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Post-Nissen Fundoplication Problems: What helps?

Digestive Health | Last Active: Feb 17 12:54pm | Replies (138)

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@marychapman @sickvick @fourof5zs @leannesalinas @pdilly

Hello All,

I wanted to post an update since I saw the surgeon a couple weeks ago. He said that after reviewing the CT scan, the Nissen wrap itself hasn't moved, but a small portion of the stomach has been pulled up through it. While the only way to fix this is through a second surgery, he told me that currently there is no danger to leaving everything as is. The risk of complications goes up from 1-3% with my first surgery to 5-10% with a second. Since they would not know why the stomach was pulled up (shortened esophagus from scarring or just a result of the small hernia), the surgery could end up even more complicated if he would have to remove part of the stomach to lengthen the esophagus. There is a greater chance of bleeding with the liver or spleen. He said that while liver bleeding is very easy to stop, the spleen is a very tender organ and it can be more difficult to stop bleeding, which can potentially lead to it needing to be removed. He also said that the chance of long-term side effects such as difficulty swallowing, inability to burp, and more limited diet could result. Finally, the recovery would be longer than the first surgery. He told me that I would have to weigh the amount of discomfort I am in right now with the potential risks.

I have opted to not have another surgery at this time. While I still have some spasms and heartburn, I consider my current symptoms very manageable. Should the hernia get bigger causing more of the stomach to move up or the symptoms become significantly worse, my surgeon said that he will always be there and we can schedule surgery whenever I want to.

I hope that this helps some of you.


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Replies to "@marychapman @sickvick @fourof5zs @leannesalinas @pdilly Hello All, I wanted to post an update since I saw..."

@btowngal A recap for those who do not know my story. My paraesophageal hiatal hernia was a booger. Kept pulling my stomach into my chest. It made it a bit uncomfortable to breathe at times. I had the Nissen wrap in 2001 and it immediately started to undo, but I lasted with it until 2007 when I chose the wrong surgeon for repair and he used mesh in a place he should not have. Then because of mesh I went to Mayo in Jacksonville in Oct 2013 and had an undo of the wrap and lost the upper part of fundus, so another wrap was out of the question. The surgeon repaired the hernia best he could, but it started to slip and within a few months my stomach was again pulled into my chest. Next surgery at Mayo was with Dr Bowers in Sept 2014. He did a gastric bypass with a twist.. not sure what the twist was. All went well except my esophagus shortened, pulled my stomach and one loop of intestines into my chest and caused a leak.. like a 1% chance of that happening. 3 weeks in the hospital with a week I remember very little. I left with a feeding tube. Surgery in the future was known when I left the hospital. I was too weak for more surgery right then. Six months later I was in out local ER. Two more loops of intestines came into my chest pushing my left lung against my rib cage. They got me stabilized and it was a couple of weeks before i could see Dr Bowers.. He was out of country. If I need to I could go to the Mayo and see another doctor.. my local hospital would even airlift me in another emergency. I stayed stable and about 6 weeks after my ER visit I had srugery in May 2015. Dr Bowers had to coordinate the surgery with Dr Thomas, a thoracic surgeon. The surgery had to be done open, because of the intestines pushing my lung against my ribs.. So it was very painful because they cut from sternum around under the arm to back of shoulder... cracking one rib and cuttting another and cutting muscle. It is a very difficult surgery to go through and to recover from. If I wanted a chance at living I had no choice but to have it. I still hurt . I had already had problems swallowing before the surgery. The pain is mostly from my shoulder, arm and rib.. still some stomach pain too. I have a smal tear of the labrum in my shoulder. I have worked with a pain specialist and done physical therapy.. which have helped, but there is stil a lot of pain. After the surgery I did spend a week in the hospital, but then had to go back in because I was dry heaving. I was still on feeding tube. I had swelling and they tried IV steroid, but the swelling did not go enough down, so had two dilations while in hospital. I think that trip was a week. I think I had two more dialation after getting out of hospital. I had another dilation August of last year and will need to go again soon. The swallowing is getting difficult again. More burping, more stomach pain and am having trouble maintaining weight. I fill up very fast. Often my food just backs up into my esophagus because of spasms right above my stomach.. the sphinter closes when this happens.

I agree with you, Sharoene. I would wait as long as I could before having more surgery and I pray all goes well for you. No problems I had were of the fault of the surgeons at the Mayo... it was my body causing the problems. Dr Bowers is a fine planner and surgeon, and has a good team. One team member had left his team by my third surgery there and he asked to be in on my care and Dr Bowers agreed to it. My case seemed to be one for the record book. I now see Dr Francis (GI dr) and her NP at the Mayo. My local GI doctor said he just did not feel comfortable treating my esphagus after all the issues and surgical changes I had. Dr Francis was already very familiar with my case history.. she said I was the talk of the hosptial for a while. Wow! I must have been one of their stranger cases.

If anyone needs to talk I'm here 😀
Zaroga (aka ZeeGee)