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Reflux after Fundoplication???

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Posted 2/13/2013 10:46 PM (GMT 0)
Hi all

I am one week post op; had a Nissen fundoplication.  Have had a very easy recovery for which I am very thankful.  However, I feel like I'm still having some reflux.  Was fortunate to never have had pain/heartburn symptoms with GERD and still have none of that.  At first, I just noticed what seemed like reflux upon waking after sleeping flat on stomach.  Then today, have started having some throat clearing after eating.

The diet protocol my surgeon recommended seems quite different than what I've seen here.  In fact, my first day post op, I had a liquid breakfast, and then pureed food for lunch.  I was allowed to go home that day because I tolerated the soft food well with no nausea.  I am still avoiding breads and meats (although have had small bites of both, just to test, and was fine) and am mostly on a soft food diet.  And I'm still have avoiding trigger foods/drinks.

I have my first post-op visit with the surgeon tomorrow and will, of course, discuss this with him.  But being a pretty inpatient person, thought I would post here just to see if anyone knows if some reflux during the healing period is normal.

Thanks!

Posted 2/14/2013 1:42 AM (GMT 0)
What symptoms did you have if not pain and heartburn?

1 week is too early to know anything. I have read several times where people have heartburn pain or other symptoms of reflux (like sour taste) early in fundoplication recovery.

I am 4 weeks out from mine and still have reflux symptoms even though I don't think they are actual reflux. I think that just like when I did have reflux, my body responds in certain ways including throat tightness and sour taste. Now the esophagus is swollen and/or irritated, which it may interpret as reflux, resulting in similar symptoms to when I had reflux. Those people I mentioned who have reflux like symptoms, that later settle down, are in my opinion good evidence that even without reflux, a person can have symptoms of reflux as the healing process continues.

Another possibility is that the swelling of the repaired tissue does not seat/seal as well as it will when it's done healing, and therefore lets some reflux through. It's probably a combination.

Are you still on a PPI? In my opinion, it's a good idea to stay on one or take one at this point. This will help in the event that there is reflux going on; it may also convince you (as it's convinced me) that if the PPI doesn't seem to help much, maybe it's not actually reflux, but "reflux like symptoms" caused from the irritation of the surgery. If it were actually reflux, then a PPI should help. Because of the possibility that the seal of a swollen LES may not be ideal, I think it's a good idea to take a PPI any way, even if it doesn't seem to help your reflux-like symptoms. I think it can only help.
Posted 2/14/2013 2:02 AM (GMT 0)
Thanks, drtinsac. My previous symptoms included throat clearing with clear phlegm after eating as well as a sour acidy taste in my mouth upon waking and sometimes during the day after eating.

What you've said makes a lot of sense. I am not on an PPIs currently. I've tried all of them and in doses that exceeded what my insurance thought was reasonable and refused to cover the prescription. No meds ever even reduced my symptoms which is why I was untreated for years. When I started having hoarseness back in August 2012, I worked with doctors to determine it was caused by the acid and decided to pursue the surgical option.

I will ask my surgeon about trying PPIs again as you suggested. Not sure though, they didn't help before, but maybe with the acid a little better controlled they might do the trick.

Thanks again; what you said about the seal not being set/fully formed yet makes a lot of sense. You've given me hope that I may still be reflux free in a few more weeks.
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