How can a wrap work?

I've had a partial wrap that didn't work too well. I'm now considering a full wrap. Will it work though? How can you make an opening so small that the acid can't get out, but you can still swallow your food?

If you have motility issues you can't have a full wrap. Did you have the manometry test?

Hi Katlan,

I asked my surgeon the exact same thing before my surgery. He said that they don't make a tight, tiny space, but rather create a "one way flap" that allows food in, but keeps the acid from escaping. That way, the "hole" maintained is large enough to allow food through.

Some surgeons use a bougie as a spacer to ensure the correct size, while others use their own abilities to determine just how tight to make the wrap. It's a delicate balance--tight enough to keep acid in, and loose enough to allow food to pass through easily.

As Joy said, good swallowing reflexes is critical, as it will take more force to get food through the wrap site. I would add that it is also important to be sure that your problems are indeed caused by a loose LES. Some who have had the surgery find later that their problem was, instead, a stomach emptying issue.

Good luck with your decision!
Take care,
Denise

Hi, I think that you might have a crocked picture of what is going on. Sure there are people who's GERD is a result of a completely loose valve, but studies indicate that overall two thirds of all reflux episodes are due to spontaneous opening of the valve when there is no food to pass. After Nissen is performed, when the stomach "clutches" the wrapped part does the same thus applying extra pressure on the wrap.

Also, your esophagus pushes down food, while nothing pushes acid out except of the difference in pressure which is aproblem when your LES pressure is low.