Hi liz,At four months, you're still at the healing stage of recovery. It takes a full six months for most of the healing and a year for the rest. It's very common to have some pain/irritation after more aggressive eating at the four month mark. You don't need to worry for a moment.
it's likely a combination of wrap irritation, food sitting at the wrap site and irritating the esophagus, and even some reflux. Everything in that area is still swollen at least a little, although the worst of the swelling has passed. Once irritated, that swelling could increase.
The surgery doesn't stop every bit of reflux, but instead brings it way down, so it's "normal"--the type people get who don't have GERD. If you were to get a little reflux from overdoing it, you could get more burn because of the post-op irritation that's already there.
This definitely does not mean that your wrap has failed and that you're doomed to feel the way you did before your surgery. It does mean you'll have to be more careful for a few weeks to get yourself feeling better again. Stay away from alcohol, acidic, and spicy foods. Be sure to chew your food carefully, until it is a creamy consistency. Don't eat things that remain rough after chewing, as it will irritate things further.
You're wise to take your PPI again for a while, but you won't have to take it forever. If you've got good prescription insuance, you could ask your doctor to order Carafate suspension and take that as well. (Follow the dosing directions carefully...2 hours before or after medication, 1 hour before meals or 2 hours ater eating.) It coats the wrap, stomach, and esophagus and helps with healing.
You're still recovering from major, major surgery. Your upper GI tract is has been revised, and it has a lot more healing and adjusting to do. Because the wrap creates an unnatural barrier that stops most acid from refluxing, you'll always have to chew carefully. It can get occasionaly irritated even after full recovery, but it's rare.
Hang in there!
Take care,
Denise