Nissen Fundoplication

[rallenr]

I have a fairly severe situation with Acid Reflux which drastically affects my voice.  I am continually hoarse, and always coughing up phlegm.  I don't, however, get heartburn.  More than one ENT doctor has examined me and found no difficulty or disease in my throat or larynx.  ALL of them point to GERD and the effect that stomach acid is having on the mucous producing tissues in the throat.  For what it's worth, my voice deteriorated at the same time eight years ago when I successfully quit a 2-3 pack/day smoking habit.  I don't drink alcohol either and am normal in all other aspects.  A test has also confirmed that my LES muscle is weak.  I am a 54 year old male and weigh 175 lbs.

So, two questions:

Might a Nissen Fundoplication procedure repair the lower esophageal sphincter and help me restore my voice?  And if so, can you recommend or refer me to a specialist in southern California?

[EliDale]

I had lap nissen fundo surgery 1 year ago.
REFLUX gone--- no problems what-so-ever.

Diagnosed with Barretts Esophagus approx. 5 years ago.
Have the regular yearly endoscope which always shows no change - good I guess. I continute to be hoarse, clearing throat quite often. People think I have a cold etc.. but no ...........!
I am hoping things @ least stay where they are or somehow manage to reverse a bit. Supposedly Barretts E. stays as is or gets worse. Time shall tell...good luck

[jaspur]

I had the Nissan Wrap done in 1995 and have not had any heartburn since. I still have sinus problems and have to take protonix,prilosec or whatever. I have Barrets esophagus which is what you should worry about if your are having acid reflux. This has to be controlled either by medication or the Nissan Wrap operation to prevent Barrets from getiing worse or preventing it.As far as I can tell even after the operation you still (most likely) will have to take meds. The surgeon will tell you no more meds after the operation and the GI Doc will say keep taking them. You should find a good teaching hospital and inquire there about a good GI Doc to start off with and remember if the Doctor is good and experienced in GERD you may have a long wait to see the Doc but it will be worth it..Good Luck

[JackieG]

Nissen Fundoplication was designed specifically to tighten a weak LES. They can do the nissen via laparoscopic surgery now (they couldn't in 1991 when I had it done). Laparoscopic surgery entails much less risk, and you will recover much, much more quickly, so I would encourage you to look into it. Any teaching hospital in your area will have good gastroenterologists and surgeons. I would ask you PCP for several recommendations and then interview them. Pick the one you are most comfortable with, but pick a surgeon who has performed this procedure alot. In this case, practice IS important.

A word to the other two people who have responded. You are correct that once you have Barrett's, the best case is to stop the cellular change. The worst case is for the cellular change to progress to low-grade, medium-grade, or high-grade dysplasia. Barrett's is already a pre-cancerous condition, dysplasia is the final set of cellular changes before clinical esophageal cancer (Carcenoma in situ, stages 1, 2, 3, and 4 esophageal cancer, in order of severity). The further down that path you go, the more dismal the prognosis. Please continue to have annual endoscopies with biopsies. IF (and I truly hope this is a big if), you start to see changes from Barrett's to dysplasia, you want to catch it as early as possible. Early detection is the key to survival AND a reasonably high quality of life after treatment. Once one is diagnosed in a later stage of esophageal cancer, the 5-year survival rates are not encouraging. If you notice any difficulty swallowing or ang change in the sensation of swallowing, schedule an endoscopy immediately.

GERD is a very serious disease that can lead to cancer. However, with lifestyle and dietary changes, and close surviellance, it can be managed. I wish the best for all three of you. Keep monitoring!!

Best regards,
Chicken Soup

[baza]

i have had a stomach wrap for 14 months now every time i eat i am in pain afterwards, i can not belch or be sick, i have had 4 stretches to slacken the wrap, i have had ulcers and constant inflammation in my stomach since the wrap.  but looking on the bright side i have not had any acid reflux, and now i am waiting to have it reversed.  it appears that it works for some and not for others.
cheers
baza

[baza]

i have had a stomach wrap for 14 months now every time i eat i am in pain afterwards, i can not belch or be sick, i have had 4 stretches to slacken the wrap, i have had ulcers and constant inflammation in my stomach since the wrap.  but looking on the bright side i have not had any acid reflux, and now i am waiting to have it reversed.  it appears that it works for some and not for others.
cheers
baza

[baza]

i have had a stomach wrap for 14 months now every time i eat i am in pain afterwards, i can not belch or be sick, i have had 4 stretches to slacken the wrap, i have had ulcers and constant inflammation in my stomach since the wrap.  but looking on the bright side i have not had any acid reflux, and now i am waiting to have it reversed.  it appears that it works for some and not for others.
cheers
baza

[baza]

i have had a stomach wrap for 14 months now every time i eat i am in pain afterwards, i can not belch or be sick, i have had 4 stretches to slacken the wrap, i have had ulcers and constant inflammation in my stomach since the wrap.  but looking on the bright side i have not had any acid reflux, and now i am waiting to have it reversed.  it appears that it works for some and not for others.
cheers
baza