FUNDOPLICATION SURGERY

[marvelyn]

IT HAS BEEN FIVE AND A HALF SINCE I HAD FUNDOPLICATION SURGERY AT THE BEGINNING OF LAST SEPTEMBER. SINCE THE SURGERY, I HAVE NOT BEEN ABLE TO SWALLOW MOST SOLID FOODS WITHOUT PAIN THAT RADIATES FROM THE CENTER OF MY CHEST. THERE IS A FEELING OF PRESSURE THAT ACCOMPANIES THIS PAIN. THE SURGEON SUGGESTED DRINKING WATER WHEN THIS HAPPENS BUT THIS ONLY CAUSES A BUILD UP OF THE WATER UNTIL THE FOOD FINALLY PASSES THRU. I HAD A BARIUM SWALLOW TEST AT THE END OF DECEMBER, THE RESULTS WERE I COULD SWALLOW LIQUID AND HAD DEVELOPED A POCKET IN MY FOOD PIPE WHERE THE FOOD IS NOW GETTING STUCK. I HAD A DILATATION IN JANUARY BUT HAVE HAD NO IMPROVEMENT. THE GAS IS VERY DIFFICULT TO CONTROL AND VERY EMBARRASSING.WILL IT EVER GET BETTER? WHAT CAN BE DONE? IT IS VERY DIFFICULT TO EAT PROPERLY WHEN MOST FORMS OF PROTEIN, INCLUDING SCRAMBLED EGGS, SALAD OR FRESH FRUITS OR VEGETABLES ARE PAINFUL TO SWALLOW. I HAVE TO CONTINUE TO TAKE THE SAME MEDICATION TO CONTROL THE ERROSION AS BEFORE SURGERY. I AM TOLD THE SURGERY IS WORKING BUT I FEEL I AM IN WORST SHAPE SINCE I HAD IT. WHAT ARE MY OPTIONS?   MARV

[Kevin Pho, MD]

With the "pocket in the food pipe", this sounds like a Zenker's diverticulum.  I would suggest an upper endoscopy to ensure there is no further anatomical lesion or abnormality causing your symptoms.  Treatment of this is can be via an endoscopy.  If it cannot be solved, then a referral to a tertiary care medical center is needed for possible surgery (with consideration of removing the pocket).  A referral to an ENT physician is recommended.  

It is also possible that the bloating and gas may be due to the fundoplication.  I would obtain a second opinion to ensure that a modication of the fundoplication won't help your symptoms.

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.

[semm]

I had this procedure done 4 1/2 years ago. The gas and flatuance have been far more extreme than I ever imagined.  It usually begins in late afternoon and continues into the night.  It seems to be worse now that it ever has. It is embarassing when you have to be around others for an entire evening!I have had two dilatations of my esophagus because of food getting stuck.  I only feel pain when food gets really stuck, but not just by eating in general.The last time, it did not improve anything. I now have daily burning of the esophagus again and lots of stomach discomfort. I have taken Pantoloc daily since the surgery as it only helped the errosion in my esophagus and not the stomach discomfort.  I feel like all my orignal symptoms have returned and even though an upper GI xray says the procedure is still working I have my doubts. I am planning on seeing my doctor soon, suspecting I need something like Losec again. If I had to do this all over again, I wouldn't choose the fundoplication.

[tessa0825]

Hello, I had open fundo with collis gastroplasty to add length to my esophagus in Sept. 2003....I have had horrible stomach pains since then, however, because of a systemic illness I also take alot of anti-inflammatories that really aggrevate the GI problems...My Drs. recently started me on Bentyl capsules 4 times daily..Started at 40mg a day and now at 80mg.He might increase again he says but we are waiting to see how this dose does...He thinks the stomach pains are from spasms and the gas has been terrible since surgery...The bentyl does seem to be helping...Just wanted to mention it......Tessa

[gerd]

did you ever consider this procedure instead of the fundoplication ??

this non-surgical procedure

http://www.mayoclinic.org/gerd-jax/rft.html

[tessa0825]

gerd,
Did you have Stretta? For me it wasn't even an option..I also think if anyone has a large hernia it isn't an option..Tessa

[semm]

I have never heard of this "Stretta" procedure and it was not offered to me. They also repaired a hiatus hernia at the time of my fundoplication. I don't know if this procedure is new or maybe not available in Canada.  I will ask my doctor about "bentyl". Thanks.

[gerd]

hi semm/tessa0825, no I have not had this done but I am looking at this.  I need something done and this looks like a good alternative.  I also have a hiatus hernia and am waiting for my GI to get back to me regarding the size, he noted it is small whatever that means...the hernia cannot be greater than 1 inch.
Also the LES pressure cannot be too low - mine is 5 mmHG (resting).  The doc says they have had good success with pressures around the same as mine.  I am also from Canada, this procedure is only available in the U.S, so if I have it done I will probably have to pay out of pocktet, but if it works the I do not care....just want to be healthy again.

[poozie]

A related discussion, Fundoplication was started.

[jesser07]

A related discussion, Fundoplication surgery was started.