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Gastroenterology (Expert Forum)
Question concerning persistent vomiting after Nissen Fundoplication
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Question concerning persistent vomiting after Nissen Fundoplication
by Taydoo, Mar 14, 2002 12:00AM
My son was diagnosed with Goldenhar Syndrome & GERD & put on medication (Zantac & Reglan) at birth. The reflux was silent till 3 months when the vomiting began one day after his cleft lip surgery. At 6 months an endoscopy showed no esophagitis & pH study showed mild reflux. Medication doses were increased with no improvement so feedings were changed from bolus to continuous with no improvement.
At 11 months he was admitted to the hospital for severe dehydration. pH study showed moderate reflux. Abdominal ultrasound was normal. Gastric emptying study was normal. We were referred to a surgeon for a Nissen.
Then the vomiting suddenly stopped. The ONLY change made at this time was an increase in trach size from Shiley 3.0 neonatal to 3.0 pediatric. Unfortunately, this improvement only lasted 2 weeks.
At 16 months a Nissen was done. For 3 months post-op the vomiting stopped. Then the vomiting slowly returned. An upper GI was done & the Nissen was still intact.
At 20 months a Jtube was placed. He continued to vomit stomach acid even with the Jtube. At 22 months the Jtube clogged another could not be placed.
Another pH study at 23 months showed no reflux, just spikes in acidity when he vomited.
He is currently 22 lbs 4 oz, 35" & 25 m old. He vomits anywhere from 5 to 20 times daily. He receives continuous feeds of Pediasure Entrail formula for a total of 1200 calories per day. All blood work is normal. All neurological scans are normal.
Has anyone else experienced anything like this? Does anyone have a suggestion on what to try next?
***@****
At 11 months he was admitted to the hospital for severe dehydration. pH study showed moderate reflux. Abdominal ultrasound was normal. Gastric emptying study was normal. We were referred to a surgeon for a Nissen.
Then the vomiting suddenly stopped. The ONLY change made at this time was an increase in trach size from Shiley 3.0 neonatal to 3.0 pediatric. Unfortunately, this improvement only lasted 2 weeks.
At 16 months a Nissen was done. For 3 months post-op the vomiting stopped. Then the vomiting slowly returned. An upper GI was done & the Nissen was still intact.
At 20 months a Jtube was placed. He continued to vomit stomach acid even with the Jtube. At 22 months the Jtube clogged another could not be placed.
Another pH study at 23 months showed no reflux, just spikes in acidity when he vomited.
He is currently 22 lbs 4 oz, 35" & 25 m old. He vomits anywhere from 5 to 20 times daily. He receives continuous feeds of Pediasure Entrail formula for a total of 1200 calories per day. All blood work is normal. All neurological scans are normal.
Has anyone else experienced anything like this? Does anyone have a suggestion on what to try next?
***@****
Member Comments
by tavon's mom, May 09, 2002 12:00AM
I really do not have any information for you because I am going thru the same thing with my son. I asked about redoing his fundoplication, and they seemed to think that not the problem. I lost so if you find anything different please let me know.
by tiger67, Apr 13, 2008 09:43PM
A related discussion, Vomiting after 2nd nissen was started.
