Swallowing issues 1 year after Hiatal hernia surgery & Lap Nissen.

Posted by faithann64 @faithann64, Apr 29, 2020

So I made a trip to the ER a couple days ago because of severe cramping and problems swallowing ! 1 year ago I had Hiatal hernia surgery and Nissen Fundoplication, Have had on and off problems since the surgery. Last couple months the abdominal pain and swallowing been getting worse ! I double over in pain and even sips of water is difficult ! The hospital did an ex ray chest and CT scan of my stomach but couldn't say really what was causing so much pain ? I have pain from throat to stomach, Even swallowing anything is painful. Abdominal pain all the time ! And yes diarrhea, ugh..And ridiculous amount of gas .. My surgeon like I said in a prior post is trying to get me in for an upper endoscopy to check my esophagus ? Has anyone had issues later on after this kind of surgery ? Thank You. ( Male , 56 years young )

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@diamae

I had a laparoscopic Nissen in 2014 and open revision with hiatal hernia repair in 2015, I have been having swallowing difficulties, some GERG and occasional regurgitation recently. I had an EGD which reveled esophagitis and it was also noted the nissen appeared loos and there was a small hiatal hernia. I am concerned as the surgery in 2015 was very difficult but concerned it may be headed that way. I am just wondering on others experiences and if there were other options i can consider or should I begin to prepare myself psychologically for another surgery

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Hi @diamae and welcome to Mayo Clinic Connect! I am sorry you are dealing with these issues after your surgeries. You will see that I moved your post to a discussion about exactly what you were talking about. A lap Nissen, Hiatal Hernia and swallowing problems. I wanted to connect you with the people here in this conversation like @faithann64, @delrenleo, @helenfrances, @faithincrisis and @marianna1968jt.

Have you talked to a physician about this at all?

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@amandaa

Hi @diamae and welcome to Mayo Clinic Connect! I am sorry you are dealing with these issues after your surgeries. You will see that I moved your post to a discussion about exactly what you were talking about. A lap Nissen, Hiatal Hernia and swallowing problems. I wanted to connect you with the people here in this conversation like @faithann64, @delrenleo, @helenfrances, @faithincrisis and @marianna1968jt.

Have you talked to a physician about this at all?

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TY

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@amandaa

Hi @diamae and welcome to Mayo Clinic Connect! I am sorry you are dealing with these issues after your surgeries. You will see that I moved your post to a discussion about exactly what you were talking about. A lap Nissen, Hiatal Hernia and swallowing problems. I wanted to connect you with the people here in this conversation like @faithann64, @delrenleo, @helenfrances, @faithincrisis and @marianna1968jt.

Have you talked to a physician about this at all?

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I actually had an upper endoscopy today and just received the results. I have a follow up with GI pending and rereferal to the surgeon also pending

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@diamae

I had a laparoscopic Nissen in 2014 and open revision with hiatal hernia repair in 2015, I have been having swallowing difficulties, some GERG and occasional regurgitation recently. I had an EGD which reveled esophagitis and it was also noted the nissen appeared loos and there was a small hiatal hernia. I am concerned as the surgery in 2015 was very difficult but concerned it may be headed that way. I am just wondering on others experiences and if there were other options i can consider or should I begin to prepare myself psychologically for another surgery

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I had my surgery back in April of 2019. I've had , I think 4 or 5 upper endoscopys . Each time it shows inflammation and like the 3rd one it showed a small hiatial hernia . Each time he stretched my Esophagus. It helps for awhile?? I still have problems swallowing and allot stomach pain but each time my surgeon says he can'take really pinpoint why. I hafta really chew my food and take small bites. Even drinking liquid hurts. It has eased up somewhat . The only good thing that came out of my nissen fundoplication and hiatal hernia surgery is that I don't have acid reflux anymore. Definitely get ahold of your surgeon and explain what's going on. Good luck !

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@faithann64 @diamae I had a botched Nissen in 2016 in Central Iowa.. to reduce GERD, was the reason.. but 2 months later and a 50 pound weight loss Mayo Minnesota found that I had post operative gastropareses... The Mayo GI Doc said it could not be reversed.. they gave me a way to cope and I have gained back 40 pounds plus.. I have to watch carefully every day to eat small portions... cut very small .. I snack a lot.. nuts, dried fruits in trail mix works ...
Be careful not to recline after eating... Gravity has to work to empty the stomach.. Sleep with the bedhead raised at least 6 inches... otherwise up the food comes..
I cannot eat leafy greens unless pureed.. or chopped up very small. Soft breads do not work.. Cabbage and Broccoli don't work unless again chopped very small... those things ball up and come up.. Vomiting is much easier than it used to be but spreading a meal over an hour or so.. is necessary to give the stomach time to empty... The bloating can be painful.. but I chew a few Papaya enzyme pills and that takes care of the reaction of too fast and too much food down there... Ken

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@ken82

@faithann64 @diamae I had a botched Nissen in 2016 in Central Iowa.. to reduce GERD, was the reason.. but 2 months later and a 50 pound weight loss Mayo Minnesota found that I had post operative gastropareses... The Mayo GI Doc said it could not be reversed.. they gave me a way to cope and I have gained back 40 pounds plus.. I have to watch carefully every day to eat small portions... cut very small .. I snack a lot.. nuts, dried fruits in trail mix works ...
Be careful not to recline after eating... Gravity has to work to empty the stomach.. Sleep with the bedhead raised at least 6 inches... otherwise up the food comes..
I cannot eat leafy greens unless pureed.. or chopped up very small. Soft breads do not work.. Cabbage and Broccoli don't work unless again chopped very small... those things ball up and come up.. Vomiting is much easier than it used to be but spreading a meal over an hour or so.. is necessary to give the stomach time to empty... The bloating can be painful.. but I chew a few Papaya enzyme pills and that takes care of the reaction of too fast and too much food down there... Ken

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Mine was April 2019. Had Hiatal hernia surgery and Nissen done ,,,,And yes small bites and watch what you eat . I still have problems swallowing and allot stomach pain. When I mention this to my surgeon he basically just shrugs his shoulders and says he doesn't understand why ???? Like I said I've had numerous upper endoscopys since ( surgery ) and each time he stretches my esophagus. And there's always inflammation and another small hernia. The only good thing that came out of all of this is I don't have acid reflux anymore. With mine i can't vomit anymore. If I do its what's in my esophagus, no stomach contents. Since surgery I've been diagnosed with IBS and take diffrent kinds of meds for stomach . Ugh. Constant battle all the time. I hafta watch what I eat and it's almost impossible to go out and eat , if I do i hafta be carefull . And yes I have the bloating also. I've told my surgeon many times that something doesn't feel right and his reaction is always the same . I see also my Gastrolologist regular and he tells me that my surgeon is one of the best ? I wish you good luck.

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I had a Lap NIssen in 2014 with open revision in 2015. I have been having increasing symptoms over the past year. Recent EGD found esophagatis, 24 hour PH testing had DeMeester score: 73.2 with 16.9% total ph <4 and 30% when supine. They are doing a barium swallow this week and then follow up with surgeon. I am hoping to avoid another surgery but with symptoms and feeling so miserable I am thinking that surgery is likely the right way to go. Wondering if anyone has had a failure this far out and if a subsequent surgery resolved issues. Looking for any experience to help decrease my anxiety. Thanks in advance!!

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@diamae

I had a Lap NIssen in 2014 with open revision in 2015. I have been having increasing symptoms over the past year. Recent EGD found esophagatis, 24 hour PH testing had DeMeester score: 73.2 with 16.9% total ph <4 and 30% when supine. They are doing a barium swallow this week and then follow up with surgeon. I am hoping to avoid another surgery but with symptoms and feeling so miserable I am thinking that surgery is likely the right way to go. Wondering if anyone has had a failure this far out and if a subsequent surgery resolved issues. Looking for any experience to help decrease my anxiety. Thanks in advance!!

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Nissen's often relax over time, requiring additional surgery's. I have a perfect Nissen and it was the worst decision that I have ever made in my life. I have been on 2 facebook forums for 2 years now that talk about your specific question. One is just called Nissen Funduplication Facebook and the other is Nissen Funduplication take down Facebook. On the take down page have seen that some people after the 2 or 3 failed nissen convert there nissen into a gastric bypass and are very happy. You may want to post your question on the take down page because this is where most people are having complication after a Nissen. I'm sure that you will find the support that you need. Good luck to you and I'm wishing you the very best.

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@diamae

I had a Lap NIssen in 2014 with open revision in 2015. I have been having increasing symptoms over the past year. Recent EGD found esophagatis, 24 hour PH testing had DeMeester score: 73.2 with 16.9% total ph <4 and 30% when supine. They are doing a barium swallow this week and then follow up with surgeon. I am hoping to avoid another surgery but with symptoms and feeling so miserable I am thinking that surgery is likely the right way to go. Wondering if anyone has had a failure this far out and if a subsequent surgery resolved issues. Looking for any experience to help decrease my anxiety. Thanks in advance!!

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I had this surgery in 2018 and now have a failed Nissen. I had an open surgery. I spoke with a younger surgeon regarding a redo surgery. After several tests the surgeon told me that he could do the laparoscopic surgery, but could not guarantee that there would be an improvement even after the surgery because the original surgeon made such a mess of it. My HMO did not want me to have the redo so I am left with the long term effects of a botched surgery. I am able to control the discomfort by small meals, sleeping on my left side to facilitate movement of stomach contents, diaphragmatic breathing exercises. Not the perfect answer, but it helps.

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@faithincrisis

Thank you for your reply’s @faithann64 and @amandaburnett . I had a follow up with my surgeon on March 7th a week after my fundoplication and had a ct scan the same day. my wrap was fine no slipped hernia or wrap being loose. My surgeon said that it’s most likely phrenic nerve irritation from the laparoscopic surgery it can mimic heartburn, pain in the chest, and also referred pain in the shoulder from the gas left from the surgery. He told I should not have to take my ppi medications anymore so I stopped taking them. About two weeks later the heartburn, chest pain started returning not as bad in pain terms but enough to make me feel uncomfortable again. maybe 3-4 times a week In cycles. I contacted my surgeon again and he sent me to do a barium swallow on April 8th. The results were no acid was coming up into my esophagus to cause the heartburn and my wrap was tight and intact. I told the doctor administrating the test I have what feels like heartburn still. He believed me that I have pain and discomfort, but that it wasn’t because of acid coming up from my stomach because the wrap was blocking it. My surgeon has referred to another GI doctor to find out if we can get to the bottom of this. I have my appointment on 5/12/2020 in a couple days. Sorry for the long reply I hope my punctuation is good. Some better news is my swallowing has gotten way better in the last week, I can eat better. Still not 100% but it’s improved. I hope they fix your hernia quick @faithann64 I haven’t lifted or done anything strenuous since feb 26 2020 for fear of hurting my wrap or having slipped hernia.

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What happen and how are you now?

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