Posted 3/6/2017 1:55 AM (GMT 0)
Hi guys, thought it might be of use to people considering the surgery for me to post how my experience has been over the last year because it hasn't been a typical case.
Type of surgery: Anterior 180 deg findoplication
Pre-op symptoms: Heartburn, excessive night time reflux, waking up choking, chronic sinusitis, esophogitis, bile reflux, nausea, constant regurgitation of stomach contents (meaning no force behind it like vomiting), post-nasal drip, globus sensation caused by over tightening of upper esophageal sphincter, dry mouth, thick mucous in nose/throat, difficulty breathing due to irritation to my airways, chronic cough.
Pre-op medications: Omeprazole, ranitadine, domperidone maleate, sucralfate.
Complicating factors: Gallbladder removed 6 months prior to operation.
I only had GERD and LPR prior to getting the operation, no history of any other GI conditions.
My recovery was pretty standard for the most part, the 2 week mark was when the pain peaked for me and it was pretty severe so its good to have stronger painkillers on hand at that time. Heat packs helped a lot too because much of the pain was caused by irritation to my diaphragm and from tugging on the surgical site. I was good about sticking to the soft diet so I never had a problem with food sticking so badly that I needed intervention, though when I started adding bread back in I did have a few close calls, but in those cases standing, walking around and sipping water helped whatever was stuck pass through. The pain subsided and was pretty manageable throughout. If I had been working though I definitely don't think 4 weeks would have been long enough for recovery, I have an office job and I would have taken 6 weeks because the limited diet as well as the pain made me tire a lot quicker than usual.
So all that was fine, things were pretty much textbook except that I had consistent watery diarrhoea from day 1. It was a mild concern initially, the surgeon said it was uncommon because the pain killers should have made me constipated but nothing to worry about. After three weeks it was still going on so he tested me for a C diff infection, that came back clean and that was about the point that the surgeon gave up and sent me back to my gastroenterologist. Due to the fact that the d would hit within an hour after eating and was almost pure bile at times he diagnosed bile malabsorption. He explained that having my gallbladder removed meant I now had a constant flow of bile into my small intestine, and the fundoplication surgery compromised my ability to properly absorb bile. He started treating me with colestid, a bile sequesterant, and it helped a bit but I still had very unpredictable d. Then as the months went by I started getting sicker, I became severely B12, vitamin D and iron deficient, could barely eat anything without it coming straight out the other end and I was INCREDIBLY bloated and in a lot of pain. It took another 8 or so months of tests to figure out that I also had developed small intestine bacterial overgrowth (SIBO) which was a direct result of the fundoplication. Its treated with a month long course of antibiotics, but it reoccurs and I'm already about to go for my second round of treatment, I only finished the last round about 3 months ago.
Both conditions are incureable, and life-long, the bile malabsorption in particular is very finicky and there is no consistency to how it affects me each day, however the SIBO had the more dramatic effect on my body because it went untreated for so long I ended up with fat and protien deficiencies as well as the vitamin deficiencies mentioned earlier. I did a heck of a lot of research before my surgery and didn't come across either of these as possible complications. To be fair bile malabsorption is uncommon, but SIBO is often caused by surgeries to the GI tract so I wanted to make sure anyone thinking about having the op knows about this possibility.
Given all of that, would I still have the operation? Absolutely. The reflux and heartburn was gone immediately, and all of the respiratory/ENT symptoms and the globus sensation, were gone by the end of the first month. I will confess that mild reflux has returned, but it is infrequent, I would have an episode every few weeks and most times its not even worth taking anything for it. I haven't had any cause to vomit, though I've felt sick enough to a few times, so I can't comment on whether that is possible, but I can still burp, better than I could before the op actually, it didn't start til after about the first month though but its a blessing because I found that the gas pain got pretty horrific while I was unable to relieve it by burping. De-gas/simethicone tablets help with that though and I would definitely recommend having them and antinausea tables on hand at all times especially in the first few months.
If anyone has any questions, feel free to ask, its been hard to deal with but I've had long enough to deal with the on going effects now that I'm fine talking about it and if it helps someone who is thinking about having the surgery, or having similar problems post-op then I am happy to help.