Gastric Bypass after Nissen Failures

Posted by terrijwright @terrijwright, Sep 30, 2023

I had a LINX in 2020, a Nissen in 2021, a Nissen re-do and a pylorplasty (for gastroparisis) in 2023. All of these have failed. My gastroenterologist, at MD Anderson is saying that the options are now limited. He is feeling that a gastric bypass is now the best thing to do, at this point. I have the reflux that makes my throat fell raw much of the time and have nausea, retching, bloating and gas from the gastroparisis. I have slow intestinal motility as well. It is surmised that much of this is due to gastrointestinal neuropathy from both chemotherapy and from a poorly done Nissen the first time. I certainly would love to have relief from all of this. However, the gastric bypass measure is scary to me. I do not have a high BMI - my weight is 127lbs. The surgeon says that in these cases they make to pouch a bit larger, so you won’t lose as much weight, but would still lose some. Does anyone else have experience with having a Gastric Bypass for non-weight loss issues? I’d love to hear others experiences.

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ZeeGee | @fourof5zs | Oct 2, 2023

@terrijwright
This is very long (even though it is a short version) .. it is MY JOURNEY and has a very slim chance of becoming yours.

I had a gastric bypass to solve the problem of a giant hiatal hernia that was causing my acid reflux. I had a Nissen in 2001 and it started failing immediately. In 2007 I had a repair with a different surgeon .. first one retired. This second surgeon did an awful job of repair .. He used mesh to on the fundus (top part of the stomach). Why? have no idea. It created much pain and the hernia still pulled into my chest. At the end 2012 I had weight loss of 30lbs and pain that had been since 2007 was much worse . I saw another local surgeon and he said I needed to go to the Mayo Clinic where they correct other surgeon's mistakes. I got an appointment at Mayo in Jacksonville Fl. The doctor I saw thought the Nissen could be repaired. When he got in there .. laparoscopically .. he found a mess. He had to remove the top part of my stomach to remove the embedded mesh. This is the part they wrap around for the Nissen. So no possibility of repair of Nissen. He anchored the hernia to the diaphragm. This repair also failed. I was out of the excruciating pain. though. The hernia .. that won't be repaired .. agony!

The doctor had ordered a barium swallow test .. the one with many photos and videos taken as you change positions on the table .. for early 2014. The doctor had since left the Mayo and I was assigned another doctor at the Mayo. The hernia had again pulled into my chest bringing with it my stomach.

This doctor .. surgeon .. decided it best to do a gastric bypass to permanently repair the hernia. Gastric bypass surgery was actually developed for this purpose and the side effect was weight loss. I had the surgery in late September of 2014. I had a 1% chance of my esophagus shortening during the procedure .. it did. In doing so it caused my stomach, the hernia and 1 loop of intestines to come onto my chest. This was not because of anything the surgeon did .. just what my body decided to do. It shredded part of my diaphragm that the hernia was attached to. They repaired (surgeon and his team) what they could over 7 hours. I was too weak for them to repair it all. The one loop of intestines was still in my chest.

I was in the hospital for 3 weeks. I had developed a gastric leak which made me very sick. The leak was so small they could not find it. So a ton of antibiotics. Many tubes to drain the leakage fluid out .. and many prayers uplifted. I came home with a feeding tube and was to come back in about 6 months. My pouch .. now stomach .. was about the size of an x-large egg and still is because I lost parts of my stomach. The feeding tube went to my remnant stomach. I don't know its size.

In early March 2015 .. I had a day I was just miserable. I can't explain explain exactly how I felt.. We had our granddaughter visiting with us. By 3 in the afternoon I gave up and said I needed to go to the emergency room. My husband's sister came and got our granddaughter and she took her to her parents (parents live in a town 1 1/2 hour drive away… but they met halfway)

CT scan at ER showed 2 more loops of my intestines had come up into my chest. (a bit crowded in there) I was in pain by time I had the CT scan. They gave me some pain meds via IV. I saw a surgeon before leaving the hospital. He said to call my doctor at the Mayo Clinic. .. don't let any surgeon here touch you! I was sent home with liquid hydrocodone.

I did call my surgeon at Mayo .. he was in South America for his volunteer work. I saw him two weeks later. By this time I was feeling better and off the pain meds. My surgeon told me the repair had to be done open surgery with a thoracic surgeon and they would have to plan out the surgery. May 18th 2015 I had the surgery .. not really any choice if I wanted to live. My intestines had pushed my left lung against my ribs .. collapsing the lower portion of my lung and sticking my lung to my ribs. They had to peal my lung off my ribs and had to work very close to my heart.

I spent a week in the hospital, but had to reenter because I was dry heaving. I returned for a two week stay. I had some swelling. First they tried steroids to shrink the swelling and a nasogastric tube to pull the mucus out of my stomach. No help. They did an endoscopy to dilate the swollen area. It helped … then had a repeat before leaving hospital and again two more times over the next 4 months.

I had the feeding tube removed in mid October of 2015. I had to eat while on the feeding tube and as I reduced the amount of formula increase my food intake and I had to maintain my weight for 6 weeks after discontinuing the formula before they would remove the feeding tube. Over the following 3 months I lost 20 lbs. Since then my weight has been between 116 lbs to 140 lbs. Right now 135 lbs I feel best between 130-135 lbs. I have shrank to a height of 5’5”. I am 72 years old.

I have an esophagus problem .. my esophagus narrows and I have to have it dilated every few months. Sometimes it gets to the point of I cannot swallow soft foods nor liquids. It was that way before all these surgeries because of all the damage the acid reflux caused.

Yes, I had complications, but that is on the low side of the spectrum. Does gastric by pass have side effects. Yes, and please read all you can find on the subject. .. even if the information is for weight loss. Pancreatitis is one. I have not experience it. Another is one I am going through now … dilated biliary duct. It is dilated at my liver and pancreas. So far no masses. I have a repeat of MRI in January. There are others .. I was given a booklet, but I have misplaced it so I too will have to look online.

Even with all these complications I would do it over again. I have to eat differently. I don't digest foods as well so I had to cut out raw foods. Greasy foods have been a no-no forever. Since I have a small stomach I cannot eat as much high fiber foods .. they take longer to digest. Most people after a short time can return to a normal diet. Try and eat high calorie nutritious foods. I eat too much junk food.

Please .. again .. my journey is on the worse case scenario side and is not what most people go through. Usually after the surgery it is a liquid .. soft food and progression to normal diet.

If you can .. gain some weight before your surgery. I managed to gain the 5 lbs my doctor asked me to. He also asked me to eat a lot of eggs for the protein .. it helps you heal. I added a little cheese and bacon bits to the eggs to add calories.

Best wishes for your journey,
ZeeGee