Should i take Nissen Fundoplication Surgery?

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4hn
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Date Joined Jul 2011
Total Posts : 77
   Posted 7/14/2011 4:47 AM (GMT -6)   
Hi there.
My name is Andry, I'm from indonesia.

I'm 27 and right now if been diagnosed with GERD for about 4 month. after got the endoscopy last week my doctor said I have GERD & Esophagitis. the biopsi found an early stage of barrett esophagus form.
even though my doctor said that my esopaghitis is not that much.

This 4 month has been very hard for me.. and i wonder if i can take an operation to get rid this all.
currently I'm taking Lanzoprasole 30MG twice a day, and still got a little heart burn.

My doctor did not tell me about any surgery, I only know it from internet.
so i went to another doctor that said he can do the surgery.

from i read from this forum, there is some criteria for the condition for the operation, and I think some of them are not available in Indonesia.

What do you think should i do?

PS: Please excuse my poor/bad English :P

Post Edited (4hn) : 7/14/2011 3:52:17 PM (GMT-6)


couchtater
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Date Joined Jul 2009
Total Posts : 12087
   Posted 7/14/2011 10:26 AM (GMT -6)   
Your english is fine.
There is surgery to fix the Barretts. It's called Halo Ablation.
If your Lower Esophageal spincter is weak then you need the Nissen fundoplication surgery.

Basically the rule for having the surgery in the USA is if the medicine doesn't help then you need the surgery.

Testing for the surgery is barium swallow, Endoscopy, manometry, pH testing, and stomach emptying.
Joy

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 7/14/2011 10:45 AM (GMT -6)   
hi joy,
thx for the reply,

actually im planning a Nissen fundoplication surgery(without laporoscopic),

but will it to early for an operation?I've been suffer about 4 month of gerd,
actually i'm afraid of dumping syndrome since the gerd operation in Indonesia is uncommon.

and here we don't have any kind of test like that, just from the symptom & gastro endoscopy only.

couchtater
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Date Joined Jul 2009
Total Posts : 12087
   Posted 7/14/2011 10:52 AM (GMT -6)   
Make sure to get an experienced surgeon. The more experienced the better the outcome.
Very few people who have posted here have had dumping syndrome. You do have some stomach upset for a week due to liquid diet requirement.
Joy

4hn
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Date Joined Jul 2011
Total Posts : 77
   Posted 7/14/2011 11:29 AM (GMT -6)   
Very few people who have posted here have had dumping syndrome -> and how their condition now?
they got re-surgery or getting better or live with it?

I think my surgeon is quiet experienced, but i don't know for the Nissen Fundoplication. Here GERD is more uncommon things than in Europe or US :(

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6877
   Posted 7/14/2011 11:41 AM (GMT -6)   
Hi Andry,

Welcome to Healing Well! First, to change the title of your thread, just click the picture of the pencil in the top right corner. It takes you back to you can edit/change your title and what you've written.

People who have written scary posts on the internet about the bad outcomes they've had after the Nissen surgery and the ones who did not select a highly experienced surgeon (in this specific procedure/surgery).

Joy's statement that you need to choose an experienced surgeon is correct. You could have a fine, fine, exceptional surgeon, but if he/she doesn't have sufficient experience with doing the Nissen fundoplication surgery, no matter how good he/she is, you will likely have problems.

We have a rule of thumb...your surgeon should have done at least 300+ surgeries, and 1000+ is better.

As far as dumping goes...some people have it occasionally during recovery. I did. But it is not something that lasts, or is particularly difficult to deal with.

I think you're rushing things thinking about surgery, though. You have just found out you have reflux, and have not been on the medication long enough to determine whether or not it will work for you. You can heal your esophagus with the correct dosage of PPI. If you feel what you're getting isn't working well after 2-3 weeks, contact your doctor and discuss increasing or changing the type of PPI you're taking.

Again, glad you've found us. We're happy to answer your questions, and provide support as you try to find out what is best for you. You're definitely in the right place. People here will understand what you're going through!

Good luck!
Denise

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 7/14/2011 5:06 PM (GMT -6)   
Thx for the reply Denise,

Currently im on LAZ 30mg in the morning & Night, before it was not working at all, but then I elevate more of my bed and its a been better, but there still a little heart burn. I have a plan to change my med to Omeprazole( because it is lot cheaper here- Generic med)
what i concern is the barrett's & the of fullness when i eat a little food(fewer than regular portion)
I am a thin person & got thinner more after this GERD. & also i got Geographic tongue from this. :(

Is there any chance for the LES working normally again somehow on some case or some person? Did you know someone here ever got normal LES again like before?(except Mr. Gerdo)

Btw I have a girlfriend, we've been together for 3 years, she's very kind & lovely, shes know my condition -But in other side I'm so afraid that I could not make her happy to live with me in the future. Some times it make me so frustated :(

Thx Andry

Post Edited (4hn) : 7/14/2011 4:12:37 PM (GMT-6)


couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 12087
   Posted 7/14/2011 5:29 PM (GMT -6)   
You can't make a weak LES stronger. If your LES is weak then surgery will strengthen it.
Joy

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 7/16/2011 6:13 AM (GMT -6)   
i'll guess i will take the surgery.. wish me luck :)

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6877
   Posted 7/16/2011 8:12 AM (GMT -6)   
Hi Andry,

Your fullness is probably an indication that you've had some burn at the LES and esophagus. When I had esophagitis and gastritis (irritated esophagus and stomach), I could only eat about a tablespoon of food at a time.

If you can take the PPI drug and elevate the head of your bed 7-8 inches, it will help a lot. You might ask your doctor to prescribe an H2blocker like Ranitidine at bedtime. it provides some extra protection while you sleep. I used to take 40mg Protonix before breakfast and dinner, and at bedtime I took 300mg Ranitidine to keep down the acid while I slept.

Right now you need to work on healing your esophagus and stomach, so be sure to stay away from spicy, acidic, and rough, abrasive foods. It takes a long time to heal the upper GI tract once it's greatly irritated, so try to be patient. You may very well get it healed up and have no need for surgery. Time will tell.

If your beautiful girlfriend is the right person for you, she will understand and support your recovery. Try to stay positive, and don't focus on your problem constantly. Don't talk about it all the time, as that can get tiring to her. Keep active and have fun while you recover. Just be careful not to put things into your stomach/esophagus that will irritate it.

Good luck!
Denise

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 7/16/2011 8:33 AM (GMT -6)   
Hi Denise,

Yes i have an esophagitis, and everyday i have a heartburn few times. :(

In your case, how long it will take for heal from esophagitis?
I'm currently on 2x30mg Lanzprasole(prevacid) and already raise my bed also for about 3 weeks.
and still got heartburn everyday. That why I think i should get some surgery.

Maybe I will try for more time let the med works.

Btw I really thankfull & appreciate for your advice & suggestion.

Andry

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6877
   Posted 7/16/2011 8:54 AM (GMT -6)   
Hi Andry

I'm sorry to tell you that it can take months to heal your esophagus fully. I believe your doctor will want you to try the medication route before going for the surgery.

I had esophagitis multiple times and because I have asthma, I was even hospitalized for it once. My reflux had caused my lungs to get very bad.

Really, it will require a lot of patience on your part to get through the healing stages. Your doctor has given you medications that keep the acid suppressed, to help with the healing.

You might ask your doctor how long he/she expects it to take before you feel some relief. If you don't get better in that time, then go back to your doctor, and perhaps he/she can adjust your medications to help speed things up.

I wish I had better news. Everyone is different, but that has been my experience.
Glad you've joined us. We're here to provide support, encouragement, and to share our own experiences. Here's hoping you heal up quickly!

Denise

Digidawinwa
Regular Member


Date Joined Nov 2009
Total Posts : 23
   Posted 7/16/2011 2:21 PM (GMT -6)   
Hi Andry... I'm sorry you are having such troubles... in my situation only Nexium would help... I tried all the PPI's... and unfortunately Nexium doesn't have a generic... my primary doc said they are all the same.. but I beg to differ! hahaha I only found relief with Nexium... tried Omeprazole for a year (Prilosec) but even twice a day it didn't work as well as even just ONE Nexium... everyone is diff though... my cousin only gets relief from Protonix... I have had Geographic Tongue since about 1995... did your doc say that could be caused from reflux??? I didn't really have reflux issues til the last few yrs... no burn really till about 2 1/2 yrs ago... but pain in my stomach after eating and feeling full since about 2004... they say it was prob silent reflux back then.. but now you have me wondering about my tongue situation.... ???? I have found that taking vitamins regularly helps with the geo tongue....
Fibro, GERD, Idiopathic Subglottic Tracheal Stenosis

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 7/16/2011 9:05 PM (GMT -6)   
@Dididawinwa:

I have geo tongue since beginning this years. I think that when acid reflux start, and changes my life. :(
My Surgeon also said that could happen because stress & lack of vitamin.

joe1619
Regular Member


Date Joined Dec 2009
Total Posts : 293
   Posted 7/17/2011 5:56 PM (GMT -6)   
ok i have lots of questions. can that surgery, ablation whatever fix a burned throat larynx i thought barrets was permanent also, what surgery makes the les stronger. I thought it just caused a new passive valve but the les is still there, but not stronger. you all are confusing me. I have never heard u can strengthen the les..fundo is just wrapping your tummy. anyone have this ablation done.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 12087
   Posted 7/17/2011 7:33 PM (GMT -6)   
This is a video about Halo Ablation
 
The wrapping of the fundus around the esophagus strengthen the LES by giving it extra support.
Joy

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 8/15/2011 9:22 PM (GMT -6)   
its been almost a month after my last reply..
my condition right now is still the same.. everyday fell the heartburn almost all day...

actually i don't know what happen, what is weird from the first time i have this gerd, during the night i can sleep normally without pain that woken me. But the pain happen on the day when i wake up.. sometimes i just want live in a dream to escape from this sickness :(

is it worth to get the surgery.. currently i really don't know what to do as my medical seems fail :(

Post Edited (4hn) : 8/15/2011 8:32:59 PM (GMT-6)


daddypig
Regular Member


Date Joined Aug 2011
Total Posts : 90
   Posted 8/17/2011 6:06 PM (GMT -6)   
I am sorry you are still suffering. The others are right about time and the need to heal and investigate and try other things. Is there any chance of seeing another doctor or specialist or asking the one you have to try something else? If whatever you are doing has not changed things for over a month if you could try something new maybe? This reflux can take over your life, I know, do keep pressing the doctors. Good luck.

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 8/31/2011 1:25 AM (GMT -6)   
all this time i though heartburn is the same as chest pain. what i had is daily constant chest pain not the heartburn.
but i think it is a little subside after my doc add sucralfate for extra protection.

i will update my condition later on..

still considering for an operation if things not getting fixed..

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6877
   Posted 8/31/2011 6:35 AM (GMT -6)   
Hi Andry,

If you've read other posts you will see that I am a big fan of sucralfate (Carafate). I have had similar pain to yours that didn't respond to antacids, and sucralfate helped with the first dose. It provided real relief. It's too bad your doctor didn't prescribe it earlier.

Are you taking a pill or a liquid form? If you're taking the pill, consider putting it in a little medicine cup, add a little water and stir. Then throw it back into the back of your mouth and swallow. That way it can coat your esophagus as well as your stomach. If you can get the liquid form, it would be even better. Just a thought.

Have you had the testing recommended before surgery? (24hr PH monitor, manometry, barium swallow (upper GI test), and endoscopy?) If you decide to move toward surgery, do so very carefully. You need to be sure that you find the most experienced and skilled surgeon possible. If you have to travel to find one, it's worth doing.

I hope you can get things straightened around without surgery, but if that's what you need to feel better, it will be a good option. Many here (like me) have had the Nissen surgery and it has improved our health and quality of life. Still, it's not something to do without great care in deciding if it's the right thing for you.

Best wishes!
Denise

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 8/31/2011 8:06 AM (GMT -6)   
Hi Denise,

Yes i think sucralfate help with my chest pain, it is a lot better for my outer chest pain. but i still got the pain inside, it is like behind the breastbone.
And i also burping a lot after eating. Is it because of PPI or just general symptom of GERD?
will it gone if my gerd is well controlled with PPI?

I taking the liquid form. take a sip before sleep & 2 hours after eating.

about the testing for the operation i have not take it yet. Still looking a hospital in my country that perform the testing (manometry & 24hr PH monitor). I can do the test in Singapore but it cost a lot, so i still considering about it.
The only one that i have taken is endoscopy that show an esophagitis grade A/B.

Yes currently i am still thinking deeply about surgery & will not go for surgery without the proper test. I don't want anything going worst.
Or maybe if everything going under control, maybe i can wait for LINX in Asia someday in the future.

I don't know how severe actually is my GERD, as i can sleep well without any trouble (no acid that woke me up etc).
But the pain just does not go, lump in the throat, it is like i dont get any big improvement.. just a tiny one over months..

Thank You very much for your kind reply & wishes,

Best wishes for you also,

Andry

Live2Skate
New Member


Date Joined Sep 2011
Total Posts : 2
   Posted 9/9/2011 11:59 AM (GMT -6)   
Andry - how are you doing???

4hn
Regular Member


Date Joined Jul 2011
Total Posts : 77
   Posted 9/10/2011 2:48 AM (GMT -6)   
hi live2skate


i am not pretty good. still cannot control my gerd with medication & still considering the ops.
but it is hard to find a good fundo surgeon here..


how are you doing?

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 6877
   Posted 9/10/2011 8:21 AM (GMT -6)   
Hi Andry,
 
Sorry I didn't get back to answering you sooner.  I guess I just missed your post.  You are wise to be very careful about finding the right person to do the surgery.  I'm so sorry that it's not something that is easy to do in your country.  There aren't many people in the US who have the surgery either, since PPI's were developed.  Most do well on the medication and don't find the need to have surgery.
 
I didn't have bad reflux either.  While I did have my bed elevated, and followed other GERD recommendations, I still get some breakthrough reflux.  I was on 40mg Protonix AM and PM plus Ranitidine 300mg at night.  It was enough to protect my esophagus, but not enough to protect my lungs.  I had my surgery because the reflux made my lungs terrible.
 
The feeling of a lump behind your breastbone is an indication that you have irritation there.  How much PPI medication are you taking?  Could you have your doctor increase the dosage to get better results? 
 
It does take time for the PPI's and Carafate suspension to work, so don't despair yet.  That type of healing of such sensitive tissue takes time.  Try to be careful to chew your food completely, and don't eat anything rough or spicy or very acidic for a while.  I find the Carafate very helpful, and hopefully over time it will help with your symptoms.  Whenever I got esophagitis before I had the surgery, it usually took three months for it to resolve.  I would generally lose about 20 pounds in the process.  It's a long-term process, and you'll just need to be patient. It's not an easy recovery, but the Carafate should help it along a lot.
 
Are you being careful to take the Carafate properly?  I was prescribed 2 teaspoonfuls 4 times a day.  You have to be careful to take it 2 hours before and after medications.  (It can interfere with their absorption) Also take it 1 hour before and 2 hours after eating meals.
 
The burping isn't from the PPI's...it's from the GERD.   
Hopefully you'll begin feeling better very soon.
Denise 
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