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nissen gas bloat syndrome
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nissen gas bloat syndrome

I had my susrgery on 2/10.  Did all the nanometry tests etc. Dr's all told me there were no side effect or complications.  4 months later I started developing the gas bloat. 12/10 had a complete gastro testing. No changes. 18 months later colonoscopy show lots of diverticuli has developed throught out large bowel due to the extreme stress of the gas bloat.  I am miserable.  Ddoctors say that from 10 -441 % of patients devope the gas bloat.  I am angry  now as I was lied to and now consulting Doctors tell me they do not know why some develop this.  Nothing can be done.  One problem of the reflux is solved but my life is so miserable now.   Have a lot of trouble passing the gas or even moving my bowels.
Has anyone had this severe of a problem?
Thanks
16 Comments Post a Comment
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620923_tn?1416285879

  Hi, I am so sorry u r having this problem or should I say both these issues, ur post op issue and the Dr that did not advise u...

But many times with surgery there is no way to know who's body will respond so they develop a post op issue, it is a wait and see type of thing, but there must be something they can do to help u.

I am not familiar with this as I have no had this surgery, but we do have several members that have....I am sure they will comment on here soon,

I pray u get answers and help so u feel better soon.

Do post updates : )
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63984_tn?1385441539
I'm guessing you are thinking that the Nissen Fundoplication procedure caused you to have Diverticulitis.  I'm guessing why the doctor didn't advise you of a problem as there is no association, at least none that I know of.
What could be an association would be if you drank beer or carbonated products after the procedure.  If you had Diverticulitis prior to the surgery and ate/drank products that produce gas, you would have the condition, in my opinion, that is giving you trouble.  Remember, you can't burp effectively after the procedure.  I'd suggest that if you were drinking any carbonated beverage, stop.  Also, limit your consumption of cabbage, onions and gas-producing products, follow a Diverticulitis diet.  
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Avatar_f_tn
Thank you for your comment.  Unfortunately you do not understand what a nissen fundo plcation does to your body. As for diet, I have not consumed an carbonated drink in 30 years.  I am on special diets such as Breaking the Vicious Cycle by Elaine Gottschall and the Paleo diet.  Very health oreinted and holistic.
The nissen causes an extreme gas bloat syndrome in 10 to 41% of patients.  This extreme bloat causes terrible stress to the digestive track.  I look like I am 9 months pregnant by evening.  Very painful. This extreme stress has caused the bowel to become very tortuous, spasming trying to move the feces/gas through thus causing the diverticuli.The motility of the gut is now very poor.  Trying to pass a bowel movement even with massive prescribed fiber is very difficult.  When small amounts do pass, they are explosions.
What apparently has happened to me is because of the surgery, food is being expeled immediately from the stomach.  Food in this state is recognized by the body as an  invader in the duodenal and small intestine.  Creating the environment to cause the extreme gas.
I am disgusted with myself that I trusted my Doctors before the surgery and did not check the nissen surgery myself.  They lied to me, my daughter and a friend were there.  They told me there are no complications to this surgery.  i have reserched and talked to other medical people.  They all said, There are numerous side effects and complications.  Law requires Doctors to tell you all the side effects and complications prior to surgery.
I am seeing a new surgeon, he states he does hundred's of this surgery and 10% of his patients get this extreme gas bloat syndrome.  They do not know why or what to do.  He is doing further testing
I am searching for anyone that has survived this situation and how they did it
Thank you for trying
Schatsy
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63984_tn?1385441539
I had a Nissen Fundoplication procedure three years ago.  A few months before the surgery was necessary I had a bowel obstruction which resulted in explosive vomiting that wrecked the LES valve, resulting in extreme acid reflux that damaged my vocal chords and stomach acid removed the enamel on my teeth, turning them black (I've had my teeth coated so don't look like a troll).  I do know about the procedure, and had it after researching it carefully.  I developed some gas problems immediately after the procedure, but they quickly went away.  
At the hospital where I had the procedure, the satisfaction rate was 93%.  That was good enough for me, and the procedure was completely a thumbs up, and probably the best thing I ever did for my self.

Thanks for clarifying your situation, I assure you I understand the NF procedure and complications very well.   Can you let us know the study that gives us evidence of what you are experiencing, 'gas bloat', in 10 -41% of patients who have had the NF procedure?  I don't doubt your discomfort, but haven't ever seen any study giving evidence of what is called 'gas bloat' starting 4 months after the procedure.  
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Avatar_f_tn
For starters look up "nissen fundo placation gasbloat syndrome"  use the address bar.
This one is from "What is the current rate of gas bloat s with NFP
The second one is from NARC 4U which is a prep for medical board test.
There are many more.
Believe me it is very real and as soon as you eat even very lightly in the AM it starts in by evening you are ill.
My current surgeon stated that his does 100's of these op's and for unknown reasons 10% of his patients get this.
The surgeons will tell you.

Portions of the articles as follows
Gas-BLOAT SYNDROME
This occurs in patients who have been operated for gastroesophageal reflux disease (GERD) or heartburn. The most common operation is (Nissen's fundoplication). This procedure involves wrapping stomach around the valve at the junction of esophagus and stomach (LES) so as to make it tighter and prevent upward flow of acid.

A natural consequence of that is that the tightened valve does not allow for upward expulsion of air either, thus preventing belching. Patients feel full of gas and bloated especially after a meal. They develop discomfort because of their inability to belch and get rid of that gas. Not only do they develop abdominal cramps, but may also pass large amounts of flatus resulting in socially embarrassing situations.

This syndrome occurs in 25-50% of patients after the fundoplication surgery, but symptoms resolve over time in most cases. Revision surgery may rarely be to correct the problem.

Gas-Bloat syndrome may also occur in patients who are learning to use their upper food pipe (esophagus) for their speech after their voice box (larynx) has been surgically removed due to cancer etc. This new form of speech involves sucking air into esophagus, and then expelling it immediately in the form of words. Increased aerophagia into the stomach may occur in these patients.
AS-BLOAT SYNDROME
This occurs in patients who have been operated for gastroesophageal reflux disease (GERD) or heartburn. The most common operation is (Nissen's fundoplication). This procedure involves wrapping stomach around the valve at the junction of esophagus and stomach (LES) so as to make it tighter and prevent upward flow of acid.
A natural consequence of that is that the tightened valve does not allow for upward expulsion of air either, thus preventing belching. Patients feel full of gas and bloated especially after a meal. They develop discomfort because of their inability to belch and get rid of that gas. Not only do they develop abdominal cramps, but may also pass large amounts of flatus resulting in socially embarrassing situations.
This syndrome occurs in 25-50% of patients after the fundoplication surgery, but symptoms resolve over time in most cases. Revision surgery may rarely be to correct the problem.
Gas-Bloat syndrome may also occur in patients who are learning to use their upper food pipe (esophagus) for their speech after their voice box (larynx) has been surgically removed due to cancer etc. This new form of speech involves sucking air into esophagus, and then expelling it immediately in the form of words. Increased aerophagia into the stomach may occur in these patients.
 





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Sorry, this was the first article ...copied for previous comment

Gas bloat following open antireflux surgery has been reported to occur in 0-41% of patients [11-13, 15, 16, 18-24] (Table I). Despite this, few randomized studies have involved a comparison of the relative incidence of gas bloat using different surgical techniques. The largest study to date randomized 137 patients to a 360° (Nissen-Rossetti) or a 270° (Toupet) fundoplication [11]. There were no intergroup differences in the incidence of bloating or post prandial fullness at any postoperative follow-up point between 3 and 60 months. Overall, the ability to belch was present in 80% of patients at 5 years postoperatively. Smaller studies of Nissen versus Lind [12], Nissen versus Nissen-Rossetti [13] and Nissen versus Hill versus Belsey markIV fundoplication [14] have also failed to show any significant differences. In a non-randomized study of Nissen fundoplication, DeMeester et al. [15] noted that patients with normal LES characteristics on manometry preoperatively were more likely to suffer from gas bloat and flatus, as were those with upright reflux alone. Uncontrolled studies of partial posterior or anterior fundoplication
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63984_tn?1385441539
Schatsy, I'm not very confrontational, and was just trying to help.

I'm not a fan of Wikopedia, it is a site where anyone can post anything they wish, so look at at the actual research, not a reporting of the research by outside sources.  Also, when I tried to open NARC 4U I was warned that the site had been compromised by my Norton Virus protection and was warned a virus lurked within.  

I believe your wrap is too tight.  Hope that helps.

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Avatar_m_tn
I have the exact same problem you are experiencing ever since my Nissen 5 years ago. I have gotten to the point I do not eat breakfast or lunch because of being at work and I become so bloated and uncomfortable. At times the gas is so much , I become nauseated and have to take phenagran for relief which leaves me very weak and tired. This usually happens at night because by then I am starving but had rather deal with the complications at home. I have spent a small fortune on endoscopies, colonoscopies, gastric emptying, upper g.i. I have changed gastroenterologists three times since the surgery who finally diagnosed me with gas bloat syndrome. He says there is no mathematical method of performing a Nissen. Basically eyeballing and unfortunately mine was done too tightly. He also said any further surgery to correct it would be a holy nightmare and he would never recommend it. So my advice from the last Gastro dr. was to take as much  simethicone  it takes  to help relieve the gas and bloating. I am basically miserable when it comes to eating and it has really consumed me. I was already 40 lbs. overweight when the surgery was performed which I gained from the fibromyalgia drug, Lyrica. So, yes I feel like a woman in her 9th month of pregnancy. On the up side, I have no reflux at all. I have never belched nor vomited since the surgery 5 years ago. I travel with nausea meds., even suppositories for extreme cases and then I have to go to bed. I know several people in my small town who have had the surgery but do not have this problem. My dr. just says theirs must have been performed just right. Not too tight, not too loosely. I take phazyme, gas x, charcoal tablets and rezvera. To this day, I deal with it daily and have no exact regimen to follow that works. I feel your  pain and hope that some day we can come across something that will give us more relief.
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Avatar_f_tn
I had Nissen Fundoplication and have the gas bloat syndrome, had the test and doctors say there is nothing wrong with surgery. Have not had a normal bowel movement since surgery. Have the hic-cups from the pressure on my diaphragm. Shortness of breath. Extreme nausea with vomiting and the heartburn.I have all the symptoms I had before the surgery. The pain runs across my chest and through to my back and into my shoulders. I am so miserable.Still have to sleep with my bed elevated. I follow the diet but find there are many things that I cannot eat that I should be able to. I, also, was lied to and had no counseling. The acid took the enamel off my teeth causing severe sensitivity to just about anything I eat or drink. Have even lost a tooth. I have tried everything my doctors have suggested but NOTHING helps. Most of clothes I cannot wear because I am so bloated. Feel like I am choking all the time. I have Vocal Cord Dysfunction where they close completely and I cannot breath. The surgery was to help this but I still have trouble, so far not as severe as before. It is so scary and I constantly fear this will occur again as before. My lung was also punctured during surgery and partially collapsed. I was not told and was released from the hospital in all of this pain; SOB; and mucous not knowing what was going on. My questions were not answered. The medical field is failing us. Why do the procedure if it is only going to add to our misery. We should be informed. I feel so helpless. Good to know I am not the only one having these problems.
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Avatar_f_tn
I had the Nissen back in Dec. 12 and by the end of the day, I too, look 9 months pregnant and am in severe pain!  I went back to my gastrologist and he put me on a probiotic for a month.  It seems to have helped but I still have a hard time using the bathroom.  If it gets really bad he will put me on an antibiotic called Xifaxam.  I cannot drink dark carbonated sodas from a fountain cause I can't swallow it.  I can drink clear drinks such as Sprite and Mt. Dew.
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329165_tn?1412685860
Hi there,

I feel really sad for everyone that had the surgery and now has Gastric issues.

I had a very successful Nissen Fundo partial Fundoplication during Feb. 2012.  I am still in my 30's and have Barret's Esophagus and had a lot of tests done before I agreed to the surgery (various Manomatry's, Impendance study, PH holters, endoscopies).

When I had my surgical consult the Surgeon explained the pro's and con's and he opted for the partial Fundoplication as with this type of procedure there are a lot less GI issues post-op and it is just as good as the full 360 Fundo.

It would be very interesting to see how many patients with PARTIAL Fundo's have the GI issues as described above... maybe that is the answer!
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Avatar_m_tn
I had my nissen fundoplication 12 years ago at the age of 25. I was skinny and very in-shape with no other health problems. To this day, I still have severe gas-bloat syndrome! It has never gone away or gotten better. The drs suggestion was to go back and redo the surgery! No thanks...it was horrible the first time, why in the world would I want to do it again. I hope you can figure out a way to live with it, because that's your real only choice. Avoiding certain foods helps a little--like beer, soda, ect--avoid carbonated drinks and any foods that cause "normal" people to bloat. It's a miserable way of life, and if I could go back and do it over--I would not have done the surgery! My reflux came back 6 months later and till this day, I have never been able to burp--which is obviously a problem. I wish my dr had informed me better before I made this life changing decision at such a young age. I trusted him and had been referred across the US to see this top surgeon. I also now have Delayed gastric emptying, the only medicine that was on the market (reglan) was taken off due to serious side effects..I'm just a medical nightmare at 38yrs old! My stomach is worse than a 90yr olds..I just do my best, ignore it and realize that abdominal pain is just a part of my life now. It's very sad and disappointing. I'm still very fit and healthy but my stomach is a mess!
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Avatar_m_tn
One more thing! It's very discouraging when Drs have no idea what a nissen fundoplication is and try to diagnose all your symptoms as Irritable Bowel Syndrome!! IBS and gas-bloat from complications of a nissen fundo have nothing to do with one another.
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Avatar_f_tn
I had my surgery a year ago and have had gas bloat for the last 6 months.  I find that taking digestive enzymes before eating helps alot and reduces the gas.  I ws the same as one other guy who didnt eat during the day due to the gas issues when eating and to some extent still only meet once a day.  I have recently gone back to the Dr's who have suggested takeing Domperidone which helps push the food through your system so will give them a go.  He has also refered me back to the surgeon to see if there is anything he can do.  If they suggested anthing that helps I will post on here.  The whole thing is getting me down and it is getting really embarassing.  If the Dr's know the side effect then they should try to come up with a solution
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Avatar_m_tn
I had my Fundo 12/11.  I too suffer from gas bloat syndrome.  I have put on 35 pounds since the operation also, but no true reason why.  My diet has not changed much.  My GI did a scope In Jan/2013 and said the Fundo greatly improved my Barrett's Esophagus.  He feared the wrap was too tight and wanted to stretch it while in there with the upper GI.  I begged him not too, but now I sort of wish I would have let him.  The gas bloat has just gotten so much worse.  He noticed it back them.  I just never want to have reflux again.  It was causing that pre-cancerous issue, which is a bigger concern to me.  

However, I may visit him again soon, or my surgeon at University of Cincinnati med center to see what she suggests.  I've read about newer procedures, one in which they use a band of magnets that help act as the LES.  A take down is very difficult, and a bit dangerous.  But quality life is important too.  So I am wondering if she could take down the wrap and use a newer procedure at some point?
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63984_tn?1385441539
I had the nissen F. 360 procedure about 5 or 6 years ago, and have noticed I can burb a bit now.  That said I don't drink beer, carbonated drinks or anything gassy.  Your weight gain is very unusual, are you taking other drugs such as prednisone or beta blockers?  Talk you your doctor about stretching the LES.
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