Post Niessen - Heartburn much worse

I am 32 year old man. Had GERD for almost 10 years. 10 weak ago, I had Niessen Fundoplication performed by most experienced surgeon in the country (more than 1000 fundoplication surgeries) because PPI was starting to loose its effectiveness. Now after surgery my symptoms are however much worse. When I woke up, I feel OK, but after first meal, I start to feel burning pain below my breast bone and occasionally also on my chest. Sometimes also feels burning and strange feelings in my throat but feels no reflux (sometimes felt reflux before operation).

Omeprasole 2 times per day does not work. I tried also 4 pills per day but no results... I had barium swallowing test which was OK and also 2 endoscopies and I was said that my wrap looks OK. However endoscopy showed gastritis and duodenitis).

I want to ask if anyone had similar experience. I am very depressed because I don't know what might be wrong. My surgeon is very caring but also have difficulty to find out the cause of my problems.

Excuse my grammar please - English is not my mother tongue

Post Edited (Martin215) : 11/20/2015 10:49:46 AM (GMT-7)

Martin 215,
Have you had manometry post-op? What kind of symptoms do you have and do you have chest pain?

Martin215,
Did your endoscopy show any stomach inflammation? It sounds like your stomach is sensitive and it's still early in your post-op recovery. Those upper GI tests you will be having will hopefully rule out any esophageal issues.

Wish you the best!

I have a referal to go see a surgeon regarding this operation. I have had heartburn and reflux for at least 10 years and I am a 71 year old female.
After having a barium meal test that my new doctor ordered they have discovered that I have a hernia at the top of my stomach. The Niseen Funduplication was advised and I will go next week to see about it.
After reading all the post op problems that everyone seems to have I wonder if I am doing the correct thing.
This new doctor told me to stop taking Pariet which stops the pain and heartburn and the very next day all the symptoms were back. He then told me to have a tablet every second night...............so I have symptons every second day.
I eat very healthy food, no bread, pasta, rice only meat, fish, fruit and vegetables.
I am totally confused and would like some info for when I see this surgeon if anyone can help me.
Thanks

Thank you, will take that info with me when I go for the appt.

Martin, I felt I had heartburn too after Fundoplication. I did quit the PPI after a week or so, but sometimes take pepcid or tums after a meal. I think the food having difficulty going down feels like heartburn, but it is a new set of problems after N.F. It's like esophageal, rather than stomach heartburn that is uncomfortable. Since the food is sitting longer in the esophagus, it makes sense. It was real bad at first, but has improved with time.

Hiya Martin, sorry to hear you feeling so bad. Why don't you try coming off your ppi to see if you feel any difference,this will let you know if it's really heartburn. I had similar problems after my op which i swore was heartburn but it turned out to be foods,liquids and medication not clearing from the esophagus.
Recovery can take 6 months to a year with fundoplication,it can vary widely as everyone is different.
Hope you feel better soon. Barry

Hi Martin, there must be something else going on as the ppis suppress the acid and you say you've increased the doses but no difference.
Hopefully your ph test will prove you have no reflux.
I know how you feel being afraid,i went through all the same emotions but you will get there,just try and be positive.
All the best! Barry

Baza and Martin, you are scaring me.

Haven't been to see the surgeon as yet regarding my problem.

Just a thought, but way back the doctor tried to change me to Nexium and all my heartburn came back so I reverted back to Pariet that I have been on since Adam was alive and works wonderfully. lol

I was also instructed to take the medications in the evening before bed and found that made quite a difference.

May be of some help

Oh I am sorry redwine you are OK on Pariet, not Nexium. But that does not change anything I mend by my previous post.

Hi, thank you for that, I don't have the appt. with the Surgeon until the end of January.
Have decided just to take the Pariet each day now that way I don't have any pains and I can get through Christmas and New Year with no problems.
I will have to look up all the other symtoms that have been mentioned, obviously I need to look into thing further.
Thanks.

Hi

Thank you for your support!

So....

Manometry - no problem, no obstruction, wrap in good position.

pH metry: Zero acid refluxes and DeMester score 0.3 (so very good) but still on 20 mg of Nexium so it is not very conclusive. However my heartburn is certainly not from acid reflux.

Impedance (for detection of non-acid refluxes): There were some non-acid refluxes, but I don´t have the exact results yet because my Consultant have to count them manualy during 24 hour period which takes a lot of time. Computer said just 6 refluxes in 24 hours which is great but doctor said that that is very inacurate and exact number will be much higher. However evrething below 74 is normal. So now I pray for less refluxes that 74 (around 40 will be great). I will have the results in Friday.

However my consultant suggested that it could be Hypersensitive esophagus which might be cured by antidepresants.

Unfortunately I don't have the results of impedance yet because it has to be evaluated manually and it is very time costing. I hope that I will havethem tomorrow and they will be negative for pathologic reflux.

Impedance test is different than bravo because bravo is just for acid reflux detection. I had pH and impedance test on nexium 20 mg and my pH metry was OK. So I don't have acid reflux on nexium. But I might have symptoms from weak acid reflux or alkaline reflux which most people do not feal. If someone has gerd symptoms from weak acid or alkaline reflux it is called hypersensitive esophagus.
Impedance testing is for direction of weak acid and alkaline refluxes.

Is normal to have some weak acid refluxes after fundoplivcation. Normally less than 70.

I pray for less than 70 refluxes on impedance monitoring because it indicates good function of the wrap.