Problems still 45 days after Nissen and exercising pains

[imabat]

I need to clarify this question again that I asked a couple of weeks ago. I'm 27 years old. I had the Nissen prochedure done 45 days ago. For some reason it seems like I have worse reflux now. I'm currently taking 40mg of protonix and will probably kick it up to 40mg twice a day.  

I also get pains on the left side of my stomach while doing exercise( walking up hills ) My heart is fine execpt my cardiolgist thinks its unconditioned and I need to do exercise to get it back in shape.(had angiogram, echo, and stess test all normal) Also I had a endoscopy done 2 wweks ago that came up clean. For some reason this pains lead to acid like pains in the stomach and like someone is putting a knife thru the left side of my stomach. Also when I eat my left eye lid twitches for some reason once the food goes to my stomach?? Like I said above when I wake up in the morning my throat is sore and it seems like I have more reflux now than I had before the Nissen. Please give me some advice on what to do. Also I can't eat salad with dressing because it upsets my stomach now( didn't before Nissen ) no carbonated drinks and milk. They all really upset my stomach.

[BigBri]

Hi,
I had the operation five weeks ago and I'm having terrible stomach upset. It doesn't seem to matter what I eat, I have a lot of pain a few minutes after a meal. The doctor suggested that I might be suffering from rebound because I'm off all of the meds. I had been on for the last three years. It also seem like I'm having some reflux at night based on the condition of my voice. I had the operation because I'm an opera singer and reflux was putting an end to my career. I'm not sure what to do? I was thinking of taking my pantoloc again.

[Kevin Pho, MD]

You note continued symptoms and a negative endoscopy.

One of the complications of a laparoscopic Nissen fundoplication is continued GERD symptoms.  The recurrence of GERD symptoms is usually secondary to a failure of the diaphragmatic or crural closure which generates a partial migration of the fundoplication in the lower mediastinum.

I would agree with the suggestion below - a 24-hr pH study to evaluate whether reflux is present should be considered.  If there is continued reflux, you may want to return to your surgeon to evaluate whether the fundoplications has failed.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[imabat]

tessa I had Laposcopic so it heals faster. Just for some reason my stomach is very sensitive now.

[tessa0825]

Please don't be fooled by the sm incisions of laproscopic surgery..Your right I did have open surgery and I will expect my recovery to take longer, at the same time the actual work being done, such as stomach being wrapped around esophagus and a new valve being created is the same with both surgeries...Its my understanding that you have to go very slowly while introducing foods back into your system after either of these procedures....We are very swollen in there for awhile while things need time to heal....Also, had you ever had any other surgeries that may have created adhesions that the surgeon needed to take down?....I had some adhesions and I wonder if that also could be causing some of your problems....Its just a thought I had....Im assuming you also had hernia repair and were told no lifting for atleast 4-6 months?.....I really do hope you get some good advise here and that you soon start to feel better....Tessa

[imabat]

Tessa the one thing that did happan after the surgery was I bleed from the stomach. They did a zillion scans and found some bleeding from the upper right side of the stomach. So I'm assuming I might have had a small ulcer going into this surgery. But I have had 2 endoscopys since the surgery and no sign of ulcers. I even had wireless endoscopy and colenoscopy nothing all clear.

[tessa0825]

Hi, I hope you dont mind me saying this but I was wondering why at 45 days post-op you are even trying to eat salads?....I was told no solid foods for 2-3 months...Im only a couple weeks post op for fundo and an esopheagl lengthening surgery that was combined with my fundo but Im only supposed to eat liquids and very soft, creamy, or mashed foods......I think lettuce could get hung-up in the repair work in there if you eat them to soon......EGD won't show if you are refluxing or not...You should maybe ask your Dr. for either a  24 hr ph probe test or the 48hr bravo test to find out if you are in fact refluxing......Do they have you scheduled for a follow-up barium swallow test?...The left sided pain is horrible and I can sympathize with you on that one......Take care, Tessa