Post Nissen Fundoplication

[jcsturrock]

Three years ago my daughter underwent a Laparoscoic Nissen Fundoplication for severe GERD.  Since then she has not been able to vomit AT ALL!!  This causes severe discomfort whenever she becomes ill.  Her eyes have been blood shot from all the wretching--yet nothing comes up.

Can this be reversed?  She has HAD ENOUGH and regrets ever having the surgery. We are looking for an expert in this area and are getting desperate.

[Kevin Pho, MD]

I would discuss these concerns with her gastroenterologist or surgeon.  Reversing the fundoplication can be considered if them symptoms continue.

I would evaluate the upper GI tract with an endoscopy or upper GI series.  A 24-hr pH study can be considered to determine if there is residual GERD.

These questions can be discussed with her personal physician.

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.
kevinmd_

[Aub]

I just had the Nissan surgery.  I am 55 and just a few weeks out and so far doing well.  At 4 weeks, they have a mandatory follow-up endoscopy.  So I would be a little surprised they didn't do that with your daughter. The follow-up checks to see if everything went o.k.  I think in today's technology, they are able to make some ajustments if it is too tight, w/o completing redoing the whole surgery.  

[sumburr]

11/14/06 My daughter is almost 5 and had g tube placement and a nissen at a young age and she too has the wretching but she actually gets a little up.  After our GI doctor told us "sometimes they do that after a nissen" every 3 months for the first 2 years of her life, we began managing our meds with our PCP.  We have been on reglan, bethanechol (actually for urinary retention) in combination with prilosec and then nexium with little or no help.  When her tube feed ran in in on the pump with a end volume of 90 cc  over a 30 min.time span, she would begin wretching as early a  25cc.  Over time, it has gotten better as a lot of things have.  Recently we have made some progress with oral feedings but wretch some during meals.  I too wondered about reversing this auful thing!!!  Just yesterday, my daughter saw a GI doctor in St. Louis, Missouri who gave us a rx for periactin.  She told us that out of the other 10 kids she started on this med, 7 of them have had improvement with the wretching!!  I will give her the first dose tonight so cross your fingers for me and ask your GI doc about this.

[Feleenista]

I don't know if this will help your child, but it has helped me. I had the Nissan Fundoplication surgery performed on me at 10 months old in order to help my esophagus recover from a TE Fistula surgery.

The Nissan is still stable in my system and I am almost 22 years old. When I get sick, I cannot vomit either. Something that always helps me is sipping water, usually cold water. And (even though this is really strange, it always helps me) I think of dairy products and my stomach calms down. I usually picture a glass of milk or something, eventhough if I drank it at that moment, it would just be horrible. I usually have to lie down for a little while after an episode like that, but this is my system's way of copeing with the convulsions. It also helps to have water running in the background, as a cover up noise, so I can't hear my own retching; because that just makes you want to vomit even more. Tell your child to take deep, slow breaths and have them sip water in between the convulsions, even the water that's comming out of the faucet if it's the only water at hand. The cool water helps the calm the burning inside and really helps the convulsions to stop.

Granted, this is just MY way of coping with the Nissan, but it may help your children/loved ones (or yourself) as well.

[Sasha50]

I am a 58 year old woman who is considering the Fundoplication procedure to repair a sliding hernia that exerts pressure in my chest.  I do not, however, have GERD. The pressure in my chest does have symptoms of heart problems but heart problems have been ruled out.   Although I would  love to get the pressure out of my chest, my area of concern is not being able to vomit after the procedure.  Although I don't vomit often, not being able to concerns me.  Has anyone had experience with this situation?  I am not sure that the cure would be worse than the hernia pressure.  Worth it or not?

[Crissy754]

A related discussion, Im begging to get my nissan reversed today!!!! was started.