Nissen or any other problem ?

[Maltaguy]

Around 5 years ago I did the nissen fundoplication open surgery. All went good.

I am having though these kind of problems that if I recall back I think I used to suffer from them even before I did the nissen. When I bend in a certain position and sometimes when I laugh I get these cramps on the left side and sometimes even right just underneath the ribs. This is very painful and I feel as if something is bloating up and going to explode and I need literally to keep my breath and calm down so it fades away. Sometimes it fades for around 30seconds and I get the pain back.

This week I visited the surgeon that did my nissen and explained to him this problem. He examined my chest with his hand and told me to cough and he said that I might have an unwrapping of the nissen (another hernia in the oesephagus) so he suggested a gastroscopy followed up by a surgery if this happened.

Do you think this pain is caused from an unwrapping of the nissen of it can be some other sort of pain maybe any other problem ? . I dont want to undergo another nissen if not required and need some sort of feedback on what these painful things on the lower part of my ribs are.

[Maltaguy]

thanks doctor for the reply. I agree with what you say and should wait for the gastroscopy first. My concern is that the pain  I have underneath my lowest rib (left or right) when I bend, laugh etc etc has nothing to do with the nissen. I get very strong pain and I feel the muscle underneath as if stuck in between the ribs and getting inflated like a balloon....I have literally to stop breathing to relax the muscle down (if its always a muscle) and back into place. Sometimes after the pain passes I get another one after I move a little bit and need to do the same process.

[Kevin Pho, MD]

I agree with the surgeon's recommendations of a repeat gastroscopy, followed by possible surgery to repair the NIssen.

If the gastroscopy is negative, you can consider imaging the abdomen with an ultrasound or CT scan, to evaluate the liver and gallbladder.  

If the tests continues to be non-revealing, a source of the discomfort outside the GI system should be evaluated for - including possible musculoskeletal causes.

These options can be discussed with your personal physician.

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.

Kevin Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd