Hi all,
new member here. I had my Nissen Fundoplication 6 weeks ago. It was after a few years of LPR symptoms , most notably mucus, sore throat, globus, related neck/head and chest pain without true heartburns.
Fortunately they responded well and relatively fast to standard dose PPIs, though they were still bothersome time and time again, especially when the temperature rises outside. So it's been an acid problem mostly. I opted for Nissen because I wanted to cut down these meds as I need to be on others for other reasons.
One of the best surgeons in my country operated me and the wrap is nicely inact (I can feel it with the swallowing and burping difficulties), a 1 month follow up was all good with him.
The problem came when I cut down on the daily 40mg of Omeprazole. I had no issues at all when I went every other day, but the first time I skipped two days, the rebound set in and although I think the wrap held a lot of acid back, enough of it leaked to start to produce the same old symptoms, plus acidic taste in mouth. Needless to say I was very disappointed and went back to the original dose for now. I know it's still quite early with 6 weeks, but I assumed it should be enough for the taper, and my surgeon thought the same.
I must add that my acid rebound can be very nasty: when I stopped Omeprazole for 10 days for the 24h acid counting and manometry, I developed a Grade 2 Esophagitis and a Duodenal Ulcer in just a week and a half. No joke here.
So, my question is to the ones who's been in my shoes: as I am one of the more fortunate LPR sufferers that responds good to PPIs (like you can call a silent refluxer lucky by any means...), can I be hopeful about
a more gradual PPI taper should result in med cessation? Or is it something that even after the Nissen and minus the rebound, the LES is so weak that I need continous acid suppression to don't gasp acid?
I'd be very grateful with someone with this experience would check in, since I have seen a lot of topic about
Nissen and LPR with a lot of different personal stories, but I've yet to read anyone with this "PPI-positive LPR - opt for Nissen - shoud it do it?" thing.
Thanks a lot!
Daniel
Post Edited (DanBudapest) : 3/22/2016 7:48:38 AM (GMT-6)