10-30-14 Nissen Fundoplication

I do wish you all the best and hope that your Nissen goes as well as mine. We have similar symptoms except for the Barrett's. I didn't have that although it is a wonder that I didn't. I suffered with recurring bouts of reflux for 40+ years. I was able to reduce the acid with Nexium but I was aspirating vomit into my lungs which resulted in a serious lung abscess. The lung problem resulted in coughing up blood and voice problems. That required many months of high powered antibiotics to cure.
I knew there was an operation that could repair my hiatal hernia but I had read about it back in the late 1960s and it was awful to even contemplate. Two years ago I again consulted a Gastroenterologist and he informed me about modern laproscopic methods of dealing with it. So, in March of 2013 I had my HH repair and a 360 floppy Nissen. I have to admit that I was fatalistic about it prior to the operation--I wouldn't be able to eat or drink this or that, and many other restrictions on my furture activities, etc.
After about three weeks of post-op dietary restrictions, I went back to my normal diet and have not had a single bout of heartburn or reflux since then.
I wish you all the best and a swift recovery

Thanks Denise! Appreciate your response. I just received thereports from my manometry and while the nurse told me they looked fine at the time, the report says i have a serious motility problem in my esophagus, which is getting me a little stressed that the doctor may refuse to do the surgery. I will see him tomorrow, and i guess i will find out.

I will take a look through your journal now. what a great resource!
Best Regards
Jason

Hi Pink,

I saw my surgeon and he explained that in his experience, patients with my problem have no more increased risk of complications/side effects from the surgery that anyone else. He said that even the ones that have a full 360 degree wrap have no increased side effect rates in longer term and that some people's motility actually improves. So i am definitely going ahead with the surgery! the only thing he mentioned is that i might have swallowing issues in the first 3 months but they should resolve.

p.s. i read the latest studies on this issue and they confirm what my surgeon said.

Hi Pink,

My main reflux symptom is night time chocking (laryngospasm), asthma, voice problems and excessive burping. The motility problem can make things worse as reflux material doesn't clear very well.

After seeing all the hard evidence on esophageal dysmotility and fundoplication I would not be worried about going ahead. Here is one good study:

http://www.sciencedirect.com/science/article/pii/S0016508501488524

shows that dysmotility does not affect fundo outcome. I read at least 3 more done in different parts of the world and all have the same conclusion. ( most also say that even the 360 wrap is also fine)

All the best, let us know what u decide
Jason

Hi Pink,

Sorry i misunderstood your initial question.

With my motility symptoms, its actually quite strange. Before the manometry i didnt even realise i had any symptoms, as i thought it was just reflux. On reflection though, when i drink a lot of water very quickly, I guess i can feel it sitting there and coming up to my throat area. I thought that was just reflux.

Apparently though, when people like you and me reflux, the esophagus doesn't clear the refluxed content very well, because of the motility. This makes reflux worse and in his opinion, the reason why you should do a full wrap to minimize any reflux.

Hope that helps
Jason

Thanks Jason, do let me know how your operation goes.

All the best

Pink

Hi Jason,

Hope that the surgery went well, and that you are feeling okay!

Do keep us informed of your recovery.

All the best,

Pink

Oh and I forgot to say last night I slept on my back and didn't get up choking!!! First time in 3 years!!

Also I feel my stomach pushing gas up through the wrap ( which actually hurts) but it never really eventuates into a burp even though I feel some kind of burping impulse. Does this disappear? I was previously ver gassy ( burping all the time) so I guess this shouldn't surprise me.

lori,

Don't worry about the burping it just feels strange and mildly uncomfortable. And hey I'm only at day 2 so it will likely get better.
A small price to pay for being reflux free.

Jason

Thanks Pink. Please also let us know when/if your surgery happens. Good luck!
Lori: my Dr. prescribed some anti nausea drugs (zofran) for me to take home.
Phil: the surgery appears to fix the burping and associated problems. I am starting realise that all my problems were caused by a weak LES causing lots of gas to reflux which carries with it acidic and non acidic stomach contents into the throat area. That's why sleeping upright never helped me very much... gas rises.
Denise: I really understand what u mean now by stomach led burping ... it's a strange thing isn't it

Hi Jason,

Welcome to the Wrapped Club! Glad to hear that your surgery went well!

I took the liberty of adjusting the name of your thread, so you can continue sharing your post-Nissen experience right here if you'd like. You're in the most challenging part of your recovery, so hang in there! My surgeon told me that my wrap would become increasingly more swollen during the first two weeks, so expect my swallowing to get worse before it got better. He knew what he was talking about!

Just listen to your body and adjust your eating to what you can tolerate. Be sure that you swallow only those things that have been chewed to a liquid/creamy consistency. I used to keep a paper napkin handy, in case something I chewed didn't "disappear". Stay away from carbonated drinks and straws (increase bloating) and iced drinks (cause uncomfortable spasms). I remember not even wanting to swallow saliva in the first days. This gets better fairly quickly.

Yes, the stomach led burping is interesting! Actually, it'll probably always be pretty much that way. My stomach has to be in the mood to burp...I can feel it coming and can encourage it, but in the end it's a process controlled by the stomach/wrap.

I'd recommend asking for Compazine suppositories for if and when you get an all-out stomach bug. Once I'm vomiting (and yes, I found out I could at the one year mark, and have had about 4 episodes since my wrap) Zofran just doesn't do it. The Compazine is really effective. I only have used it when I had those bugs, but it was invaluable at those times. I always have it on hand.

If you can surrender to your recovery and follow its lead, you'll do just fine! You can't rush this process. Give your body the time it needs to heal.

Glad you're journaling your experience! It'll be very helpful to others who come to the forum seeking information.

Happy healing!
Denise

Jason-

Yes. As things swell more the wrap won't work quite right. Also food can sit at the wrap and cause irritation that feels like reflux.

Take care,
Bill