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5 months after nissen op having major complications need advice

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Posted 2/19/2014 11:10 PM (GMT 0)
had nissen fundoplication surgery 16.9.2013 still on liquid diet. Had a barium swallow before op couldn't perform motility test due to me throwing up the liquid had another after op on 20th dec which showed oesophageal dismotility and delayed transit time. Lost masses of weight. Constantly have pain at op site when even trying soft foods constant runs. Dietician has put me on supplement drinks. Went to see consultant on 27th Jan he now wants to perform an endoscopy to see whats happening. Although he said operation went well. He has then proceeded to send my dietician a letter saying that the dismotility and delayed transit time will now cause problems and he wants the dietician to assess me for an NG feed or a peg feed. none of this was discussed with me when I saw him and he also wants me to see a special gastro dietician as well as the one I am currently seeing. Has anyone else been through this really concerned and confused
Posted 2/20/2014 12:23 AM (GMT 0)
Hi jocog, did you not have a manometry test before you had the op?

That would have been the better test for showing and esophagal problems. Just wondering, how experienced your surgeon is ? Did you ask him how many fundoplications he had done ?

I am not sure where you live but in the uk gastroenterology and surgeons are two different specialities so you have to see both. You seem to only have the expertise of one person which can be a bit one sided view...

Maybe you should consider finding a gastro consultant rather than a surgeon or at least a second opinion.

Hope you find the answers you are looking for.
Posted 2/20/2014 4:01 PM (GMT 0)
Hi jcog. Jamosca has a good idea. A gastroenterologist would be the right person to do the tubes anyway, because they do them all the time, so seeing him for a second opinion makes sense.

Since the esophagus has to be "let down" to make it long enough to wrap, it's easy for a few nerves to get cut during the fundo. Ask the gastroenterologist if that's what happened, also if the condition will improve.

As for "supplement drinks," read the labels. They're mostly corn syrup and some milk protein and a few vitamins. Then they add thickeners to make you think you're getting something worthwhile. Might as well drink a glass of milk with a crushed vitamin and skip the sugars.

There are a few meds for chron's disease that help with the "runs." They come in powders, so insist on not taking the "horse pill" that might be prescribed.

I'm not sure what an endoscopy would see since you wouldn't be swallowing. Have you had a barium swallow? That does show what's happening when you are actually swallowing. They can do a special sideways one if there's any chance of choking. (I had this done after nerve damage from breaking my neck to see if it was OK to remove feeding tube.)
Posted 2/26/2014 10:02 PM (GMT 0)
hi thanks for replies. I have had endoscopy surgeon found that wrap was spasming and performed a balloon dilation to stretch the wrap. Been told that I could have had the dismotility for a long time and they are not sure how it is going to affect me long term. In answer to Jamosca i had barium swallow before the wrap but couldnt perform dismotility test as i was throwing up the liquid by itself, but they went ahead with the operation anyway. Even with what they have done yesterday they are still wanting to put a ng or peg feed in as i have lost so much weight as having problems with stomach and bowels. When to an independent consultant for a second opinion and he said that some people are fully better and able to eat by 6 months but i am one of the unfortunate ones. He also stated that my throat stomach and intestines are out of sync and the ng feed or peg feed for a period of time will sort this out and get them working again, and also that the problems i am having are down to IBS confused is not the word
Posted 2/26/2014 11:35 PM (GMT 0)
jocog

I wanted to share some of my experience with you about the NH and JPeg.

I had to have these when my esophagus tore and wouldn't stop leaking after surgery. Between the 2 my preference is for the JPeg. While it is a surgical procedure it is a lot more comfortable and easier to deal with all around. Anyone who has had a wire PH study knows the tube can be challenging to deal with and pulls when you swallow. The NG feeding tube does the same.

If you don't need 24 hour feeding the JPeg just lays under your shirt. I was on 24 hour feeding and was much more comfortable with the tubing going under my shirt vs my nose.

When they removed the JPeg the hole healed very well and no stitches were needed. I had to keep it covered for a week or so and it just closed up by itself.

Take care,
Bill devil
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