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Old 06-06-2011, 08:33 AM   #1
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Post Nissen Fundoplication Issues

I had a Nissen Fundo in January of 2009 at the age of 31. I have had acid reflux and GERD since my early teen years. It was treated with various meds, but they never worked well. I began vomiting in 2008, almost after every meal. It started as a small amount and increased to where I was loosing nearly everything that I ate. The GI doc said that the reflux caused the LES to "erode" and I could not longer keep food and liquid in the stomach. This led to the Nissen.

I was desperate to get better, so I did not research the surgery very well. My recovery went pretty well in the first few weeks. I was angry at some of the problems I had post-op, but I have learned to live with most issues.

I am still unable to burp, so I avoid carbonated beverages at all costs. I cannot vomit, stomach virus' have been spent with lots of diarrhea and dry heaving. I developed IBS after the surgery, going from constipation to diarrhea in a matter of minutes. But the two issues that I am struggling with are the chest pain and discomfort as well as the persistent intestinal gas.

After many tests and switching GI docs (now consulting with a Mayo doc), I was diagnosed with Neuropathy of the Esophagus to explain the chest pain. I still get that food stuck in my chest feeling that is sometimes mild but sometimes increases to significant pain. My doc repeated many of the tests I had before surgery- pH tests, motility tests, Upper GI, but it looks like the surgery worked and it is not acid reflux or motility issues. He said that it is nerve damage (neuropathy) caused by excessive reflux and vomiting in the past. It is being treated with Lyrica. This helped initially, but it is beginning again. Does anyone have any insight they can share on this issue? It is quite frustrating. It takes a lot of enjoyment out of my life and discourages me from eating, even small quantities of food. (On a side note, I still eat small meals and avoid real starchy foods).

I also have developed lots of intestinal gas issues that are at their worst directly after I eat and when I lay down in the evening. My stomach rumbles and gurgles loudly and sometimes hurts. I feel bloated a lot. The only relief I have is expelling the gas, but this is not always possible or appropriate I have tried OTC gas remedies like Phazyme and GasX. Does anyone else have experience with this? Suggestions?

I know that this procedure was necessary, but it has altered my life a lot and 2 1/2 years later I am still trying to adjust. Thanks!

 
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Old 10-28-2011, 06:46 AM   #2
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Re: Post Nissen Fundoplication Issues

I read your story with interest and wonder how you're doing now. I've had super bad GERD since 2000 and finally got a Nissen Fundo on August 1 of thie year (2011). Like you, it seems to have fixed the acid refluxing up but I'm left with a myriad of strange symptoms which are not like anything the GERD ever did to me.

I don't want to ramble because I get very tired of relating my symptoms to doctors who look at me like I'm a brick shy of a full load and I get even more tired of telling friends and other interested parties that I "feel just fine". No one wants to hear it and I don't blame them. Heck, even "I" don't want to hear it.

In short, 4 months after my NF I'm doing everything you do but in addition I have something called "water brash" which the surgeon calls "inter-esophageal reflux".

We thought the wrap was too tight so it's already been stretched once. That lasted for 2 days and it fixed a lot of the esophagus pain and pressure and the reflux of food and water from within my esophagus was about 90% better but it didn't last. I'm back to where I started.

The dilation of the wrap site was preceded by two barium swallows one thin and one thick. They were both normal. Yet my food hangs up at the wrap site and so does water and medication and mucous from my head and throat.

It tastes bad, smells bad and it begins as soon as I lay down at night and has gotten worse with time after the Nissen. I cough and spit up every single morning that I awaken and it is very upsetting.

I'm on my way now to a new chiropractor who tells me it may be my Vagus Nerve. The surgeon also told me that it was probably my Vagus Nerve but the only thing he knew to try didn't help me.

I'm losing my spunk, if you know what I mean. I love to decorate. I don't have the energy. I had to quit my job. I can't taste my food and I have no appetite and I've lost a great deal of weight.

My gall bladder came out about 20 years ago and after Nissen instead of having diarrhea I now have constipation and diarrhea.

I hope the person I'm replying to will contact me. This is a very strange situation to be in. Oh, my throat is sore all the time and my chest feels as if someone is sitting on it. Someone overweight.

Replies are welcome if you have anything similar. I'm getting desperate.

 
Old 10-28-2011, 05:03 PM   #3
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Re: Post Nissen Fundoplication Issues

Hi There,

I understand not wanting to ramble on, it gets old quick. But, I am glad that you shared your story.

I am still in the same boat as July. I have consulted with my doctor more, he did another test to confirm that there is no acid in the esophagus, but I still have the chest pain and discomfort. Every morning I feel like there is an elephant sitting on my chest! It is hard to get going in the morning with this feeling.

During my last conversation with the doctor, he assured me that I am not alone, but... he does not know how to treat the pain. So, thank you again for responding, because now I know that I am not alone.

I can hear the frustration in your words, and my heart goes out to you. I know just how frustrating it is to know that something is wrong but all the diagnostic tests come back "normal." There have been days that I am just fed up with it all, but there is not a whole lot I can do.

I am not familiar with "water brash," but it sounds terrible. However, you said something that resonated with me- that it tastes bad and smells bad. I have had this since surgery as well. I talked with my last doctor about it and he looked at me like I was nuts! I never had this taste or smell prior to surgery. I have become a compulsive gum chewer during the day and use a strong mouth wash at night and upon rising.

My scopes show that I do not need a stretch. So, I have not had that done. But often feel like food is stuck in my esophagus. I do not drink carbonation because I cannot burp, so I know that the wrap is tight. But the doctor is not concerned about this.

As I mentioned in my last post, I also struggle with the constipation and diarrhea issue. The one thing that is working for me, actually balancing the problem, is using Miralax daily. The GI doc recommended this late in the summer. I have followed through and it makes a big difference!

I know that I was not much help, but it was good to talk with you. Please let me know what the new chiropractor says about the Vagus nerve, I may mention it to my chiro as well.

I wish you better health and less frustration in the near future. Please keep in touch with updates.

Last edited by hb-mod; 10-29-2011 at 11:53 PM.

 
Old 10-28-2011, 06:30 PM   #4
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Re: Post Nissen Fundoplication Issues

Good to hear back from you. I've done so much research on this subject in the last three months I think I could write a book. I'm actually pursuing two avenues at this point to try to find some relief and improvement.

One is the chiropractor. He is one of only 850 in the country who are trained in and practice only on the neck. He deals with the upper spine and is NUCCA certified. You can read more about it online at various sites.

He says he can help me with the Vagus nerve and I'm going for it since my surgeon even said he thought several of my "strange" symptoms were being caused by the Vagus nerve. If I ever heard of this nerve before it's been a very long time ago.

The other avenue is trying to get out of my malnourished state. I have not eaten enough in the last 6 mos -3 of which were after surgery. I know I need the food but I can't taste it and have no appetite so I'm just making myself eat more. I had three fairly good meals yesterday and today and even though my tummy doesn't approve, I'm going to give it a go.

I'm fairly sure my wrap is still too tight but the chiropractor wants me to hold off on having it dilated again until we see how things go. He has patients from all over this part of the country and seems like a really nice and caring person.

I've slept sitting up a whole lot in the last year and not even that helps now. Everything backs up and there is some kind of pressure that I feel in my esophagus whether it's coming from there or not. The taste in my mouth and throat is from the water brash. I've read tons of studies some of which go back to the British Medical Journal called the Lancet as far back as 1824. I'm just going to tough it out and use a lot of mouth wash. lol I even brush with mouth wash now because toothpaste just doesn't do well enough.

I have a friend who swears by the Miralax. Her GI makes her take it. I've been a little scared to try fiber since it went south on me several years ago and actually made me have the Big D instead of regulating me. I'll think about it.

I have a birthday coming up and also would love to feel better for the holidays. It would be a nice change since it's been about 3 years since I really felt well enough to enjoy that special time with my family.

Maybe we can try to stay connected and see how things go with both of us and share a bit here and there as we see improvements. I'm for it if you are. Just let me know.

So very nice to hear back from you.

 
Old 10-31-2011, 05:11 PM   #5
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Re: Post Nissen Fundoplication Issues

I hope that this note finds you in good spirits today.

It is good to hear about your chiropractor. I hope that he is able to give you some relief. I have done some reading about the vagus nerve and gastroparesis since your last message. Many of those symptoms sound quite familiar. I have slow motility and stomach emptying, but the doctor says nothing so dramatic that it should cause so much discomfort.

I understand loosing the joy of eating. I have weeks that are terrible, but on the brighter side, it goes in cycles of good and bad. The GI doctor explained that this is part of the nerve damage cycle. I hope that you are eating a bit better in the last few days and that the discomfort is manageable.

The first year after surgery I had to eat small, non-starchy meals. As time went on I was able to increase the size of my meals, but still must be mindful because I fill up quite fast and quickly can feel sick. I still avoid bready foods and absolutely do not drink anything carbonated. I seem to eat better these days, meaning fairly regular meals, but often still suffer from the chest pain, pressure, and bloat.

I wish you better health for your birthday, and the quickly approaching holidays. Thanksgiving certainly isn't as enjoyable when you cannot have your favorite foods, or feel miserable after eating them. Or when you are wiped out and not feeling well from lack of nourishment.

Be well.

Last edited by moderator2; 10-31-2011 at 11:10 PM.

 
Old 11-02-2011, 02:42 PM   #6
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Re: Post Nissen Fundoplication Issues

I gave in today and realized I have to get back on an antidepressant. I stopped mine last spring just before we sold our new home and bought a smaller one and I had my surgery. It was a very hectic time followed by the surgery and the unpleasant recovery and I've just kept going downhill.

I think everyone has a little depression now and then but dealing with my GERD for so very long really wore on my body and my brain and I think they've both been paying for it the hard way. So, I called my doc and he agreed.

I have no idea if it will help any of the post-op problems but I bet I can tell you in a couple or three weeks. I just started today and if it does nothing but help me get my appetite back I'll be grateful.

My computer has had some problems and my Facebook wall has been down and it's raining and cloudy here today and I didn't sleep again last night. I hope I can sleep tonight but being new on the AD I'm not sure how it will go. I'm going to continue with the med however because in spite of all my post-op complaints many of them fit the profile for depression as well.

I hope you're having a good week.

 
Old 11-02-2011, 02:45 PM   #7
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Re: Post Nissen Fundoplication Issues

I gave in today and realized I have to get back on an antidepressant. I stopped it last spring just before we sold our big home and bought a smaller one and I had my surgery. It was a very hectic time followed by the surgery and the unpleasant recovery and I've just kept going downhill.

I think everyone has a little depression now and then but dealing with my GERD for so long really wore on my body and my brain and I think they've both been paying for it the hard way. So, I called my doc and he agreed.

I have no idea if it will help any of the post-op problems but I bet I can tell you in a couple or three weeks. I just started today and if it does nothing but help me get my appetite back I'll be grateful.

My computer has had some problems and my Facebook wall has been down and it's raining and cloudy here today and I didn't sleep again last night. I hope I can sleep tonight but being new on the AD I'm not sure how it will go.

I'm going to continue with the med however because in spite of all my post-op complaints most of them fit the profile for depression as well.

I hope you're having a good week.

 
Old 11-02-2011, 02:52 PM   #8
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Re: Post Nissen Fundoplication Issues

I found that the anti-depressants made the reflux worse, so look out for that.

 
Old 11-02-2011, 02:57 PM   #9
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Re: Post Nissen Fundoplication Issues

I found that the anti-depressants made the reflux worse, so look out for that.

 
Old 11-07-2011, 04:17 PM   #10
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Re: Post Nissen Fundoplication Issues

How are you feeling? I agree, everyone does experience depression now and again, but this disorder makes it worse..... and combine it with the post op issues, it's rough.

It sounds like you had a lot going on right around your surgery. Did you notice a decline in your GI health when your stress level was higher? Or was it bad before selling your home and downsizing? Just curious because I have often wondered if my stress levels contributed to the GERD prior to surgery. My life was a bit crazy and then my health got worse and worse, leading up to the surgery. It had calmed down some by the time of surgery, but I never felt like I could regain my "normal" feeling.

My last GI doctor suggested an anti-depressant awhile ago, but I fought it at the time. I really felt that my symptoms were from GI issues and I felt like he was pushing me into a new med. Now that some time has passed and I have not seen much improvement, recently I have considered it more and more. I understand that they can take a few weeks to take effect, but please keep me updated, I am pretty much out of options right now. I quit taking Lyrica awhile back and allowed the doc to put me back on another nerve blocking medicine, but I have not felt any better, only more tired.

Hopefully the meds have encouraged your appetite and you are up to eating. And sleeping better. And hopefully better overall. How is the chiropractic work going?

Hang in there. I hope that your computer is up and running better. I looked for a way to contact you off the thread, but I came up empty handed. Hoping that if anything, maybe I would see the updates quicker.

Be well :-)


Quote:
Originally Posted by Sleepwalk View Post
I gave in today and realized I have to get back on an antidepressant. I stopped mine last spring just before we sold our new home and bought a smaller one and I had my surgery. It was a very hectic time followed by the surgery and the unpleasant recovery and I've just kept going downhill.

I think everyone has a little depression now and then but dealing with my GERD for so very long really wore on my body and my brain and I think they've both been paying for it the hard way. So, I called my doc and he agreed.

I have no idea if it will help any of the post-op problems but I bet I can tell you in a couple or three weeks. I just started today and if it does nothing but help me get my appetite back I'll be grateful.

My computer has had some problems and my Facebook wall has been down and it's raining and cloudy here today and I didn't sleep again last night. I hope I can sleep tonight but being new on the AD I'm not sure how it will go. I'm going to continue with the med however because in spite of all my post-op complaints many of them fit the profile for depression as well.

I hope you're having a good week.

 
Old 11-07-2011, 04:42 PM   #11
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Re: Post Nissen Fundoplication Issues

Good to hear back from you. I replied promptly so I don't know why the post took so long to appear.

I will be one week on Lexapro tomorrow. Couldn't handle the Elavil. I'm doing a little better but it will take a couple of weeks to see much improvement. I did sleep a little better last night and am hoping to tonight as well.

I also tried Carafate (Sucralfate) again today for the first time in about 6 weeks and it seemed to help this time. I've had two doses and will take another in a little bit and one before bedtime. It had made me terribly sick before surgery and right afterward causing nausea, burning and bad diarrhea. I'm hopeful that if the Carafate can calm down my esophagus that maybe the cycle of hypersalivating might be broken.

I'm going in this week for blood work - the first I've had since surgery - to see if all is well. Hubby is concerned because I haven't eaten nearly enough in the last 4 months including the month before surgery.

I have no regrets starting the 5 mg of Lexapro at this point. I know people who should be on something and they're not and they're making themselves and their families miserable or at least not as happy as they could be. I keep trying to remember that if I didn't have enough thyroid I'd take medication. Same thing holds true for my brain or any other organ that gets messed up. I have to help myself all I can.

I hope we both find the help we need because I do believe it's out there. I'm feeling more positive on the AD and because the Carafate didn't hurt this time.

Maybe we can help one another.

Stay in touch and get better soon.

Last edited by moderator2; 11-07-2011 at 06:52 PM.

 
Old 11-07-2011, 04:53 PM   #12
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Re: Post Nissen Fundoplication Issues

I keep trying to reply and my message keeps disappearing or won't post.

I'll try again and see if this shows up.

Okay, it did. I'll be brief in case it doesn't work again. I'm not sorry I started Lexapro. I've been through enough in the last year or so and I have to have a bit of help.

I've had surgery so I'm not worried about a small amount of AD. It can actually help with LPR.

I'm also very glad today that I tried Carafate again and it didn't burn or make me sick this time. I'm hoping that it will help heal my esophagus and maybe break the cycle of my post-op symptoms.

Stay in touch and get better!

Last edited by Sleepwalk; 11-07-2011 at 04:59 PM.

 
Old 01-25-2012, 03:28 PM   #13
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Re: Post Nissen Fundoplication Issues

Hello,
I have my consultation for my Nissen Fundoplication on the 31st. The surgery is right around the corner and is now actually starting to become real to me. I am worried that after surgery I am going to become depressed. I have a past of depression and I know that not being able to eat solids for a while and being tired bc of the lack of food, and not having energy to do anything is going to eventually cause me to fall back into a depression. I don't know how to prevent it, but it honestly does make me nervous. AND...enfection, and the trapped air also makes me nervous. I guess I would just like to have someone to talk to about it....to help me understand it more, and try to prepare somehow for the changes in my life that are about to begin. Thank you. =) I am in nursing school and I have a B+ GPA and clinicals are just around the corner and I can't wait to finish, I just dont want the recovery from mental and physical strains to prevent me longer then need be. I fought through brain surgery in 09' and was on life support 3 times, transported to Boston, visited multiple states and different doctors and still beat my way through school to get this far, so I SHOULD be fine. BUT I know that it is a huge comittment. Any suggestions?

 
Old 01-25-2012, 03:55 PM   #14
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Re: Post Nissen Fundoplication Issues

I sympathize with what you're going through. I'm still taking a small amount of Lexapro (7.5mg) as I have just never worked up to 10 mg yet. I know I could feel better as far as depression goes but I am better than I was without Lexapro.

I really don't know anyone besides myself who had problems long enough both before and after NF that they are taking an AD except for one friend. She and I both have extenuating circumstances such as IBS and sleep apnea and they both combine to make things slow in recovering.

It will soon be 6 mos since my surgery and although it's been a long row to hoe I am better as far as the surgery goes. I still have to be careful about things like soda, caffeine, chocolate and fried foods but hot or spicy things don't really seem to bother me that much.

I have two grown children and recovering from childbirth was certainly much harder than the NF surgery. I never choked and when I bloated I used ice packs.

If you go through with the surgery, LISTEN to what your doctor says about the eating schedule. Keep a journal and write down how you feel after you have eaten. Eat slowly, do not overeat and take it easy and rest.

My age and putting the surgery off too long had an impact on my recovery and I think you will do fine. Don't worry about depression. It's a waste of time. My depression came about because of everything put together including not sleeping due to sleep apnea and steroids etc.

I do know about a half dozen people who have had the surgery and they are all doing well.

Take care!

 
Old 01-25-2012, 04:06 PM   #15
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Re: Post Nissen Fundoplication Issues

But the reason I am having the surgery is not because I had heart burn and could feel the acid it is b.c I have barretts, a hiatal hernia and when the acid comes up it makes my vocal cords spasm which causeses me to have HORRIBLE breathing attacks that land me in the E.R 3-4 times a week. I am getting Botox injections in my vocal cords right now, but I cant do that forever and still end up in the e.r once a month. So there is a lot that is going on too, because if the acid isnt the only thing that causes my breathing problems, it was pretty much done for nothing in my eyes. Im just frustrated and worried about that.

 
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