Reversal of a fundoplication

Posted by Pawsboy9 @pawsboy9, Aug 5, 2012

I had a hernia and the fundoplication done in February as post this my chest is on fire. Going back to see the surgeon who did it on Tuesday. Has anybody had the same experience? If this guy does not have a answer heading for Mayo.

Thanks
Dennis

@kdubois

Hi @kozlo52,

I had a Nissen Fundoplication at Mayo on October 18, 2016 to fix a 4 cm hiatal hernia and non-functioning sphincter muscle. Pre-surgery, I would constantly have heartburn and GERD. I would have to finish dinner before 6:00 p.m. every night, and sleep upright using a bed wedge or I would wake up choking on with partially-digested food and stomach acid. (We did the surgery to fix these issues but also because Mayo figured out that genetically, I don’t properly-metabolize many medications, including proton pump inhibitors.)

Since the surgery, I have had no GERD or heartburn, and I can sleep normally and eat at normal times again. Post-surgery, I did take NSAIDS for pain for about two weeks.

Important to note: to test my fundoplication post-surgery, Mayo had me do an esophagram and not another manometry. The esophagram will better-show that fluids aren’t coming back up into your esophagus as it’s a true imaging test and they can literally watch the fluids (barium) real-time while you consume them.

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Kelly when you say eat normal again, does this mean very small meals 6 times a day? Yesterday i had another manometry test as well as an endoscopy with biopsies. I was told that from the endoscopy my hiatal hernia was intact as well as my LES being right. I then asked why am i still getting heartburn. The explanation from the surgeon was that i am eating too much at a given meal. I am on max antacids and this is 147 days after the initial fundo/and hernia repair.I also asked when i take pain medication that 4 hours later i get heartburn? They have no answer for this part. Are you on any pain medication? I plan to see the head surgeon ,Dr. Blair Jobe to go over the manometry results as well as the endoscopy. I am about ready to have this reversed. Please comment.

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@kdubois

Hi @kozlo52,

I had a Nissen Fundoplication at Mayo on October 18, 2016 to fix a 4 cm hiatal hernia and non-functioning sphincter muscle. Pre-surgery, I would constantly have heartburn and GERD. I would have to finish dinner before 6:00 p.m. every night, and sleep upright using a bed wedge or I would wake up choking on with partially-digested food and stomach acid. (We did the surgery to fix these issues but also because Mayo figured out that genetically, I don’t properly-metabolize many medications, including proton pump inhibitors.)

Since the surgery, I have had no GERD or heartburn, and I can sleep normally and eat at normal times again. Post-surgery, I did take NSAIDS for pain for about two weeks.

Important to note: to test my fundoplication post-surgery, Mayo had me do an esophagram and not another manometry. The esophagram will better-show that fluids aren’t coming back up into your esophagus as it’s a true imaging test and they can literally watch the fluids (barium) real-time while you consume them.

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According to the specialist i saw last month, once you have the Nissen you should not need any kind of antacid again He explained that is the wrap is working, no acid should be able to come back through. my wrap is to tight which is why i am having it adjusted next week.

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My wife had a Nissen Fundoplication in January 2014. ( that surgeon is now retired) For the past year symptoms have become progressivly worse and we were recently advised that the Nissan wrap had failed and was now herniated into her chest cavity. Local surgeons advise redoing the surgery is beyond their expertise. (Eureka ca) and advise going to larger hospital. Mayo Scottsdale was suggested as having Doctors experienced in this proceedure. We certainly want someone with a lot of experience. Any advise or suggestion greatly appreciated. Thank you Joe

REPLY
@kdubois

Hi @kozlo52,

I had a Nissen Fundoplication at Mayo on October 18, 2016 to fix a 4 cm hiatal hernia and non-functioning sphincter muscle. Pre-surgery, I would constantly have heartburn and GERD. I would have to finish dinner before 6:00 p.m. every night, and sleep upright using a bed wedge or I would wake up choking on with partially-digested food and stomach acid. (We did the surgery to fix these issues but also because Mayo figured out that genetically, I don’t properly-metabolize many medications, including proton pump inhibitors.)

Since the surgery, I have had no GERD or heartburn, and I can sleep normally and eat at normal times again. Post-surgery, I did take NSAIDS for pain for about two weeks.

Important to note: to test my fundoplication post-surgery, Mayo had me do an esophagram and not another manometry. The esophagram will better-show that fluids aren’t coming back up into your esophagus as it’s a true imaging test and they can literally watch the fluids (barium) real-time while you consume them.

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@kozlo52 I don’t have to eat several small meals every day anymore, and haven’t for a while. I only take Advil every once in a while, but I have never experienced heartburn from it. I honestly haven’t experienced any heartburn since I had my surgery on October 18.

I do stop eating immediately when I feel myself getting full, but I have over-eaten a couple of times and had no heartburn.

They *really* need to do an esophagram to see if there are fluids coming back up. This test includes imaging while you are standing up straight but also while you are laying down and rolling around in circles. I would ask them to perform an esophagram.

How frequently are you experiencing the heartburn? Daily?

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Hi @onejoe, I agree, your wife needs a very experienced surgeon, but it’s nice to see that her local surgeons are willing to admit that they aren’t experienced enough. A consult at Mayo – Scottsdale is an excellent idea if you are in California, though I can only speak on my personal experience with Mayo – Rochester. (I had my Nissen done at the Mayo – Rochester by a thoracic surgeon named Dr. Francis Nichols. He’s been doing these surgeries for more than 30 years, and I’d bet my life that he’s done tons of corrections, redone these surgeries, etc. He’s very nice, has a great bedside manner, and also a great sense of humor.)

As an aside, my brother had a Nissen fail a few years ago after he became sick… coughing and sneezing for several months made his Nissen fail. He had his redone at UVA (he lives in Virginia) a few years ago, and it’s been good ever since! These can be successfully redone!

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@kdubois

Hi @onejoe, I agree, your wife needs a very experienced surgeon, but it’s nice to see that her local surgeons are willing to admit that they aren’t experienced enough. A consult at Mayo – Scottsdale is an excellent idea if you are in California, though I can only speak on my personal experience with Mayo – Rochester. (I had my Nissen done at the Mayo – Rochester by a thoracic surgeon named Dr. Francis Nichols. He’s been doing these surgeries for more than 30 years, and I’d bet my life that he’s done tons of corrections, redone these surgeries, etc. He’s very nice, has a great bedside manner, and also a great sense of humor.)

As an aside, my brother had a Nissen fail a few years ago after he became sick… coughing and sneezing for several months made his Nissen fail. He had his redone at UVA (he lives in Virginia) a few years ago, and it’s been good ever since! These can be successfully redone!

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Thank you Kelly, we are considering Mayo in Scottsdale but am also looking at UCSF or Stanford as possibilities. It is heartening to hear of any sucess stories. If I still lived in Massachusetts We would certainly go to Rochester, i am glad you had good results. Thanks again. Joe

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Dennis, My 20 year old son (who was born with a congenital problem of his stomach) He had his 2nd NF of his life in 2014. That surgeon did the wrap too tight and too high up on his esophagus. He lost 30 pounds and currently has a feeding tube due to other health problems because of the too tight NF. Please go online and look up on youtube. Steven P Bowers MD – Jacksonville Mayo. Instead of doing yet another NF on my son he inserted and performed augmentation of the linxs device. magnetic beads form to close and open with food. It is a fairly new procedure hopefully it will take over as the standard not many surgeons know of it. I would highly recommend it. The evening of surgery you are able to eat real food. In fact it’s encouraged to eat to keep the beads moving so not to fuse over. Good luck.

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The LINX device is awesome, and being able to eat the same day is super-awesome.

With that said, note that not all insurances will cover it (probably because it is new), and it can’t be used if the hernia being repaired is too large. My hernia was 4cm and Mayo told me it was too large to use the LINX.

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@onejoe

My wife had a Nissen Fundoplication in January 2014. ( that surgeon is now retired) For the past year symptoms have become progressivly worse and we were recently advised that the Nissan wrap had failed and was now herniated into her chest cavity. Local surgeons advise redoing the surgery is beyond their expertise. (Eureka ca) and advise going to larger hospital. Mayo Scottsdale was suggested as having Doctors experienced in this proceedure. We certainly want someone with a lot of experience. Any advise or suggestion greatly appreciated. Thank you Joe

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I had my N fundoplication redone at Mayo in Scottsdale by Dr. Richard Schlinkert in 2012, and it has held wonderfully.

REPLY
@onejoe

My wife had a Nissen Fundoplication in January 2014. ( that surgeon is now retired) For the past year symptoms have become progressivly worse and we were recently advised that the Nissan wrap had failed and was now herniated into her chest cavity. Local surgeons advise redoing the surgery is beyond their expertise. (Eureka ca) and advise going to larger hospital. Mayo Scottsdale was suggested as having Doctors experienced in this proceedure. We certainly want someone with a lot of experience. Any advise or suggestion greatly appreciated. Thank you Joe

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Welcome to Connect @mariann, and thank you for sharing the information. Do let us know if you have any questions.

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kelly, since your fundo was very successful how long were you on the liquid diet; the semi solid diet; then the solid diet. I just had another endoscopy on march 16, 2017 and a esophagael manometry the same day. I meet with the surgeon on march 23, 2017 and we will discuss all the results. His other surgeon who did the above tests tell me that i am eating too large portions. That will cause the stomach to push on the diaphram and that is the pain i am experiencing. Now on sunday march 19 i ate smaller portions ( 3 meals per day) and had no problems with heartburn. i did get a migraine ( flashing lights and aura) and settled on tylenol for that. The next day to prevent continuance of the migraine i took one of my fioricets adn it did help the head but got terrible heartburn. The same thing happens if i use mobic (NSAID). I will request an esophagram to be done. After 4.5 months i should not get heartburn , even being on antacids. i do have a problem with headaches which the neurologist and neurosurgeon think is related to my C3-C7 stenosis, but i can’t get to the neurosurgeon because of all these post fundo problems. Any other advice would be appreciated…..thank you… kozlo52 (Paul).

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Hi Paul @kozlo52, the schedule Mayo gave me to follow post-surgery was very different from those I researched online beforehand, which was nice to learn.

Th instructions they gave me were full liquid diet for two weeks followed by soft diet until my follow-up appointment, which was in December. My surgery was 10/18/2016, and I was able to eat a small Thanksgiving dinner. They gave me a four-page handout of the soft diet food to eat; it included foods that were okay and also foods to avoid during this timeframe. I still stick to smaller meals, but I also struggle with remembering that I need to stop eating as soon as I start to feel full.

From what I have recently learned (one of my friends is a pharmacist), it is very common for NSAIDS to cause heartburn, and fioricet and mobic contain an NSAID.

Moving forward, I would avoid NSAIDS. It sounds as if you experience traditional migraines (aura); have you ever tried migraine meds, such as sumatriptan? These do not contain NSAIDS.

With that said, I would still definitely request an esophagram because of the frequency you are having heartburn.

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