3 Weeks after Nissen and reflux is worse

Hi Folks,

I had the Nissen fundoplication surgery performed on my on 28 August 2015. The surgery was not performed due to my reflux, but due to a giant hiatal hernia. My entire stomach and part of my intestines were sitting on top of my left lung, and my stomach was rotated upside down. The doctor wanted to perform the surgery because I had a risk of strangulating my stomach. Before this surgery I was taking 20mg of Omeprazole/Prilosec for the past 15 years or so for some reflux.

I feel fine and I am not on a full diet yet, but my reflux is much worse now that it ever was before the surgery. I get constant heartburn, even though I am still taking my PPI. My stomach feels fine on a empty stomach, but becomes upset easily.

Is this normal and will these symptoms subside in time, or should I ask about modifying my PPI dosage to something higher?

Thanks,
Brian

Hi, I feel fine other than the heartburn. I am walking over 5 miles a day and doing some exercises. My doctor told me to keep taking the PPI. If I don't take it then I get the acid backing up into my throat, which is not pleasant.

Regards,
Brian

the baron

I've heard there are quite a few surgeons that keep their patients on PPIs for a time after NF surgery. Is your doctor weaning you off of your PPI medication?

Sharon

Hi thebaron,

Welcome to the Wrap Club! Glad you've joined us!

A couple things come to mind.

First, it's not at all uncommon for a surgeon to ask his/her patients to stay on PPIs during recovery. It protects the healing wrap from rebound acid, and helps in case some reflux sneaks past the wrap--as it can become misshapen during the swollen phase.

Second, my guess is that the reflux you are experiencing isn't reflux, but rather, pain. My surgeon explained that the esophagus is a "dumb organ" that interprets all pain as reflux. So when your esophagus (and the poor thing has undergone trauma with surgery) is irritated or is just experiencing post-op pain, it tells your brain that you're refluxing.

Also, people who are recovering from the type of paraesophageal hernia surgery you had, will typically have more pain and have a rougher recovery than those who have a simple diaphragm repair and wrap. So be patient with yourself, and try to relax into your recovery. If you can surrender to it, and follow its lead, you'll find things much easier.

Everyone's recovery has some shared experiences with others, but we're all unique, and our bodies react in unique ways. Give your body permission to heal. Try not to panic and think negative thoughts!

This recovery takes six months for most of the healing and a year for the rest. You're at the very beginning of your healing process, so relax and let it happen!

Stick around and ask any questions that come to mind! We're here for you! That's what's so great about this forum.

Happy healing!
Denise

Hi Brian,

I know it's scary to be in the early stages of your recovery, and there is a fear that things will never get any better. Be confident that they will! I'm glad you spoke with your doctor and that it helped you understand how healing will progress for you.

Often surgeons don't prepare their patients for what to expect during recovery. It's a very common occurrence. That's what makes it so hard. Normal healing processes are interpreted as problems, and people often panic.

This recovery is very manageable, but the first weeks are a real challenge. There is no doubt about that. Also, don't become worried if you hit some bumps in the road as you move through recovery...feel great for a while, then have some discomfort/problems. This doesn't mean that your wrap has failed. It's a very normal part of the process.

When people begin to feel well enough to go back to their more normal eating patterns, they often post their panicked feelings about returning or worsening symptoms. This is just a reaction to the stress that has been put on the new and still healing wrap. When that happens, just take a step back to easier foods for a couple weeks.

Also, just because you're feeling like you can handle normal foods doesn't mean you don't have to keep chew, chew, chewing your foods to a creamy/liquid consistency. You have a new and unnatural barrier that has been created to keep acid in your stomach, and you will always have to chew your foods more carefully. This isn't a big deal, because chewing is when you get the most satisfaction out of your foods! Chewing is an important part of digestion in even your unwrapped friends, and is a just plain healthy habit!

So hang in there, and
happy healing!
Denise