Is here some way to eliminate the pain I experience when I eat?

[Kerrigan]

I am a 65 year old woman in pretty good health.  I had bad reflux disease and Barrett's disease so I had a gastric wrap two years ago.  It turned out that I also had a hiatal hernia.  Following the surgery I experienced severe pain in my left shoulder whenever I ate for some time which my doctor attributed to the wrap being stapled to my diaphram and the nerve from the diaphram going up to my left shoulder.  He thought it would go away in time.  It didn't.  My doctor kept suggesting that I wait a little longer hoping the pain would eventually disappear.  Although less severe now, I still suffer pain in my shoulder whenever I eat more than a small amount of food.  I don't want to go the rest of my life suffering pain when I eat.  I love to cook and my son is a professional chef. Discussions with my doctor have not been satisfactory. He doesn't seem to know if it's possible to find the staple, much less remove it.  And he is unsure whether removing the staple will remove the pain or possibly cause the reflux to return.  At this point I would rather have the reflux since I can take medication for that which is less problematic than the pain pills that I sometimes have to take now. I have never heard or read of anyone else having this problem.  Is it unusual to have the wrap stapled to the diaphram? Is there some way to undo the prodedure or at least remove the staple from the diaphram so that I can eat without pain?  Or do you know of any other way to end the pain I am experiencing?  Are there any web cites that could provide more information?

[Kevin Pho, MD]

To answer your questions:
1) It may be possible that the procedure may have irritated a nerve that may be causing your discomfort.  From my reading, I would say that this complication is uncommon.  

2) A second opinion with another surgeon can determine whether a redo or undoing of the procedure may improve your symptoms.  

3) A neurology referral to evaluate whether any nerve disorders can be considered.  Electrodiagnostic testing (i.e. an EMG) can be done to further evaluate this.  If all the evaluations are not revealing, a referral to a pain specialist to minimize the discomfort can be considered.  

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.

[Sadiehhh]

GET ANOTHER DR.!!!  If your Dr. doesn't take your concerns seriously and you continue to be in chronic pain, find a Dr. who WILL listen and take you and your concerns seriously.  You DESERVE to live a life as pain free as possible, as we all do.  Best wishes to you!

[tessa0825]

I would think alot of surgeons could take down your wrap and redo it....I have spoken with people who have had their wraps redone, for various reasons...I agree that you should seek a second opinion....I think you should talk with a surgeon who has alot of experience with this surgery and one that has done many rewraps...good luck, Tessa

[jenEbean19]

Well imagine my finding this post!  I have the EXACT symptoms!  I had a hiatal hernia repair 3 years ago and woke up with this pain in my left neck and shoulder.  Was told that it was from the gas that they use to expand your belly to do the surgery laparoscopically and it would go away within 1 week.  Then they said 6 weeks, then 1 year.  Now it is 3 years later and I still have the pain if I eat too much. The surgeon said he had never heard of this before. Trouble is, I don't feel full, then the pain hits and it is too late.  It can be quite excruiating.  I wish I had an answer for you about what to do. I haven't found anything yet, I just thank God that I am not nuts like the doc seems to think.

[jenEbean19]

Oh, a couple of things that I should have mentioned.  I have been to every doctor you can imagine.  Went to a gastroenterologist, another surgeon, neurologist, PCP, everyone said the same thing, damage to the diaphragm but the surgeon who did the surgery just won't hear of it.  I have found that Neurontin has helped with the everyday pain.  I take 300mg at bedtime and another 100mg during the day if needed.  You might ask your doc about trying it.