Question Title: GERD and fundoplication

Hi, I have a 4mth old aughter who was born at 32weeks wth GERD. She has been on cisapride and zantac for 2 mths and still having problems. The Dr has scheduled aph probe for Monday , and she says she thinks she is severe enough that a fundo is going to be needed. We will see. My questions are, if she says she does(She thinks they will find a very irritated esophagus that could lead to scarring f left untreated)want to do surgury wouldnt it be prudent to at least wait a few months to see if she outgrows this? I have read about the conplications that the adults have had with their fundos on the gastro board and I am not sure that my daughters quality if life would even be improved? How do mst babies do after this? I am so sared , but I also dont want to submit her to pain longer than I should if she wont outgrow this.Any hep wih this would be appreciated! Thanks, Lora

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Dear Lora :

Thank you for your question .
The timing of antireflux surgery is subjective and should be decided on individual basis.
In general the indications for fundoplication include :
1. esophageal stricture
2. Barret’s esophagus ( an absolute indication as this may end up in cancer )
3. Life-threatening apnea( cessation of breathing) and aspiration pneumonia
4. Large hiatal hernia
5. failure of maximal medical therapy and
6. severe esophagitis ( esophageal inflammation)
7. recurrent pneumonia , chronic lung disease, bronchospasm
8. failure to gain weight.

Most gastroenterologists now include proton pump inhibitors ( e.g. omeprazole) as a component of treating severe esophagitis and respiratory complications together with cisapride and H2-blockers.
The procedure itself is usually very successful in preventing vomiting.
Short term complications include early satiety , increased bloating and or retching. If you decide to do the surgery , talk to the surgeon about the long term complications he/ she most commonly encounters .

L.M.

Disclaimer : this information is for educational purposes only.

Keywords : fundoplication,indications*(surgery), infant GERD*(gastroenterology)

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