Fundoplication Reversal

[Gastroboy]

Hi everyone, I'm trying to find out as much information as possible on having fundoplication surgery reversed.
I had this surgery not so long ago. Without going into too much detail a series of events and mistakes made by myself and others led me to believe that having this surgery would be a good idea. My reflux wasn't that bad at all really and the medication was working well.I had a small sliding Hiatal Hernia so I still had occasional reflux on the medication but it was more like a gas with no acids or liquids really and all of my other symptoms had gone despite not taking my diet and lifestyle changes that seriously.

Now I'm sure this surgery helps a lot of people with severe reflux that cannot be controlled well with medication and lifestyle changes but I have to say that in my case all of the complications or side effects associated with the procedure are 50 times worse and harder to live with that what the surgeon described to me himself after reviewing my 24 hr PH study as mild reflux.

I'm very keen to have this operation reversed and would love to here from anyone anywhere who has managed to have a full reversal. I would love to know if the bloating and abdominal pain has gone or improved. if you can burp freely whenever you need to ( something I totally underestimated the importance of in my case ), if your bowels have improved and if your reflux returned any worse than before having the operation.

Also I live in Australia, so if anyone down under has had this operation reversed or is looking into it please help me out with any information you may have.

I feel this operation is being marketed by some practitioners as a convenient thing to have done to avoid taking medication each day. Something I have learnt the hard way and wish someone had said to me is this operation is a big deal and the recovery time can be very long. Take your diet and lifestyle changes very seriously and only consider surgery if your reflux is bad and when you have tried every other option available with no success.    

Thank you,
Gastroboy.  

  



              

[Smiley2000]

Hi there Gastroboy,

All the best with your consult in 2 weeks!  Maybe you should ask the Surgeon to arrange an Endoscopy and possibly Manomatric study to see the function of your LES and esophagus motility?

I am now about 6 weeks post-op and I am eating small pieces of steak, chicken and anything I want.  I just eat very slowly, chew very well and eat small portions.  I can even tolerate coffee and chocolates again!  I have lost about 7kg's in the past month and now I am borderline-underweight, so I am trying to get myself into good shape.  But so far I am happy that I had the operation.

After the Nissen Fundo it is almost impossible to "burp", but a few minutes after a meal I can feel an air-like/bubble sensation coming up my throat and I am just glad that it didn't come out the other end :)

I have an upcoming Endoscopy on the 17th of April and on the 18th I am going to see an ENT.  My throat and voice was my biggest problem and that has not improved and I am afraid that I might have nodules on my larynx/throat due to longstanding GERD issues.  I started working at our local TAFE as a Microsoft Instructor and I need my voice to hold after a full day at work!

Looking forward to hear from you again!  best wishes,

[Gastroboy]

Hi Smilley2000,

I'm in Victoria. I have a followup appointment with my surgeon in 2 weeks.  I don't really know how willing he will be to help me out but I guess I will now where I stand in another 2 weeks time. If things don't go well I may just get your surgeon and GI's details for some advice via email or something. I now have a referral to a GI and an ENF doc. My local GP had some bloods done and is looking into thyroid problems and they came back borderline on the low side, I have to have that done again in another 6 weeks to double check that the results haven't been thrown off by the surgery. He said that can happen sometimes ?

My GP seems to think that maybe my throat complaints are just in my head brought on by anxiety I swear that's not the case. Sometimes a bubble of air will get caught exactly were I feel the problem is. It won't come up and I end up talking funny for a while until it frees itself.      

How is your healing coming along, hope your making progress. Are you on soft foods now ?    

[Smiley2000]

Hi there Gastroboy,

In which state are you in?

If you see a Surgeon regarding getting your Nissen re-done, I would suggest that you look into getting a Partial Fundoplication.  Studies shows that this Fundo is better option w.r.t. IBS symptoms afterwards.

If you are in SA I can recommend very good GI and Surgeon to you.

[Gastroboy]

Thanks Flycaster305,
Definitely wont rush into another surgery again in my lifetime - lesson leant.
I have an appointment with the surgeon in 3 weeks to talk all this through with him. I have been in contact with the clinic on the phone, talked about the pulling, tightness and lump sensation in my throat. After the surgery on my first followup appointment I still had a lot of GERD symptoms, the surgeon wasn't that concerned, but he did say that my original symptoms were rather unique or not the norm and suggested that maybe something other that GERD was causing them. My local GP ended up putting me on Nexium for a week after that appointment and the acid taste and stinking saliva or smelly gas in my mouth has pretty much gone. Still feel as if something is going on with my lungs or breathing from time to time and my
throat is still driving me nuts. The clinic said the other day maybe my throat complaints are from something else ? Think I'm going to go back to my local GP and make sure that I don't have something else going on in my throat - thyroid problem or something ?

You said that you can burp, are they big burps ? I can do tiny tiny little burps a few seconds after having a sip of drink, I think it's just coming from above the wrap and not actually relieving any of the pressure in my stomach. Last week though I started getting pressure and pain around the wrap site, it built up over say 10 - 15 seconds then a really big burp came up from my stomach, then nothing for 10 seconds and it happened another 2 times. I was not in control of it at all.

Just curios did your surgeon or doctors ask you if you had any existing digestive or bowel problems ( IBS )  while being assessed for the surgery. I have recently found out that if you already have digestive / bowel problems that this surgery should be avoided as it can make things worse. As mentioned previously I was only told that this operation may make me more regular, I was not asked about pre existing bowel and digestive problems and didn't know it was a consideration. I do have pre existing digestive and bowel problems, it runs in the family, my sister is the same and my father was as well. Would have been nice to know this or be asked the questions before having the operation.

Forgive me for being pessimistic about this operation but I feel as if this whole process has been done backwards, shouldn't they be completely sure of what's causing your symptoms before you have surgery?
Shouldn't a person be made fully aware of any and all pre existing medical issues that may effect the outcome of the surgery.

Thanks for your advise,
Gastroboy

      




    

  
          

[Flycaster305]

It does sound to me that you weren't given enough information prior to your surgery, and it sounds like indeed the wrap might be too tight.  

Keep in mind, I'm just a patient, not a doctor, but believe if surgery was performed to make the wrap a bit looser, it would be far less invasive than to try to put things back as they were.  Also, your surgery was only seven weeks ago, and I think you are just at the point where you should be feeling better.  As I mentioned in my earlier post, the NF surgery was for me a more difficult recovery than open heart surgery.  I really paid when I ate solid foods for at least two months.  

Foods that worked for me included Instant Breakfast, mashed potatoes, soft noodles.  Here's a meal that really worked for me at your stage of recovery:  Drain the liquid from chicken noodle soup, add some ground-up crackers, sprinkle in a bit of Romano cheese, microwave about a minute or so.  You get protein and carbs, plus a bit of dairy that can aid digestion.  Just don't rush into solid food!

The wrap will loosen up on it's own, at least mine did a little.  I can and do burb now, I couldn't do so right after the procedure.  If I can offer anything, I'd say I wasn't far from where you were at your stage of recovery, and now can eat about anything I want without fear of GERD, just not as much.  

I really think you are at the stage that you will start feeling better.  Just don't rush it, and please, don't rush into another surgery.  I'm betting you will start recovering soon.  

[Gastroboy]

Hi Flycaster 305,

I have read the same about the reversal being hard but have also read that when they do a second fundoplication surgery to correct a failed first fundoplication one of the first steps involves undoing the wrap and retuning things to the way they were before starting again from scratch. Again don't know how true this is as I have only seen it online.

To answer your questions I am only 7 weeks out from my operation. I did get a meal guide and have followed it carefully. My partner has been present at all of my appointments before and after the surgery jut in case I missed something. We both feel that we haven't been told enough info on this whole process. In relation to my bowels we were told that I might become more regular as a result of having the operation but that was it, nothing about IBS like bowels.

I was told at a followup appointment that my wrap is too tight, I feel a tightness and pulling sensation in my throat. I also feel the pulling when I pick something up with a bit of weight as well - uncomfortable feeling.

4 weeks after surgery I started feeling very lightheaded, nauseous and week/ sick, almost crashed my car on the way to the supermarket because I was so out of it. My partner and myself noticed that my completion was very pale as well. When I felt really nauseous she could tell as I became really pale. This would last most of the day, I would start to feel more normal around 3 - 4 in the afternoon. I have had my bloods tested by my local GP but they seem fine, he was checking for internal bleeding. My blood pressure was down a tiny bit. The nausea has improved somewhat, still feel it in the mornings but tends to get better earlier in the day.

Without getting too gross my bowel habits are ranging from some fairly normal movements, a lot of diarrhea and some full on IBS with bad abdominal pain while sitting on the toilet dry reaching and feeling as if I'm going to pass out any second.

I know that I have gone into this operation without knowing nearly enough information to feel comfortable about the situation I find myself in now. I suppose I want to learn all I can about having this reversed as if things don't improve I still may have another option.

Thank you for your input.