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gastrogaresis after Nissen?

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Posted 2/23/2016 5:27 AM (GMT 0)
I had my Nissen Fundoplication done in May of 2015 for LPR. I felt great for months other than mucus in throat immediately after eating. My surgeon thought that this was due to interesophageal reflux because the wrap was still swollen. I could sleep at night and all my other symptoms disappeared. -For the last 3 months LPR is back with a vengeance. I can barely breathe and take 5 asthma medications including 2 nebulizer treatments. My stomach also hurts after eating and I have a lot of bloat and gas. The later disappeared after switching to a gluten free diet. I went to a gastroenterologist and had an endoscopy done 3 weeks ago. finally had a follow up done today. He thinks that I may have gastroparesis and advised me to take a daily laxative, a stool softener and metamucil. I'm not constipated and have daily BMs. I'm wondering if any of you have been told of this regiment. My endocospy showed a lot of bile in my stomach which explains the bitter taste in my mouth. He could not explain to me why the bile is there. I also have gastritis again.- I think I rather have a gastric emtying study done instead of taken daily laxative.-In the meantime I also made an appointment with a surgeon in LA but this doctor advised against the redo surgery because it is too risky, because I'm 60. Any advise?
Posted 2/23/2016 5:30 AM (GMT 0)
I forgot to mention that according to the doctor who did the endoscopy , the Nissen is still intact but too loose. I did have a floppy Nissen.
Posted 2/26/2016 6:09 PM (GMT 0)
Anybody? Was anybody prescribed laxatives for LPR? -I'm still reluctant to take it because it does not make sense to me unless I was constipated.
Posted 2/27/2016 2:00 AM (GMT 0)
Hi Elke 55

Metamucil is not a good idea. If you have gastroparesis you need to try to reduce your fiber intake because fiber stays in the stomach the longest. You might want to google: gastroparesis diet. The main ingredient in Metamucil is psyllium husk which is a source of fiber. There are gastroenterologist who specialize in gastroparesis. Unfortunately not all gastroenterologist are familiar with this illness.

I've had delayed gastric emptying for over two years caused by a PPI (omeprazole 20mg). The delayed gastric emptying has been slowly reversing since I weaned off ALL acid suppressant medication. I used Miralax instead for constipation only.
Posted 2/27/2016 6:48 AM (GMT 0)
Thank you for answering my question. My gastroenterologist never did any test to see if I really have this condition, he just thought I might have it because sometimes people get it after the Nissen fundoplication.-I think I will ask him to do a gastric emptying study before taken daily laxatives. Like I said I'm not constipated. He told me the fuller the stomach is the worse the reflux so he seems to think the daily laxatives are moving things out faster.
Posted 2/27/2016 3:44 PM (GMT 0)
He is correct, the fuller the stomach the more reflux issues and the longer the reflux will last. I am not a doctor, but I would think taking a laxative such as Miralax would help move things out of the colon quicker and not the stomach. With my delayed gastric emptying I would have to take Miralax at times because I could not eat much fiber since I was on the gastroparesis diet. However, drinking more liquids would always help the situation. If you have delayed gastric emptying make sure you are not taking the laxatives that have fiber in them like Metamucil.

Post Edited (CAGU) : 2/27/2016 8:59:07 AM (GMT-7)

Posted 2/27/2016 7:16 PM (GMT 0)
thanks for your input and advise!
Posted 2/29/2016 4:25 AM (GMT 0)
You are Welcome :-)
Posted 3/2/2016 2:19 PM (GMT 0)
The doc may be right that the wrap is too loose.

I'd go with the others in avoiding Metamucil, because it causes gas. You could ask for metaclopramide, but some people like me get nasty reactions. I use miralax.

If nothing works you may have to get a re-do.
Posted 3/2/2016 6:52 PM (GMT 0)
Hi Alcie
I have an appointment with a surgeon at UCLA on the 24 th of this month.
I will bring him all my recent records and hope that he has some sort of idea what I could do or what he could do. My enterologist is really against a redo because it's supposed to be a very risky procedure especially since I have lung problems and a pacemaker. I will be 61 in April. Am I too old for a redo???
Posted 3/4/2016 10:38 PM (GMT 0)
You'll for sure have to get a clearance from a cardiologist, maybe a stress test too, because major surgery is no joke. But you were considered well enough for the first op so ..... The main thing may be to wait until you are as well healed as possible, but it's nearly a year now.

There are all sorts of tests, you know the ones like you had before the first op. I'd be happy to go through th m all again, except maybe for Bravo. I'd be scared of not being able to get it past a wrap when it comes off.
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