magic in terms of stopping pain and taking away the inflammation. It can be taken as often as necessary since it is a natural product. Just make sure that you mix it in a blender. It doesn't taste great but it takes some of the bloat away and all of the pain. I also use digestive enzymes with every meal. This really helps me. I can't drink red wine at all and can only have a little white wine if it has a bit of sweetness and only if my stomach is feeling very good.
For anyone that is considering this surgery I would strongly advise losing weight first. Eliminate all carbonated beverages, foods that are acidic, highly spiced, gassy or highly processed. Drink lots of water through your day, easy on the juices. Eliminate everything that contains aspartame. Don't chew gum. Once you've done these things and you still have problems then consider the surgery.
There is a product called Betaine that you can use to help balance your stomach acids. See a good naturopath and they can help you with that. The sad truth is that many cases of GERD are due to low acid in the stomach not too much acid. If I had known about Betaine all of those years ago, I would have used that regimen first. All of these things are simple to do.
As for not being able to throw up or burp after this surgery, this has been a huge problem. Not being able to burp means that the gas that is causing excruciating pain must go through your intestines and be eliminated through flatulence to gain relief.
Just do the simple things that I have suggested and remember that your stomach will act up in the spring and fall.