Nissen Fundoplication

[pattiecy]

I had a laporscopic fundo done 6 weeks ago.  I am not feeling any better at all.  In fact, I feel worse.   I have had a burning throat and mouth for almost 3 years.  I've tried all of the meds (priolsec, Zantac, Protonix, Aciphex, Nexium) twice a day and none of them work for me.  I decided to have the Fundo done and was assured that the surgery went (as the Surgeon says) "perfectly".   How long does it take to start feeling better.  I'm eating solid foods (since 2 weeks after the surgery), but I'm not eating like normal people (I'm still keeping my reflux diet, no spices, tomatos, carbonated drinks, etc.).  I'm still taking Nexium 2x's per day.  I have had no relief of my symptoms at all, I'm also not getting any direct answers from the surgeon.  Please help.  The surgeon tells me that it could take months to feel the difference because the inflamation (inflammation) and erosions from the reflux need to take time to heal.   My question is - How can the inflamation (inflammation) heal at all if I am still having the reflux 24 hours a day and how long does it take before I assume the surgery did not work at all.  Thank you.

[Kevin Pho, MD]

Normally the success rates for fundoplication range from 70 to 90 percent depending on the study.  Thus, this is not a fool-proof procedure.  Studies also show that 60 percent of people who undergo fundoplication still needs to be on anti-reflux therapy.  

It may also be possible that it does take a few months for improvement to be felt.  

If there continues to be symptoms, you may want to consider 24-hr pH study to determine whether there continues to be reflux.  If positive, there is a possibility that the surgery may have failed and options to correct this can then be discussed with your surgeon.

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.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[toydrive]

I had the surgery two yrs ago by a top doctor in the NY area and i have never been the same i am only about 40% better still having burnign in throat,shortness of breath I just had a 24ph test and it came back the results are worse than before i had the surgery the les pressure got a little better but still refluxing bad so i also do not know what to do

[KaseyT]

I had the surgery in 1987 and for 14 years everything was pefect and I required no medication. In 2001 I began to have reflux problems again but was advised that 2nd surgeries are not recommended and they now have better medications to control the reflux. I did have my gallbladder removed and that helped a lot. I still take a 20mg Omeprazole (like Prilosec) daily and that takes care of the problem.  I tried to stop taking them but then I was waking up with reflux every night and popping Rolaids. So I went back to the Omeprazole.
I know I am fortunate since many people like you get no relief from the surgery.

Bottom line is that the surgery doesn't work for everyone.

[Sconney]

Had the op 7 years ago...

Told me I was due for another one in 7 years as they told me that is as long as they last,as I'm not a medical person I suffer from a range of symptoms including:Pains from Testies to throat,shortness of breath,massive heart burn,Nuasea from eating and bowel movments,loss of conciousness or delerium through bowel movements...
Doctor says I'm a case study...please help as I've had both camera procedures I am 37 male...now on disability pension..

Anything would be a plus...e-mail me at ***@****

[fishinadish]

It took over 6 monthes for the swelling in my esophagus to normalize after Nissen.  Don't lose hope.  It can get better.

[NICK_ROGERS]

pattiecy, Any update on youre condition ? I had the fundo done 4 months ago, it was working but now has stopped...

[pattiecy]

To date I still have no relief from the reflux.  I am going to have the Bravo Test done.   My surgeon is at a loss.  He feels the surgery went perfectly and that I should be feeling great..

[NICK_ROGERS]

Hi pattiecy, what is the Bravo test ? I am looking at the stretta procedure now.  Seems with the fundo there are to many vaiables - if the wrap is not tight enough, if the wrap slips up the esophagus, if the wrap comes undone etc....

[NICK_ROGERS]

Hi fishinadish, so do you mean it took 6 months for the procedure to start working ??

[fishinadish]

It took 6 months before things started working properly and before I could eat a bit more normally.  I still have stomach pain and nausea frequently but my doctor thinks the Nissen fixed the GERD and that the symptoms are from Functional Dyspepsia.  I don't know if I agree yet.  I have to have Bravo done too.  It is pH monitoring but instead of putting a wire down your nose for 24 hrs, they can now put a lil camera in your stomach and it passes through you system.  Pretty cool.  Much less painful.  What is the test you are having??

[fishinadish]

Nick, I just read about Stretta.  What would the effectiveness of Stretta be post-Nissen?  Is it because your wrap not tight enough?  Do you have symptoms other than heartburn?  (I never had heartburn- just stomach pain, nausea and chronic vomiting.)

[NICK_ROGERS]

Hi fishinadish, my fundo seems to be working again...I was taking some anti-inflamatories for my hand, well these meds did a major number on my stomach ! after a week or so after my meds got out of my system things settled down again.  I do still get a mild lump in my throat, and do these funny burps that are not proper burps -but are burps in my esophagus...I think that my stomach is still very much inflamed from the surgery/stress/anisthesia- and on certain foods the extra gas comes right up.  My wrap is not so tight that I cannot burb so I guess its allows gas to come up..

I did email Curon (makers of the stretta device) and they stated numerous docs have performed the stretta on failed fundo's.

[bucklebj]

A related discussion, tickle was started.