Post Nissen question

Hi,

I am just over two weeks post Nissen surgery. My surgeon asked me to cut my Esomeprazole and Ranitidine by 50% as soon as I had my surgery. He then said to start taking them every other day after two weeks.

For the last few days I have had reflux. Is this due to rebound from cutting my medication by 50% or a sign that the wrap has failed?

Should I hold off taking them every other day until the reflux subsides? If it doesn't subside should I go back onto what I was originally on until I see my surgeon? I am not due to see him until the 14th April.

I appreciate your thoughts.

Thanks for your response Tony.

How have others come off PPIs and H2 blockers after Nissen surgery? Did anyone get rebound? How did you deal with it?

I have read a few posts on here suggesting it is better to stay on these medications until the wrap has healed. Anyone have experience of that?

Thanks.

I think it's all dependent on the surgeon's opinion and experience. I didn't get any rebound at all and almost a year later, haven't had any.

Be well!
-TonyG-

3 weeks is very early in the course of Nissen recovery. It can take weeks to several months to get pre-op swallowing back. There is swelling for a long time. How well you swallowed before the surgery determines what you can expect - and should have been tested before surgery. I have polio throat, so my wrap was a partial.

Don't complain too much about swallowing too soon, unless you can't swallow liquids. Some docs will immediately want to do a dilation. I had one resident who wanted to do a scope and insisted that he would do a dilation also, even though I refused it! So I said no scope. I could not convince that dunce that I was swallowing as well post-op and I had pre-op, due to the polio. There is no point in wrecking a perfectly good wrap unless after a very long time you still get soft foods stuck. Actually, some soft foods can stick before they ever get to the wrap. I can feel toast bits in my throat, well above the valve, for as much as half an hour and have to wash them down with my coffee. My problem is not due to the wrap. Part of the problem, besides a weak swallow as tested, is pain meds that keep my throat very dry. So, consider that as something that can affect you also.

If you can't stand to chew meds and don't have them as liquid, one secret is butter. They're tasty that way too. Check what the manufacturer allows. Some capsules can be sprinkled on applesauce. Don't mess with time-release if the method involves the pill or capsule shell like a tiny hole for release. But, Nexium says their coated granules can be sprinkled. Crushed meds that are bitter - try putting them in strawberry jam. I just chew my tramadol and ignore the taste.

OA-

It is normal to have swallowing issues period during this recovery. It will get better, but as Alcie said it can be a few weeks to months. This is a slow recovery and it takes a lot of patients to get through it.

It's WAY to early for anyone to say if the wrap is to tight. that can't be determined until 6 months minimum and maybe more like a year.

Take care,
Bill

I am 4 weeks post Nissen. I am trying to make the transition from mashed + pureed food to light foods with more texture e.g. stews.

I am finding I get the same feeling like I did when I couldn't swallow pills. It feels like the food is stuck above the wrap. I also feel like I cant swallow and experience a minor pain in my chest. I have tried using soda water to wash the food down but it doesn't seem to be budging.

Did others experience similar problems when they tried to eat foods with more texture? I am supposed to be able to eat toast and salads at this point too but I cant imagine being able to eat them if stew is so difficult.

OA-

Remember to chew your food extremely well. You are still very early in recovery. Chew to a liquid still and small bites. Be sure to drink somewhat room temp water, it helps keep things from constricting.

Every time you advance your diet expect some set backs as your body adjusts to the new food.

It will get better with time.

Take care,
Bill

I thought I had reflux problems too after the Nissen, but it was due to me trying to eat too much, once I cut down the size of portions, it was so much better. I stopped my meds straight away with no probs. sometimes I thought I had heartburn so took some Gaviscon and it disappeared.

It does take a long time to feel better, you will get there.

Hi

I still drink decaf coffee, it seems to help. Certain foods definately irritate, but it does pass. Enjoy your travelling and try not to eat too much bread, that also makes it worse

Julie