Laparoscopic Fundoplication

[Igzoey]

I have read through all the posting regarding the side effects of this procedure and am looking for a bit more information. I had this procedure done about about 5 1/2 years ago, and though completly successful regarding reflux problem I have since developed severe bowel dumping problem. I was told the surgery would take about 45 minutes to one hour and was in surgery for over six hours. Before the surgery I had a constipation problem that I had dealt with my whole life and now I have the opposite problem, I lost 125lbs after the surgery and had great difficulty keeping on weight. I had had 3 colonoscopies and they have found no reason for the dumping problem. I have been put on several different medications with no helpful results. My bowel movements are never solid in form and most always contain what looks like phelm, I have tried many over the counter remedies and have greatly changed my diet in hopes that it will help slow things down. Often food passes undigested, I continue to stuggle to maintain a healthly weight and often stuggle with feeling exhausted and in high levels of pain due to cramping. I have gone back to surgeon a few times with no results or answers, I have also consulted with new gastro doctors but they tell me these symptoms are not a result of the surgery and unrelated. Could what I am experiencing be a result of the surgery? the tests done before surgery were PH test, mobility test (showed no mobility) also endocopy which show both upper and lower syfexter (sorry don't know spelling) were staying completely open. Help need some advice and answers.

[Ci CI]

I finally had a consult with my surgeons partner about my continued pain post Nissen.  My surgeon is no longer in the practice. After viewing the xrays of my distended stomach, etc. he said I definately had a problem.  I was beginning to think it was all in my head.  He is talking about a "slipping Nissen" which is a complication of the surgery. Also a damaged vagus nerve. I also have problems with diarrhea. He is talkig about redoing the surgery. If he can't help me, he talked about putting a tube in my stomach to relieve the pressure. Has anyone heard about either of these? I have read that a redo is very difficult.  Has anyone had one? I asked him if they saw many complications from the Nissen.  He said about 2 a year. This is a large hospital in Chicago so that isn't too bad.

Ci Ci

[Kevin Pho, MD]

You may want to consider further tests for malabsorption, which can cause the symptoms.  Tests to evaluate this includes the colonoscopy (which you have already had 3 times), as well as stool tests for fecal fat.  A blood test for celiac disease can also be considered.  

Chronic pancreatitis can also cause similar symptoms.  A blood test for amylase and lipase as well as a CT scan to evaluate the pancreas can be considered.  Treatment with pancrease tablets can be considered if this disease is suspected.  

If all the tests are negative, there are some cases of irritable bowel disease that can present with similar symptoms.  If this is suspected by your physician, treatment with increasing fiber intake as well as antispasmodic agents can be discussed.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

It's conceivable that the vagus nerve was injured during surgery. That can, in some cases, cause diarrhea. Dumping, per se, would not result from a fundoplication. There are ways to test if the vagus nerve is functioning; however, if it were not at this point, there's no way to reverse the injury. So the issue is being sure there's no other treatable explanation, and figuring out whatever works best to treat the symptoms.