Toupet Fundoplication post op problem

Posted by nikki0120 @nikki0120, Oct 8, 2022

I am four weeks post and was doing very well advancing my diet. I was even able to eat some chicken in very small bites. The last few days it seems my progress is going backwards. I have been drinking more of the meal replacement shakes because I am struggling to swallow anything. Today I tried to eat some scrambled eggs and after taking one small bite I can feel it stuck at the bottom of my throat. I contacted my surgeon and said just to continue drinking small sips and try to push the egg down and he will do a UGI study next week. Has anyone else experienced this? It’s very discouraging since I was doing so well.

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I am 5 weeks out from hiatal hernia and Toupet Fundoplication surgery. I am adding in soft foods every day in small amounts. Liquids can still be challenging when I ingest too much air when drinking (if I’m thirsty and forget to sip). I get dry heaves and feel like I’m having a heart attack. I use Gas X for a little relief. Has anyone else had this problem with liquids? It makes me scared to drink enough fluids. Thank you!

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Profile picture for jmedj55 @jmedj55

I am planning on having a toupet fundiplocation next month for severe esophagitis and GERD . I am apprehensive about the procedure regarding possible side effects etc like problems swallowing and being able to maintain adequate nutrition. Can some of you please provide your thoughts and experiences? I’m hoping I’m making a good decision. I also don’t want to take the ppi medicine long term if possible .

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I have had GERD and a small sliding hiatal hernia for 33 years. I am one of the many patients who have not responded well to PPIs. My GI MD recommended Voquezna. He also cautioned me about disasterous outcomes of Toupet surgery. I want to try Voquezna first, but its first filler ingredient is ascorbic acid (I have to inject vitamin C---ascorbic acid---because ingesting vitamin C makes my symptoms worse). If any of you have insights on your having taken Voquezna or if any of you have insights as to the outcomes of having gone through the Toupet partial fundoplication surgery, please let me know your experiences. (Currently, due to a flare up of GERD symptoms, I am living on water and non-fat milk for the next 4 - 7 days.) PS I was a biomedical researching specializing in molecular biology for my career before retirement. I will be 70 soon, and hope I can eat my usual bland low-FODMAP diet by then.

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Profile picture for jmedj55 @jmedj55

That is good indeed . Are you on PPI medicine currently. Also, is pain manageable? I’ve heard an abdominal binder is a handy item during this time

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Yes, I am still on Prilosec 2 X day and Pepcid 1 X day. Hopefully that will change once I recover.
All my meds are liquid right now, which makes life easier! I stopped Oxy the 1st weekend we got home because it made me feel "loopy." I am on liquid Tylenol. I have never had much luck with it until now. Maybe because it is in liquid form it starts working immediately. I take it every 6 hours for this pain in my left shoulder (from the gas used during surgery.) I am getting better. I read about abdominal binders too and almost got one, but didn't. Personally, I have not needed it.
I can't tell you how much connecting with other people who have gone through or are getting ready to go through this surgery helps. any suggestions are helpful and welcome.
Have a good day @jmedj55.

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Profile picture for klelebub75 @klelebub75

I am 16 days out and doing much better. No bloating. Swallowing is better. I make sure to eat slow & small bites. Diarrhea is gone now that I'm on soft foods. Dr. Jung explained, yesterday, that the diarrhea was normal due to the liquid diet. I will carefully begin real food next week. I am having my 3rd good day in a row too. I am thankful and encouraged.
Please stay in touch when you can and I hope your surgery goes well.

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That is good indeed . Are you on PPI medicine currently. Also, is pain manageable? I’ve heard an abdominal binder is a handy item during this time

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Profile picture for jmedj55 @jmedj55

Hoping this helps you. Sounds like it will. How are things going at two week mark ? Any difficulty swallowing , bloating , diarrhea etc ?

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I am 16 days out and doing much better. No bloating. Swallowing is better. I make sure to eat slow & small bites. Diarrhea is gone now that I'm on soft foods. Dr. Jung explained, yesterday, that the diarrhea was normal due to the liquid diet. I will carefully begin real food next week. I am having my 3rd good day in a row too. I am thankful and encouraged.
Please stay in touch when you can and I hope your surgery goes well.

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Profile picture for 2longlife @2longlife

I had a 270 degree Toupet Fundoplication about three years ago. It was the best decision I ever made. I am able to eat normally, swallow normally, burp if necessary. I no longer have acid reflux or take medicine. I was concerned that I might not be able to vomit if I had to. That proved not true. At the same time I had a hiatal hernia corrected to prevent my stomach from entering my diaphragm.
I do remember very painful shoulders for about a day after surgery due to migration of the nitrogen gas that was used during surgery upward from the chest cavity. Eventually your body purges it. The slow advance from eating small soft foods to normal foods was not a problem. Again I am so very happy I did it.

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Thanks so much for the reply@2longlife. It is good to read of your success. I am on day 16, post 270 Degree toupet Fundoplication. Instead of us driving to 3 hrs. to Duke yesterday we did a Zoom appt. with Dr. Jung. It went well. He expained that everything I am experiencing is normal. The shoulder pain is getting better. He said everyone is different... be patient. I have been on soft foods now for almost 2 weeks and will transition slowly to real food next week. He said to avoid steak, fresh leafy greens, and bread for now. I would love any other foods to avoid if you can think of anything.
This will be the third day in a row that I have been feeling better. I am encourage. Another piece of good news- where I used to have to nebulize 3 different meds twice a day, I only have to do it in the A.M. and one of those in the P.M. It is sodium chloride due one of my lung problems called Bronchiectasis. Twice a day helps keep my lungs healthy and prevents pneumonia.
For the 1st time I can see light @ the end of the tunnel!

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Profile picture for jmedj55 @jmedj55

I am planning on having a toupet fundiplocation next month for severe esophagitis and GERD . I am apprehensive about the procedure regarding possible side effects etc like problems swallowing and being able to maintain adequate nutrition. Can some of you please provide your thoughts and experiences? I’m hoping I’m making a good decision. I also don’t want to take the ppi medicine long term if possible .

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Hello,
I can only speak with reference to Nissan Fundoplication. My BF had it done in conjunction with hernia repair. He doesn't know WHY it was done, his gerd problem was long resolved and he failed the 3rd test to see if he was a viable candidate. It was done without his express consent, he wasn't expecting it to be done. He has a ' half twist'...is probably looking at revision surgery because its too tight. He gets terrible nausea after he eats, lays down for hours waiting for this effect to subside. He woukd mostly certainly suggest you research the procedure very carefully. I am myself a SCS horror story. I urge everyone to consider less is more. Drs to this day experiment on us and 80% of my issues are the result of poor decisions by Drs. Personally im going to do everything holistically to regain what health I can. Wishing you luck...PLS research thoroughly.

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Profile picture for Janell, Volunteer Mentor @jlharsh

Hi @jmedj55. I went to the Digestive Health Support Group home page and searched for toupee fundoplication. It looks like there are a few other discussion you might review as you wait for others to comment here.
- Toupet fundoclication discussions: https://connect.mayoclinic.org/group/digestive-gastrointestinal-problems/?search=Toupet%20fundoplication&index=discussions

It may help others know how to comment if you are comfortable sharing more about your journey. What brought you to this decision, how are you hoping it will improve your day-to-day? Why did you opt for toupet instead of Nissan fundoplication?

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I had the Nissen flundoplication doctors choice. It was done laparoscopic and repaired hiatal hernia revised gastric bypass from 1978 so they removed part of my stomach. It ended up being a 5 1/2 hr surgery on a 69 year old woman. But I had severe GERd with bile reflux as well. I was a mess I couldn’t eat pretty much. It was a pretty rough recovery for me I got dehydrated because I couldn’t get hardly anything down it was so tight in my esophagus. Had to go and be dilated got little better after that. Couldn’t eat or drink much at one sitting. Took a few weeks. Couldn’t vomit until a few months ago a d it’s been 4 years. Now I have gastoporesis and I developed PBC (autoimmune liver disease). I don’t have reflux anymore!

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Profile picture for 2longlife @2longlife

I had a 270 degree Toupet Fundoplication about three years ago. It was the best decision I ever made. I am able to eat normally, swallow normally, burp if necessary. I no longer have acid reflux or take medicine. I was concerned that I might not be able to vomit if I had to. That proved not true. At the same time I had a hiatal hernia corrected to prevent my stomach from entering my diaphragm.
I do remember very painful shoulders for about a day after surgery due to migration of the nitrogen gas that was used during surgery upward from the chest cavity. Eventually your body purges it. The slow advance from eating small soft foods to normal foods was not a problem. Again I am so very happy I did it.

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FWIW when I had the laproscopic procedure for partial nephrectomy and adrenalectomy at Mayo Methodist a year ago I didn't have the shoulder pain. They may have used a different gas, but more likely the gas couldn't get far enough into the chest cavity because of the membrane separating the heart and other organs from the intestinal area.

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Profile picture for klelebub75 @klelebub75

Hi- I had my Toupet Fundoplication 2 weeks ago today @ Duke University Medical Center. It was a great choice. Duke is amazing.
The reason I had the procedure was due to on going chronic lung disease. Pulmonologist & Gastroenterologist have figured out the lung/ esophageal/ GERD connection. I have been sick for mostly 3 years & getting worse every year. In Jan., 2025 I had an EDG that found a Grade 3 sliding hernia. It would slide up my weakened esophageal sphincter into my chest. As a result, microscopic pieces of undigested food were doing more damage to my lungs.

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Hoping this helps you. Sounds like it will. How are things going at two week mark ? Any difficulty swallowing , bloating , diarrhea etc ?

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