I can't decide if I should have Nissen or not

Hello everyone,

I have enjoyed reading all of the stories here about getting a Nissen done. It has really helped.

I am a 40 year old male. I have been living with GERD and on ppi's since I was 16. I have a 3 cm hiatal hernia and some inflammation at the bottom of my esophagus. Monometry states that my LES is lazy and the Bravo shows I have many incidents of reflux. I have plenty of gastric polyps in the stomach. Overall, the ppi's have managed my GERD symptoms well. I am currently on 40mg of Nexium, and I supplement with some tums, but overall it is managed. Three years ago, I went through all of the testing to get the LINX procedure done. I was excited, and I thought it was a good option. Of course, insurance wouldn't cover it, and I just postponed things until now.

Lately, I was having more burning, and things weren't managed as well as before. Age and weight (slightly overweight) are probably some of the reasons. I decided to go through the Bravo and monometry again to look at Nissen. I wasn't interested in it three years ago, but I just feel like I want to be off ppi's. I have tried a few times over the years to stay off of them for a few weeks at a time (while using H2's), and even though the burning is pretty bad, I just feel better mentally. I really think that the ppi's make me moodier, give me headaches, and zap my energy.

My question is this...I am overall managed well by Nexium. Even though I think I feel better off of the Nexium, I am still a productive, active, and happy person. I really just need to decide if my condition warrants the risks of surgery, or should I continue the ppi's for the rest of my life. I already have 24 years under my belt with them. I have a surgeon setup that I am comfortable with and surgery is schedule for July 6. I just keep going back and forth with this decision, and I am sure I will until the day of surgery comes. Any insight or advice would be appreciated. Have a good day.

Hello everyone,

tusharriv, you expressed my feelings exactly, the last paragraph feels like it was taken out of my head.

I am a 27 year old male, 3 years with GERD on PPIs. I, too, have the GERD well managed by the PPIs and I am highly productive, active, and happy. My lower esophagus looks like a baby's when viewed through the endoscope, no sign of inflammation.

The problem is, my literature research indicates that stomach contents are carcinogenic for the esophagus even when the pH is neutral, which would mean that all that stuff that makes me cough, occasionally gets into my lungs and makes me wake up before the alarm clock despite sleeping with my torso in a 30 degree angle, might, in 20 or 30 years' time, screw my life up more than any surgery could. It is the fear of distant future that made me schedule my surgery for July 19.

I would love to feel like Mark afterwards. On the other hand, I cannot express the degree to which I would hate myself for demanding the surgery if it made my life worse.

Chris

I'd say yes, do it. Meds didn't manage my situation well and I had lots of side effects but almost 2 weeks after surgery and feeling good (even if food is a struggle) I feel so much better.
I didn't get bad reflux until my late 20s so it completely took over the life I'd developed for myself. The idea that I can have some of this back is incredible; you may be surprised just how much you have adapted and fitted around the condition and what life COULD be without it. Rxx

I'm happy I had a modified Nissen 8 years ago. I was doing OK on PPIs for many years and only had the op after I was in an accident that caused a large hernia that left most of my stomach in my chest.

I went first to my gastroenterologist to find where to get the surgery. I have read since then how important it is to get the top people you can find! I had a group in a university hospital, not a single doctor, because it takes more than one surgeon to do a 5 hour or more surgery with a really big hernia that is causing problems. A simple bad valve only takes a fraction of that time, but I'd still try to find the most experienced surgeons available within a reasonable distance.

I'd do it again and a lot sooner for the happy results! It took most of a year to completely recover - age, injuries from accident, stomach stuck in chest and needing to be "let down." (Look that one up if you have a paraesophageal hiatal hernia.)

It doesn't change my food and chemical allergies and sensitivities, but the relief from stomach contents coming up in my esophagus and nearly choking me often at night is worth it!

Surgery is lots better now than when I had it. Just get a thoracic surgeon and team who have hundreds of success stories. It makes a difference. I haven't needed any "stretching" or revision.

Hi rweintra,

I'm now 8 months post surgery and doing great. It's really gotten better with each month that passes. My body has adjusted well to the changes. Bloating and gas problems can still be an issue but I know what to expect and can manage it pretty well. I'm so glad to be off the PPIs and reflux free.

-Mark

rweintra,
I haven't had an episode of sickness since surgery so I can't speak personally to whether I can or can't. I do burp from time to time but it's not something I can control much. It's more like a silent pushing of air from my diaphragm. The surgeon will have the most insight regarding the your ability to vomit or burp post surgery. From what I know a partial wrap is done when someone has a weak swallowing function and again the doctors will know from the motility tests if that is the best direction for an individual.

I will note that getting sick shortly after surgery is a bad thing and risks damage to the surgery. After the first few months have passed and healing has reinforced the area sickness is not as much of a risk but it's miserable to go through from what I've heard.

-Mark