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gastritis or reflux or both?!

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GERD & Acid Reflux
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Posted 2/10/2016 10:45 PM (GMT 0)
Hello everyone
I had the nissen full wrap in december 2013 and had relief and a good recovery but over the last few months have had a return of symptoms and alot of burning pain in my central abdoment. I have been perscribed gaviscon for after meals and nexium 40mg to be taken twice daily. my doctor says 6 weeks of treatment and it should clear up as they believe i am suffering gastritis and have a history of flare ups even after my surgery. the reflux is bad though and i was told that you can get a flare up of reflux post op but not like it was before and it tends to be self-limiting due to the fact the wrap is supposed to return reflux levels to normal. I have been really worried about my wrap coming loose or undone as I am 22 years old and keep thinking if that has happened i will be told nothing more can be done and have to deal with this awful problem forever! my doctor is confidence the wrap is intact but i will just have to wait......

any response or input would be good, anyone know what procedure is if your wrap comes loose? can a flare up occur? I live in the UK if this helps.

Thanks
:-)
Posted 2/11/2016 2:27 AM (GMT 0)
Hi Gloopstar,

Sorry to hear you're having problems. Like you, I have a reactive stomach, and sometimes get flare ups that can be very painful. I can also get a burning feeling at the wrap site/base of the esophagus. A Nissen does nothing to prevent gastritis, but it can prevent esophagitis after a stomach flare. Prior to my Nissen, when I'd get gastritis, my esophagus would be burned, and take two or three months to heal. So gastritis/reflux or not, the Nissen protects from the majority of the damage that was much more likely pre-surgery.

PPIs for a few weeks will help your stomach calm down and get things more comfortable. You're definitely on the right track.

I wouldn't worry about your wrap. I'm sure it is doing its job. When your stomach flares, it creates more acid, so you may get a little breakthrough reflux. As you said, it won't be enough to be a problem the way it was before surgery.

If at any point your wrap fails (don't worry about this!!) they can redo the procedure. While nobody likes having to go through surgery again, I know that redo surgery is safe and effective. Bill, a moderator on this forum, has had two redo surgeries...the first was required because the initial wrap was done incorrectly. The second was required after damage was done to the esophagus/wrap during a procedure. Not to worry!!

Hope your stomach gets feeling better soon!
Happy healing,
Denise
Posted 2/11/2016 11:45 AM (GMT 0)
How do you know if the wrap fails.
Posted 2/11/2016 1:42 PM (GMT 0)
Hi Denise, thanks for your response and as a sufferer yourself of this you have put my mind at ease as i have had experiences of doctors chucking tablets at me and saying it will clear when it inst always that simple. how long do your gastritis flare ups last since you had the surgery? I was a chronic sufferer and have had 3 or 4 major flare ups since the op two years ago....not nice and they last a few months!

M60 Tanker....there are a number of symptoms that can suggest a failed wrap but the suspicion of it coming loose is much more common than this actually happening. I have read many statistics but the most reasonable leaflet i have read suggest over a lifetime around 10% of people experience a return of symptoms post wrap. However, many people choose to or have to take medication after surgery as an irritated wrap can cause alot of pain as i am experiencing at the moment. there are people on this forum who have had re-do's and experienced a failed wrap so maybe they can give you more accurate information on this.
Posted 2/11/2016 3:06 PM (GMT 0)
My problem is upper chest pain and a return of acid.
Posted 2/16/2016 5:59 PM (GMT 0)
Hi Gloopstar,

Since my surgery, my gastritis flares don't last nearly as long. The worst part of the pre-surgery symptoms were esophageal...burning so bad I couldn't eat. It is true that the wrap gets very irritated with you get a good gastritis flare going on. Your wrap is created out of your stomach, so it follows that it gets irritated when the stomach is struggling.

My flares probably last about a month when they get raring. Usually it's triggered by either medication (antibiotics), coffee, beer, popcorn/rough foods, spicy/acidic foods and is never just one of these. It's a perfect storm of just the right combination.

There is one thing that really helps, you haven't mentioned. Carafate suspension. It is a godsend when I have a flare. It coats my stomach and wrap and really makes me much more comfortable. I am never without it in the house, because I never know when I'll need it. Often, when a flare seems to be starting, I take it, and "nip the problem in the bud". It is much more long-lasting than Maalox or Gaviscon. The coating lasts up to 6 hours.

I hope you feel better soon! Has your doc suggested Zantac at bedtime in addition to the PPI? That is also helpful.

M 60 Tanker,
Upper chest pain and the return of acid is certainly a symptom of a possible failed wrap. It can also be a symptom of a too tight wrap, where food/drink/medication is being held up by the wrap and irritates the esophagus at that location.

I assume you've contacted your GI doc or surgeon. If you have recently had the surgery, the tight wrap has a higher likelihood. If you've had your wrap a long time and have been comfortable, the failed wrap scenario is a possibility.

Good luck and best wishes to you both!
Denise
Posted 2/16/2016 8:38 PM (GMT 0)
For me the feelings are like my hernia has returned. I started chest pain around 4 months ago and acid about 1 month. I had the nissen Jan 15. The feelings are just like before I had it done.
Posted 2/17/2016 1:22 AM (GMT 0)
Hi Denise

Thanks again for the response, yes you have mentioned carafate before but I will ask should i need to seek hep for this again. Your symptoms are very much similar to mine, i used to vomit acid and have a lot of burning at the oesophagus site pre-surgery and don't suffer this anymore. would the zantac over the counter be OK if taking with PPI's?
I must admit, I am now two weeks into the PPIs and am feeling considerably better. Another question....my heartburn has cleared up but a few times a day I get acid in the upper throat which I have never had before?!

Kind regards.
Posted 2/21/2016 9:12 PM (GMT 0)
Hi Gloopstar,

Yes, OTC Zantac would help. I they come in 75mg tablets, I think. When I was at my worst, I took 300mg at night. I'd take at least 150mg at bedtime if I were you.

I wish I could give you an answer about your acid in upper throat symptom. All I can say is that when the stomach is stirred up, there will be more acid and a little reflux is more likely. Hopefully, things will get feeling better soon!

M60 tanker,

So from what you wrote, it sounds as if your Nissen in January 2016? If that is the case, your symptoms are extremely normal with recovery. This recovery takes six months for most of the healing and a year for the rest. I found improvements into the second year.

Many people who are recovering have pain and "reflux" symptoms that feel like their wrap has failed. This is not the case.

The esophagus is a dumb organ, and it interprets all pain as reflux. Your wrap/diaphragm are still healing, and can have pain very similar to that which sent you to the surgeon in the first place. You also very likely still have swelling.

It's very common for people to worry that their wrap has failed and interpret normal recovery symptoms as evidence of that fact.

It takes a lot of patience and trust to recover from this surgery. Laproscopic surgery is great, but it creates the impression that the surgery was not a big deal. Five little slits heal quickly, so it seems as if you should feel better than you do. Inside you've had major surgery, and it will take a good long time to heal from it. Give your body the permission and time it needs to heal. Go with the flow. Try to surrender to your recovery, trust, and allow your body to go through the healing process.

Take care and best wishes!
Denise
Posted 2/21/2016 11:40 PM (GMT 0)
dencha. I had my Nissen on Jan 15 2015. I went to my GI dr Thurs. And had a upper GI done yesterday the 2/19/16 and yes my hernia has come back but the wrap is good. And my back on the left side has been hurting the last three days I am thinking that the acid has my colon pissed off. On 40mg nextem and carefat a day. Getting a little worried.
Posted 2/22/2016 1:27 PM (GMT 0)
Hi M60 tanker.

Are they not going to fix your hernia then? is it a hiatus hernia? seems strange not to solve that if thats causing your symptoms. your colon problem could be due to the medication. anything used to reduce acid and eliminate stomach discomfort can have an impact on your bowels.
Posted 2/22/2016 2:41 PM (GMT 0)
Yes it is a hiatus. And yes I am going to get it fixed. I had the nissen done Jan 15. Started getting acid and chest pain about 3 months ago. My lower back left side has been hurting since acid came back.
Posted 2/22/2016 4:38 PM (GMT 0)
Thats good news to hear you are getting it fixed. I am being referred for evaluation if my wrap has slipped but they suspect mine may be due to the wrap being too tight. the back pain could be a separate issue or could be due to the location of the hernia and cause referred pain.
Posted 2/22/2016 5:13 PM (GMT 0)
Yes I think the pain may be from PPIs. Because the pain started after acid started.
Posted 2/24/2016 6:17 PM (GMT 0)
M60 tanker - are you having the nissen again or is there another way to fix the hernia?
below the top scar on my stomach it feels tender when i touch and i wonder if i have a hiatus hernia. would be interested to know what the surgery protocol is. thanks
Posted 2/24/2016 7:12 PM (GMT 0)
I don't know I would like some one to tell me. How they do this. My Nissen is still in tact.
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