Has anyone had nissen fundoplication?

frh, have you had a 48-hour Bravo probe test on your current dose of PPIs? It is critical to find out before you have surgery whether the symptoms you're describing are truly caused by reflux. Have you been on this dose of PPIs for 3 months, taking them 30-60 minutes before meals, twice daily? If so, do your "throat/voicebox" symptoms go away on this dose? If they do, then the voicebox symptoms likely are from reflux. If they do not go away, there is a good chance, they are not from reflux. You want to avoid having the surgery and then continuing to have the symptoms after the surgery. Ask your doctor if they have done a 48-hour Bravo probe on PPIs to prove you are having acid reflux. Keep in mind that, even if your symptoms are caused by reflux, which is questionable, IF the surgery helps you, how long will it help you for?

Hi frh, I had a nissen fundoplication about 15 years ago. I'm satisfied with the results. I had it because, as SU says, I was on a PPI doses greater than the usual prescription levels, along with zantac, pH test quite acidic on meds, and having heartburn day and night, despite sleeping on a bed with the head lift up 6 inches. Turned out I did have reflux and a hiatal hernia.

The surgery was right before Thanksgiving. I remember having to pureed foods for a couple of days, then by Thanksgiving I could eat the mashed potatoes, peas and cranberry sauce. I used a baby spoon to keep me eating in small bites--regular sized bites were quite painful. The most difficult thing to swallow was bread--it tended to ball up in my esophagus and really hurt as it went through my newly small esophageal sphincter. Over the next couple of weeks I gradually was able to eat bigger bites until I could eat carefully and normally. I eat normally now, but occasionally (like twice a year) if I forget and take a whomping bite of sourdough french bread it hurts going down through the sphincter.

I was able to gradually get off the PPIs and zantac. I cut the dose in 1/2 right after surgery, and gradually tapered down over the next few years. I think that my stomach had to get used to producing the right amount of secretions after having such large PPI/antacid doses for so long, so I might have had some rebound when lowering the dosage. But I've been off the meds for years, and can eat most anything without heartburn. I still can't take NSAIDS for more than a couple of days, or after dinner. I've stayed with not eating fried foods, no wine at bedtime, no chocolate at bedtime, and I think those measures have helped keep my good results also.

My only negative side effect of the nissen fundoplication is that I can't vomit. If I feel nauseated and attempt to vomit, my stomach literally feels like it would tear apart some stitches if I try to throw up. I've told my doctor about this, and he states that it is not an uncommon side effect. As a result, I'm very careful about what I eat (like watching out for salmonella...). I keep antinausea meds in my medicine cabinet, and before a recent colonoscopy I asked for antinausea meds in my anesthesia as well as some zofran to take home. All went well.

Good luck to you, Happy Sleeper

My surgery was on Friday and they let me out of the hospital today (Tuesday). My throat felt like they shoved a fire hose down it until this morning. Wait a minute, the doc said they did. Actually what he told me is they tore-up my throat with the hose they had to put into my stomach to size the opening in my diaphram.

My wife said the doc gave her a blow-by-blow of the operation and showed her a bunch of pictures when I was in the recovery room. I remember highlights of what he said, but I guess I was too out of it to remember most of it. I do remember asking him if I really needed the operation. His response was something about how huge my hiatal hernia was. Evidently, I was correct in remembering about a third of my stomach was above the diaphram around 25 years ago. I asked him why they did not find that on the endoscopy or upper GI. He said it would have showed-up if they everytime I strained or bent-over, the stomach would slide back up.

My stomach has been aching since the surgery. Yesterday the aching changed to more like being very hungry. Last night they let me have a small cup of jello and about 6 ounces of warm tea. I took my blood pressure and other medications by mouth a couple of hours later. The difficult part was not so much swallowing them as it was feeling bloated from what I ate earlier and the water I washed them down with.

This morning 6 ounces of chicken stock and a half of a tub of jello made me feel over-full. After the doc came in this afternoon I got about a half-cup of tomato soup and a tub of vanilla pudding. He let me go home with a stern warning about how much of what I can eat. Basically nothing much thicker than pudding (although he said I could eat a scrambled egg if I did it very slowly and carefully). After getting home I discovered the hard way a 16 oz bottle of green tea is way more than my stomach can handle.

Here's what I look like tonight:

I am 59 years old. I had a nisson fundoplication July 2009 and it came undone, again March 2010 and it is undone again, now scheduled for an open fundoplication Sept 23rd. Not looking forward to it at all, 8 days in hospital, drains and pain etc. Right now I burp, vomit almost all my food and even vomit water and milk. I have a barium swallow this Friday which I hate; not sure how I will do since I vomit all the time. Each time it was four months that it took to fail. Wondered if anyone else had to have it done a third time. My surgeon has done a few a second time but never a third. He has done opens before. Linda

interesting debate here.

That does it. Y'all have talked me out of ever having that surgery!

lindasuebob wrote:I am 59 years old. I had a nisson fundoplication July 2009 and it came undone, again March 2010 and it is undone again, now scheduled for an open fundoplication Sept 23rd. Not looking forward to it at all, 8 days in hospital, drains and pain etc. Right now I burp, vomit almost all my food and even vomit water and milk. I have a barium swallow this Friday which I hate; not sure how I will do since I vomit all the time. Each time it was four months that it took to fail. Wondered if anyone else had to have it done a third time. My surgeon has done a few a second time but never a third. He has done opens before. Linda

With these problems I would have to guess that either...1.) Your surgeon is not experienced enough with this type of surgery or 2.) You were not a good candidate to begin with. Did you have all the pre-op tests?

The procedure that does the reflux repair through the esophogus is called the Transoral Incisionless Fundoplication. If you that name on youtube, you can get a video of how it is done and NIH has posted studies online. From what I have read on the TIF and the Nissan, the TIF is safer and has an easier recover. The Nissan has a little higher of a success rate but more risk.