several years after nissen fundoplication problems

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ikandy
New Member


Date Joined Jan 2009
Total Posts : 7
   Posted 1/24/2009 11:08 PM (GMT -7)   
Hey all!! This is my first time here so any help with answers to my questions will be appreciated!! about 5 years ago I had a nissen fundoplication for acid reflex and a small hietal hernia repair. Boy did my surgeon not prepair me for what would go on afterwards. Anyway...after about a year I was pretty much able to eat normal again and started putting back on the 35 pounds I had lost (I only weighed 145 pounds before the surgery). Now, 5 years later and free of acid reflux, I have other problems that have worsened in about the last year. I have problems swallowing at times especially liquids and my own salava. It's as if my throat is constricted at times and liquids dont always go all the way down and I end up getting strangled. Also I can feel and hear a bubbling sound deep in my throat at times. I can halfway burp at times and at times I can't. My stomach growls a lot even when I'm not hungry. Do all these things sound strange for so many years after surgery and to have worsened within the last year or is anyone else experiencing these problems many years after the surgery? Also I've had a couple of stomach viruses since the surgery and food poisoning and apparently I can no longer vomit=dry heaves...not fun when u have food poisoning or a stomach virus...

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 1/25/2009 9:54 AM (GMT -7)   

ikandy

Hello and Welcome to HealingWell and the GERD/Heartburn Forum.  I am so sorry to hear you are having such a rough time.

I have not had the surgery but many of our members have.  I am sure some will be along shortly and give you some support and words of wisdom.

Have you followed up with your physician re your latest issues? If not I would strongly recommend that you do.

Again welcome to our forum and I hope we are able to meet your needs.

Kitt


 

Kitt, Co-Moderator: Anxiety/Panic & Depression
&  Moderator GERD  Forums

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baroni
Regular Member


Date Joined Jul 2008
Total Posts : 35
   Posted 1/25/2009 9:37 PM (GMT -7)   

I had surgury 12 yrs ago.I have of late been experiiencing some problems though not all of what you have described.I burp alot, at times feel like i cant swallow, heart has been racing, for the last 2 days I cant seem to eat anything without getting horrible heartburn.I hope that you call your Dr.I am going in tomorrow for that and some other issues.I wish you well.I can say that this forum has literally been a lifesaver to me.One more thing I need to add. I too cannot vomit.Not that I want to but at times stomach virus, a person needs to and its been 12 yrs and still cant vomit.Just the dry heaves.

Jo-Ann


kandtsmom
New Member


Date Joined Jan 2009
Total Posts : 1
   Posted 1/26/2009 7:55 PM (GMT -7)   
I had the surgery a little over 10 years ago and considered it a complete success.  Heartburn gone, I could enjoy other foods, no more emergency room trips due to stuck food, and best of all no more scopes or having my esophugus dialated.  about 7 months ago I was hit with my first bout of heartburn in close to 10 years, did not really think anything of it.  I then started feeling pressure in my chest like things were stuck but it was minor and went away.  Last week taking a drink of water the pain hit me, the water was not going down very well and very painful when it was.  I was a little sore for a few days but then it came back this weekend and has not left.  Even swallowing my own saliva hurts right now.  So I called my Doctor first thing this morning and got in.  She says my symptons and where the pain is points right to my esophugus.  She says could be a few things, the surgery has weekend, my esohophugus could have scar tissue on it due to the amount of scopes and dialation I had gotten, or I could have another stricture.  She is sending me in for a Barrium swallow, has put me back onto medication and is getting me in to see a Gastro guy.  I can tell you right now how upsetting this is, I do not want to go back to where I was.  Is there anyone who is in my position right now or been there.  Can you tell me what they could be finding.  My GERD actually went undiagnosed for close to 7 years, I then did the diet and medication for 4 years before opting for the surgery.  At my worst before the surgery I was going in about every 6 weeks to have my esophugus stretched.

ikandy
New Member


Date Joined Jan 2009
Total Posts : 7
   Posted 1/28/2009 7:40 PM (GMT -7)   
I called today about seeing my old GI doc so when i get in to see him i'll let u guys know what i learn, I work with a cardiology group and i think i'm gonna ask the docs t;omorrow if the Nissen can cause heart problem. I'll let u guys know the answers tomorrow night. Good night my new friends!!! :)

SCPinSWFL
New Member


Date Joined May 2009
Total Posts : 1
   Posted 5/29/2009 9:11 PM (GMT -7)   
ikandy, I too have swallowing difficulty that started about 3 1/2 years following a nissen fundoplication. Pasted below is a posting I placed on another blog. I suspect we have a similar problem in that we both have trouble swallowing saliva which is unique compared to the more common swallowing disorders. Please read my post and let me know if you share any common symptoms, have any questions, or have any suggestions. If you want to email me directly, my email is scpinhb@aol.com.
 
I'm 45 yr old white male living in metro Atlanta. I'm 5-9, 175 lbs, I am presently taking Levoxyl 0.112 daily for low thyroid for past 3 years. I also take Cymbalta for past 2 years for mild depression along with Androgel for low testosterone (been taking for past 5 years) and Adderall XR for Adult ADD (also taking for past 5 years). I have also been treating asthma symptoms for past 10 years. I had sinus surgery in '98 to correct a deviated septum, Nissen Fundoplication in 2001, Tongue reduction in '07, UPPP together with Septoplasty in '08 unsuccessfully to treat obstructive sleep apnea.
 
Also, in early 2004 I had a cosmetic chin implant added to augment my naturally recessed chin. ( I do not recall exactly when these swallowing symptoms started as they came on gradually but they did start not long before, or not long after the chin implant was done.)
 
My primary complaint surrounding my swallow is that I have residual material remaining in my lower throat after I swallow. I estimate 95 to 98% of whatever I am trying to swallow goes down fine with 2 to 5% remaining somewhere in my lower throat. This residual material can be either solid food particles, incompletely swallowed saliva, or incompletely swallowed liquids. The presence of this residual material makes me short of breath and difficult for me to breathe. I sometimes inhale the residual food particles or residual pooled liquids and cough and choke but more often or not, I sense the residual material and automatically go into a careful shallow breathing mode, during this shallow breathing mode, any physical activity makes me short on breath. Whether this residual material is scattered small solids (like ground beef or chewed nuts), single solid piece (like a pill or small piece of steak) or is simply pooled frothy liquid or saliva/phlegm, repeated dry swallows will not get it down. Similarly, drinking liquids will not wash down the residual material either.
 
The above described swallowing problem has existing for past 4 to 5 years and has become progressively worse in spite of Radio Frequency Tongue Reduction surgery in January of '07, Lower Esophageal dilation in 07, upper Esophageal dilation in 08 (it's possible my ENT Dr didn't actually stretch my UES as he's absent minded and may have forgot to do the stretch during the mid '08 Esophagoscopy w/biopsy after he saw the "burned tissue" in my lower throat and esophagus.) The "burned tissue" biopsy turned out fine. I suspect this burned tissue was caused by me habitually drinking large quantities of extra hot liquids which I find works better than anything to wash down the trapped residual material. After being advised on the "burned tissue" I have backed off on the extra hot liquids both in regards to temperature and quantity.
 
I have had three Modified Barium Swallow studies. The first one (November of '06) revealed extraneous tissue attached to my epiglottis that was further spotted on a subsequent CT scan . However, my ENT could not find any extraneous tissue during a fiber-optic examination of my throat so he dismissed the MBS study and CT scan as being a "fluke."
 
At this point I went to another practice (Emory Voice at Crawford Long Hospital) who, based on their fiber optic examination of my throat, said it was my lingual tonsil on my tongue base that was the extra material appearing on the first MBS and recommended a Radio Frequency Tongue Reduction along with a trimming of my epiglottis. On the morning of the Jan '07 tongue reduction/epiglottis trim surgery, the Doctor told me decided he didn't want to trim the epiglottis at the same time so only the Tongue reduction was performed. Several months later, I still had residual material in my lower throat so a second MBS was ordered which did reveal some residual liquids or fluids pooling in the vallecular space and pyriform sinus cavities. Based on this the Epiglottis trim was re-recommended but with a warning that it could make things worse and couldn't be reversed if that turned out to be the case. Before agreeing with the epiglottis trim, I asked for a second opinion from the senior Doctor at Emory Voice who after careful review indicated that he believed I was suffering from sensory neuropathy and the epiglottis trim was bad idea and that the previous tongue reduction probably was not of any use. Based on the sensory neuropathy diagnosed, I was prescribed Lyrica for several months which brought no improvement in systems.
 
After several months of unsuccessful Lyrica pills in conjunction with the fact that no matter ho hard I tried to swallow or wash down the residual material and I was now having to do a nightly 3 to 5 hours session (up from 1 to 2 hours) in a chair facing the tub forcing belches to force up the trapped residual material in my throat that refused to be swallowed so that my airway would be clear enough to allow me to sleep, I decided to give my original ENT another shot. I explained to him I was spending several hours a day burping in order to clear my airway and explained that I was often having to sleep in an upside position so that the residual material wouldn't drip into my airway during sleep. I pleaded for some sort of surgery on my lower throat but the ENT thought with all my belching and upside down sleeping I was half crazy and he refused to proceed with any treatment until I was on anti anxiety medication for at least 3 months. I asked him to write me a prescription and he indicated that treating anxiety is not part of his specialty and he referred me back to my primary care Doctor. Because I am on Adderall XR for adult ADD, I have to see my primary doctor monthly and on my next visit I asked him to put me on anxiety treatment in which he then explained that my antidepressant Cybalta is actually a antidepressant and anti-anxiety combo which I had already been taking for a couple of years.
 
I then returned to my ENT and explained I have already been doing anti-anxiety meds for 2 years so could we please proceed with the next step to fixing this swallow problem. He then disclosed that he see's nothing wrong with my throat and doesn't know what to else to do. I then told him that I've been told I snore and asked if it is possible I have obstructive sleep apnea of my lower throat which could also be causing these swallowing symptoms. He replied that I should have a sleep study. A sleep study was performed within a week and it revealed I was having between 65 to 200 AHI events per hour with oxygen saturation decreasing down to 83% and overall sleep efficiency of 79%. A couple months later MY ENT ordered a CPAP trial which later lead to me going on BiPAP treatment during sleep. I tried the BiPAP mask for 3 nights but it gave me major chest pains and seemed to want to blow the residual material in my throat down into my airway. I suspect that my shallow breathing brought on by the presence of pooled secretions at the top of my airway was triggering the BiPAP machine's "smart switch" to falsely assume I wasn't wearing the mask and would automatically shut down the machine causing me to re-breathe expelled air lingering in the 6' tube.
 
In between the two sleep studies,on one afternoon, earlier in the day than usual, I sensed a large accumulation of residual material in my throat and was able to get in to see my ENT within a couple of hours who looked down my throat with the fiber-optic scope and found "lots of crud" in each of my pyriform sinuses. I explained to him that "crud" was residual material left over from breakfast that I had eaten several hours before. I was so glad I was able to get my ENT to finally see for himself this residual material as he was under the assumption it was either reflux or was imagined.
 
Regardless of why the BiPAP wasn't working in conjunction with the confirmation of pooled secretions in my pyriforms, my ENT recommended UPPP and septoplasty to eliminate the obstruction causing the sleep apnea. I am now recovering from this combo surgery that was performed two weeks ago. The residual matter in my throat has become worse since the surgery and like I said before, the presence of this residual matter makes it hard for me to breathe which is a frustrating way to live, in that I'm always having to carefully inhale without sucking in the residual material into my windpipe.
 
I am desperate to resolve this matter. I have hit my maximum annual out of pocket limit on my BCBS insurance and I basically now have 100% insurance with no deductible.
 
Some additional general bullet point information is also provided below:
 
1) I have NOT had a Fiber-optic pharyngoscopy done while using continuous positive airway pressure (CPAP) to find the areas in my airway that collapse during sleep.
 
2) I have had a CT scan of my neck but not one of my sinuses done.
 
3) A cephalometric X-ray has not been performed.
 
4) After swallowing I am more likely to aspirate viscous liquids like water or soup broth than I am to aspirate thicker liquids.
 
5) I often cough up from my throat items that I have eaten several hours or even the day before.
 
6) If I eat a colored popcicle, I will for several hours (or even the next morning) be able to spit up or cough up from my throat saliva matching the bright color of the popcicle (even after drinking plenty of liquids and broushing my teeth and garling with mouth wash).
 
7) My ENT has indicated I do not have a Zincker's pouch.
 
 I awake often during the night having to clear un-swallowable saliva and phlegm and spit it out on to the hand towel I sleep with.
 
9) I often have to burp after drinking or eating in order to "re-set" the top of my esophagus and bottom of my throat in order to be able to receive more liquids or solid foods.
 
10) After I have already sipped liquid or chewed food and worked the bolus to the back of my tongue, I suddenly realize my esophagus is not going to accept the bolus and I have to spit out whatever is in my mouth, do a "re-set" burp and then re-attempt the swallow.
 
11) I used to be able to close my mouth and do a downward suction snort to gather the residual material gathered in my throat which I could then spit out or swallow. This maneuver is no longer effective.
 
12) Chin tuck swallows do not help.
 
13) Head turned swallows will keep additional food particles from going into one pyriform sinus but does not prevent the other pyriform from retaining the newly swallowed material.
 
14) I purchased a suction machine off ebay in 2004 in hopes it would suction out the un-swallowable residual material in my lower throat. At first, this machine was useless as I could not get the suction tube low enough in my throat to be of any use. However, in the past year, the machine has become more useful to remove large quantities of frothy liquids in my lower throat but I am not able to get it to "get it all out" with the suction device.
 
15) I often have trouble swallowing my normal saliva so I have to spit often which is made worse when I experience excessive drooling which occurs when something is "stuck" in my throat.
 
16 I often feel the need to swallow, I want to swallow whatever's in but regardless of my inability to dislodge and swallow the retained material, I sometimes tongue pump and repeatedly swallow involuntarily.
 
17) I have not had a FEESST test done.
 
I am wondering if I might have a cricopharyngeal disorder and wondered if I might benefit from a cricopharyngeal myotomy.

beareilly
Veteran Member


Date Joined Mar 2009
Total Posts : 553
   Posted 5/29/2009 9:54 PM (GMT -7)   
Hello guys,
Welcome to the healing well's wrapped club. 3 weeks post op for nissan and I feel great. My problems b4 this wrap were ruining my quality of life. I had "Nite time gerd 24 hours a day 7 days a week.I had 3 esphageal strictures that required opening of course. I had several endoscopes including the bravo ph test. I didnt take the manometry becuz I have seizures and it was too much for me.I had astma related to gerd. My LES was defective, esphagitis, gastritis,h pylori ,sour taste 24/7, a hiatial hernia, a clicking noise in my saliva/throat,backwash so bad i almost aspirated numerous occassions, besides the fact I also have epilepsy. I HAD NO HEARTBURN WHATSOEVER!
I had "The classic wrap" according to my surgeon. I can burp and most of all sleep since my surgery. No sour taste . I lost 20 pounds and hopefully will lose more.I havent had any asthma. No more snoring or phelgm vibrating my voicebox while I sleep. I have heard that you must keep a prescription of anti nausea drug on hand at all times to defend yourself against the dry heaves.
However minor or severe as a nissan patient, you must contact your GI to find out why every1 is experiencing symptoms such as throat strictures etc. It sounds like a few ppl need an endoscope. Please dont hesitate to contact your dr. What seems abnormal to you, IS.Take care everyone and best of luck,
Bea

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6971
   Posted 5/30/2009 3:31 PM (GMT -7)   
Hi All,
Sorry to hear you're experiencing problems with your wraps. Unfortunately, that is a possibility over time, and the reality that all fundoplication patients must face. Unfortunately there are no guarantees that the wrap lasts forever. Some of us will need to face redos.

This forum does have members who have had redos, so hopefully someone with experience will respond to your post soon. Every situation is unique, and Bea is right that it's an issue that needs to be discussed with your GI doc and surgeon. Since redos are more complicated and riskier, it's even more important to get the most competent surgeon possible.

I wish you all the best of luck in finding resolution to your problems. Try to keep in mind how much your symptoms were helped by the surgery. Mine was done to resolve uncontrollable asthma, and I am thrilled with the results. A life-threatening situation has been turned around by this surgery. I would not live the way I did before--and would definitely opt for a redo, should my wrap come undone.

Again, best wishes to all of you.
Denise

beareilly
Veteran Member


Date Joined Mar 2009
Total Posts : 553
   Posted 5/31/2009 1:00 PM (GMT -7)   
ditto and kudos to denise.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6971
   Posted 5/31/2009 1:16 PM (GMT -7)   
Hi Bea!
You've recovered from your spring fling, I see!
Enjoy your day!
Denise

beareilly
Veteran Member


Date Joined Mar 2009
Total Posts : 553
   Posted 5/31/2009 9:53 PM (GMT -7)   
Oh Boy Denise!!!
I am not use to gettimg home at 5am. What a night.My hubby did the bartending,my sister in law served the food along with 2 others.I believe it or not was standing the majority of the time to help my hubby against his wishes. I ate but last night for the 2st time,I felt nausea. I dont know why either .It couldnt be the potato salad.I eat that 4times a week.I just felt so sick but put on a happy face. I couldnt wait to get into the car and sit my old 44 year old but down.My feet were killin me, The incision was annoyin at times,not to mention I being the nice one, decided to help the cleaning worker of the hall ,clean!!! ugh.
But all & all I had a great tme lol.I saw alotof old co workers,friends from my grammar school days. I did sleep today from 3pm to 6pm.I needed that considerin i didnt go to sleep until 6am this morning and awoke at 1030 and made a grand breakfast!!!
I hope ya well,
Bea

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6971
   Posted 6/1/2009 4:00 AM (GMT -7)   
Hi Bea,
Glad you had fun at the fling! I figured you had a great time, since you were AWOL here! It isn't fun to stay up that late when you're over 25...it is almost impossible to catch up on that sleep. At least you're still on medical leave, so you can catch up all week. Nap, nap, nap!

You were pushing it, sweetie. You did have major surgery, and although you're feeling frisky, you are still recovering! The nausea is probably your body/tummy telling you to take it easy! On your feet all that time? Yikes! You owe yourself some R&R!

Even 3 months out, my stomach and wrap yell at me when I don't eat carefully. I'm especially bad sometimes--eating too fast and not chewing things enough...live and learn!

On the bright side, my asthma is a lot better...so I'm not coughing my hernia out daily!
Enjoy the day.
Keep an eye on Bill, OK? I know you will!
TTYL
Denise

sewingqueen
New Member


Date Joined Feb 2009
Total Posts : 3
   Posted 12/1/2009 11:38 AM (GMT -7)   
I also had a Nissen done about a year ago. about 5 months later, I was noticing that I could not swallow liquids without choking. It got pretty scary, but I didn't think anything of it. I saw a new GI doctor because my heartburn was still occurring and because my surgeon was concerned about my swallowing. They performed a few tests and discovered I had high pressure in my esophagus due to the muscles not contracting in sync with one another. I had a dilitation performed where they basically insert a balloon in the esophagus to stretch it out. After a few weeks, my swallowing problems were mostly resolved. My GI doctor said I might need to get the procedure done again, but that's okay with me. My throat hurt a couple days after but it wasn't anything to complain about.
I would recommend looking into that if you haven't already (or if someone else hasn't suggested that yet).

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 3673
   Posted 12/1/2009 1:56 PM (GMT -7)   
Ikandy and Baroni -
I would be seeing the docs and asking for a barium swallow. Your problems could both be reherniation. This happens a lot with the older Nissens. Or it could be one of the many things that causes constricting of the esophagus. Things aren't always seen on scope, especially if you're sedated. When you swallow on the barium swallow they can see what's going on.
Alcie
 
 


couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 12643
   Posted 12/1/2009 4:04 PM (GMT -7)   
Ikandy and Baroni have not posted since January, Alcie.

Joy

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 12/2/2009 7:42 AM (GMT -7)   
sewingqueen

Hello and welcome to HealingWell and the GERD/Heartburn Forum. I am so glad you found us and thank you for the information.

Please do feel free to start a thread of your own if you would like or if you have any issues or topics you would like to see addressed here in the forum. We always love to have new members so again welcome.

Kitt

bingaux
New Member


Date Joined Jan 2011
Total Posts : 0
   Posted 1/9/2011 4:18 PM (GMT -7)   
WOW, was I unprepared for this surgery in 2002. I had just had a laparoscopic cholecystectomy and felt wonderously better. I thought the NISSEN FUNDOPLICATION would improve my life too because a pb&j sandwich eaten at 4pm was causing gerd at 11pm. I wish they had done more preoperative education/ testing and discharge education to prepare me. The GERD was completely gone for 5 years. However PAIN started postoperatively. I found out I had delayed gastric emptying times I started having more troubles including H.Pylori and upper right quadrant pains. EGD showed return of the hiatal hernia in just a year or so. SMALL BOWEL CAPSULAR ENDOSCOPY showed nothing wrong. GERD returned in 2008. On top of all this, I apparently lost the ability to digest iron and became severely iron deficient with less than 5 Total Iron. The oral iron did not improve this. The intramuscular iron did not improve this. Of course no one related this to the NISSEN, but I can't help but wonder! So, I have not had such a wonderful time postoperatively. I am back on the controversial GERD meds since 2006. I wonder if I screwed up the fundoplication somehow postoperatively. I am not sure that a repeat would be of benefit or not. I am wiser about the surgical implications since they started lap-banding... but this education (which would probably apply to the fundoplication) was not offered in 2002. IF YOU HAVE THE NISSEN, eat small frequent meals. NEVER BINGE since this might cause the food to rest and stretch the hiatal area. ASK ALOT OF QUESTIONS and get thoroughly oriented to the procedure and implications and complications preoperatively. GOOD LUCK TO ALL.

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 1/9/2011 6:11 PM (GMT -7)   
 
Hello and welcome to the forum.  Thank  you so much for sharing here in the forum.  Perhaps  you would like to start a thread of your own so everyone has a chance to meet you and greet you.
 
I agree with you that asking alot of questions up front is the best way to advocate for yourself.
 
Again a warm welcome,
 
Kitt
 

 
~~Kitt~~
Moderator: Anxiety/Panic, Osteoarthritis, GERD/Heartburn and Heart/Cardiovascular Disease.
www.healingwell.com

"If you can't change the world, change your world"

Ames870
New Member


Date Joined Aug 2013
Total Posts : 2
   Posted 8/10/2013 6:55 PM (GMT -7)   
I had Nissen done 5 years ago and for the past year I have been experiencing extreme pain at the sight. There is also a large hard mass there. Lately the pain has been radiating down my left side and up into my left shoulder. Has anyone else experienced this? What can be done about this?

Phyle
New Member


Date Joined Sep 2014
Total Posts : 1
   Posted 9/1/2014 7:37 PM (GMT -7)   
Hello Everyone. I'm new here and ran onto this site doing a web search for help. I had Nissen Operation March 2008 for a sever hiatal hernia. I too have issues to this day. I felt people thought I was just complaining because I could. Its good to see others have some of the same issues I have had since my operation. (not that I want y'all to hurt...lol)
My problems are that my stomach can't tolerate foods a lot of days. I have to eat light a lot of times. I get gas a lot which will not come up in the form of a burp.... if it doesn't expel the other way I am in misery the rest of the time. It settles in my left shoulder causing me terrible pain. It's even caused me to go to hospital thinking I was having a heart attack because the pain lasted for hours (over 5 hours) and hovered in my left should down my left arm. I too find it difficult to swallow liquids, etc... I've had my throat "stretched" twice, the last time it hurt terribly and didn't seem to help a lot. I don't believe my food is digesting right any more. I have found that potato and onions are not my friends now both of which I love together or separate. I am a vegetarian but I'm out of foods that I can eat that don't attack me back. I'm tired of having that nagging pain in my shoulder. Anyone with any suggestions to help would be greatly appreciated.
Thanks, Phyllis
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