Possible failure of Nissen Fundoplication (2021)

i had a hiatal hernia repair redo laparospic Nissen fundoplication (the first failed for anatomical reasons-vein caught in the back of the wrap). The redo was seven months ago. I then had constant problems swallowing solids following this redo. I have had three follow up dilations 20mm but solid food still wont go down but appears stuck in my esophagus. the last dilation i initially thought it was better but didn't last for more than few weeks. fluid/liquid is also causing problems to swallow now. Barium swallow shows normal passage down oesophagus with holdup at gastro-oesophageal junction causing stasis and redirection. this is more apparent in the supine position. there is no evedence of oesophageal dysmptility. no signs of gastro-oesophageal reflux. no anatomical abnormalities of the oesophagus/gastro-oesophageal junction. i am now chesty at times especially after trying to eat solids and in the morning. I am also regurgitating after solids. But very little reflux but i am constantly trying to clear my throat and it is flemmy most of the time. i have addisons disease. My surgeon only wants to do a gastroscopy and another dilation 22mm - this will be my fourth. he says the wrap is in its correct place and he seems to think he can now see from the barium swallow results where it is too tight. I do not want to seek a seond opinion as he is regarded the best here. but i am worried he may be missing something

@alve My father-in-law had swallowing problems for a few years. Same symptoms that you describe. He had Botox injections and these helped. He is in his 80's, so he's thankful that he can eat. I hope you can get help.

@connilou Thank your for the encouragement. Much appreciaed.

@connilou thank you for your advice. I hope your FiL keeps being able to swallow.

Hi, I got an NF in 2013. In 2015, I had a repair due to a hiatal hernia. In 2021, I had pain and got surgery again, this time due to adhesions. In Feb 2026, I had another endoscopy showing I had a sliding hiatal hernia, gastritis and esophagitis. I am waiting for a barium swallow and pH manometry now to determine if I need further surgery. I read that 10% of people who have an NF will need further surgery, but I hope you get sorted.

@figuringitout - welcome to Mayo Clinic Connect. Sorry to hear you've had trouble following your Nissen fundoplication.

When will you have the ph manometry and the barium swallow? What is your doctor hoping to learn from each of these?

@lisalucier Thank you. I am still waiting to be scheduled, and I am guessing the doctors want to assess whether the NF has structurally failed and whether my oesophageal muscles are strong enough.