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5 Weeks Post Nissen

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GERD & Acid Reflux
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Posted 7/6/2020 9:25 PM (GMT 0)
I am 27 years old and have been dealing with GERD for about 2 years now. My symptoms were severe bloating, waking up in the night choking on saliva or acid, or waking up extremely tired after a "full" night sleep and a sore throat.

After an ulcer and several scopes, a manometry test and a few other tests a few doctors recommended the Nissen. The original plan was to do a partial wrap but upon going under my surgeon realized I had a large haital hernia an an extremely damaged esophagus. They decided to do a full 360 wrap. The surgery was deemed a success and I went home a day later.

The reason I am writing this is because at 5 weeks out my symptoms are severely worse than prior to surgery. I have introduced a solid diet and am taking 40mg pentaprazole a day (per doc request) I am still being very strict avoiding my trigger foods/drinks and not eating 4-5 five hours before going to bed. While I have zero problems swallowing foods, I have burping spells up to 30 times a day with 5-10 burps per spell. I do have to force the burps slightly by taking large inhales and opening my throat. I also feel strong heartburn upon my first few bights of food but it decreases as the meal progresses.

When I deviate from this strict diet (having one glass of tequila, or one slightly spicy lunch) I am waking up in the middle of the night like I am choking again. I have woken up exhausted almost every night since surgery. Prior to the surgery, deviating only slightly would not have lead to these results. I also regularly feel a gurgling in my throat after I swallow (something I also felt pre-surgery).

While I know this typically takes a long recover time I am worried that this wrap has had negative effects. My surgeon said that since my esophagus was so damaged it will take time to heal but how can acid still be coming up to my throat with such a secure wrap? What will a healed esophagus do differently?

Post Edited (Rudy Wilson) : 7/6/2020 4:02:34 PM (GMT-6)

Posted 7/7/2020 12:55 PM (GMT 0)
Rudy:

You are absolutely right that this surgery has a long recovery period. I didn't feel much better until 6 months post-surgery, and my "new" self at 1 year. IMO, a solid diet with spicy foods, might be too ambitious at 5 weeks as well as tequila. You should dial back your food intake to softer foods and try solid foods again in a week or two. Everyone's recovery is different, and you are still very early in your recovery. I wouldn't force the burps, but try taking an anti-gas medication such as simethicone. I also had a full wrap, and no longer can belch as I have in the past, and taking the anti-gas medication works well for me. My suggestion would be to follow-up with your surgeon, and follow his advice.

Sharon
Posted 7/7/2020 2:15 PM (GMT 0)
Hi Sharon,

Thank you for the reply! My doctor was the one who recommended switching to solid foods / trying a drink every once in a while (for relaxation). I have had zero problems, since week 1, with solid foods. What is the benefit if continuing to consume small foods at this point of recovery? I always figured it was because most esophaguses couldn't handle solids and the point was to ease into them.

My concern is why I was able to handle solids with zero issues and able to belch after a full wrap. Not to mention acid still finding it's way back up my esophagus. Wondering if it is loose?

I've been taking Gas-X but not feeling the results. I will look into simethicone. Thank you!
Posted 7/8/2020 12:43 PM (GMT 0)
Look up your symptoms in the archives - the search box at the top of the page.
I would guess your wrap is fairly loose since you can burp at all. I couldn't for a year or so. But don't panic yet. As Sharon said, dial back on the solid foods. One of the things we used to hear was chew, chew, chew. If you chew your food enough it will be much easier to swallow.
Also, I agree with not trying to belch. Don't stress your wrap!
You might not be able to vomit, so get a script for Zofran in case you get nauseated. After a dozen years I still can't vomit.
See your surgeon.
Posted 7/22/2020 7:35 PM (GMT 0)
@alcie @sharonZ

Thank you for your replies! I have decided to stop the forced burps and that has definitely helped. They've gone down greatly, rather than burp though I have some pressure for a second almost like a hiccup but with no noise.

My doctor had me on 40mg of omeprazole once daily and recommended I start weaning off. I have and my reflux has come back worse than I can remember.

As I mentioned I have absolutely zero issues with solid foods what so ever, my triggers are spicy, garlic, alcohol, and oily foods which I have cut out. Since my reflux started years ago I have been an extreme chewer and make sure my food is broken down and also don't drink liquid before or after mealsI'm curious how soft foods will help my cause at this point?. Also curious as to what will change over time? I figured a wrap would tighten my sphincter and relieve symptoms?
Posted 7/23/2020 3:24 PM (GMT 0)
Because the surgery doesn't give you an instantaneous "fix" and your body is recovering from major abdominal surgery. Although you may feel fine with solid foods, you are still early in your recovery process and solid foods are easier for your body to handle when you experience small setbacks. The acid you may be experiencing is the rebound acid from your body withdrawing from the weaning process of the PPI. Just following the schedule he gave you for the weaning process and you will be fine.

Sharon
Posted 7/23/2020 5:41 PM (GMT 0)
Thank you Sharon! Always making me feel less stressed
Posted 8/26/2020 7:21 PM (GMT 0)
Currently I am almost 3 months past surgery and struggling more than before the surgery.

I have limited my diet to avoid all my triggers and am eating 4 hours before bed but I am burping small burps constantly all day and first thing when I wake up in the morning. I am waking up with an acidic throat most mornings and regularly through the night. Heartburn constantly which was not a big symptom before the surgery. I tried slowing moving off the pentaprazole but after a few days I was in horrible shape and the surgeon has be back on it daily.

While I know I should be patient it's hard not to assume this surgery was unsuccessful. Isn't the whole point to wrap my esophagus so that burps and acid can't come up? What will healing do to prevent that?

Is it time to have the surgeon do an endoscopy?
Posted 8/27/2020 11:45 AM (GMT 0)
Rudy:

It's probably too early for an endoscopy, but your surgeon would know best. A lot of people need to continue to take PPIs post surgery. I know right now you are feeling terrible, but 3 months is actually still early into your recovery. You can always seek a second opinion regarding your care.

Sharon
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