burning 1 week after nissen--ADVICE?

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lstek
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Date Joined Aug 2009
Total Posts : 17
   Posted 8/6/2009 5:26 PM (GMT -6)   
Hi there,
i am new here. i am about 1 week post nissen and have not yet had much relief from the burning in my throat I fely before the operation. PPI's stopped working for me a while ago, and the nissen was the path i chose after many doctors and much deliberation. i am 39, female, thin, active and healthy in all other ways. my surgoen said everything went wonderfully and i should expect no more reflux---he repaired a substantial hernia and a torn diaphragm muscle( from having children). he also mentioned that my throat was very very inflammed at the time or suregery. Could this burning that feels just like reflux be healing/inflammation? has anyone else experienced this? this burning is all the time, not just here and there---even increases at night just like the old reflux did. I do not seem to get relief from gaviscvon either......what to do? any thoughts? advice? my surgeon assured me it was not reflux, but I am sceptical.
thanks
lstek

beareilly
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Date Joined Mar 2009
Total Posts : 553
   Posted 8/6/2009 6:47 PM (GMT -6)   
Hi isek, welcome to the wrapped club. I too have had the operation and have my own thread going.You may go read it if you have the time. I do not have burning but I believe that will subside eventually. I am doing very well & I wish you the same.
Bea

lstek
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Date Joined Aug 2009
Total Posts : 17
   Posted 8/6/2009 6:51 PM (GMT -6)   
Thanks for the welcome to the wrapped club. Other than the burning continuation, I am doing very well. I am moving slowly at 8 days out and have to rest a bit, but I am eating soft foods, digesting ok, and the pain is not so much to deal with now. My main concern is the failure of the operation. Have you heard of others with a post-op burn that subsides?
best
lstek

beareilly
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Date Joined Mar 2009
Total Posts : 553
   Posted 8/6/2009 7:13 PM (GMT -6)   
im not sure but oogle it. It may be temporarily. I do still have a slight sour bitter taste every 3 days or sooo but dr assured me after all the swellings go down i will be fine.

dencha
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Date Joined Feb 2009
Total Posts : 7188
   Posted 8/6/2009 7:57 PM (GMT -6)   
Hi Lstek,
Welcome to the "Wrapped Club"! You need to keep in mind that the inflammation in your esophagus won't disappear just because you've had the Nissen surgery. It'll take time for that tissue to heal. You said your surgeon told you that it was very, very inflamed. My experience an inflamed stomach and/or esophagus take a long time to heal. I had asthma problems that led me to surgery. My lungs were inflamed after years of being irritated by the refluxing acid. They took several months to heal, and at around 3 months they cleared up, and my breathing was great.

I had "reflux" sensations in the early stages of recovery (I had the surgery on Feb. 27th of this year), and discussed this with my surgeon. He said in the early stages of healing anything is possible. The wrap is swollen, and some acid could possibly slip by. "Pretty much anything is possible at this point" was his response. It has been my experience that whenever my wrap is irritated and bothering me, that's when I get those very infrequent "reflux" sensations. I've read that the esophagus is a "dumb organ" and interprets any pain as reflux. So, are we having reflux? I can't tell you for sure. I can just tell you that my lungs have continued to improve, and I'm breathing freely without any coughing or mucous. That's my indication that whatever I'm experiencing is not true reflux.

I can totally understand your concern, but I think you can rest assured that you're not refluxing. You've got everything going for you. You're young, thin, active, and healthy. Those are four things (in addition to a skilled and experienced surgeon) that set you up for a successful surgical result. Don't waste your time worrying! I think you can be very confident that the burning is residual, from the inflammation that you had at the time of the surgery. Be patient, take care to follow your surgeon's directions regarding diet, and trust that your wrap is just fine.

I hope you'll stay around this forum and report on your recovery experience.
There are lots of people out there searching for information and encouragement as they decide whether or not to move forward with surgery.
It's not a perfect surgery, but it can be a lifesaver for people suffering from severe reflux.
I wish I'd had the surgery years ago, before the steroids I took caused permanent damage to my body. Oh well...better late than never!
Take care, lstek!
Denise

opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 8/7/2009 8:26 AM (GMT -6)   
lstek-
I had some heartburn feelings the first time I had the Nissen done. It last for a 2 or 3 weeks. I was told basically what Denise said. It takes quite a while for the esophagus to heal. I was told to continue the PPIs for a month after the first one, but not after my redo. Well actually I did end up on them again for a month, but that was because of the holes in my stomach not reflux.
Again, welcome to the Wrapped Club!

Take care,
Bill

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/7/2009 9:20 AM (GMT -6)   
denise and bill,
thank you so much for your responses. It is really good to hear that someone else actually had this, and it got better. I will do my best to relax and wait for the swelling to calm down, and see where that leaves me. I have been trying antacids to calm it down for several days, but they do not work AT ALL. My surgeon told me this is a sign that is is indeed not reflux. I hope everyone is right. I will post back when I know more. Thanks for helping me calm down.
best
lstek

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/7/2009 2:29 PM (GMT -6)   
Hi lstek,
We're glad to share our experiences with you! Have you tried Maalox? Whenever my wrap has felt irritated, the Maalox has really helped. As I think I said, drinking lots of water can also be soothing. It's just a long-term process, and it takes lots of patience!
Good luck, and feel well.
Denise

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/7/2009 3:26 PM (GMT -6)   
yes, it seems it will take patience. Bill, did you feel as though you still had heartburn? or just a few occasions here and there. Mine feels just like before...all the time. I will try to drink more water to see if that helps as well.
lstek

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 8/7/2009 7:50 PM (GMT -6)   
lstek-
After my first one I did feel as if I had the same heartburn as before surgery. My esophagus was really messed up. After the redo I haven't had any significant heartburn. I did get a little when I ate some thing very spicy, but it wasn't enough to take anything for.

Take care,
Bill

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/8/2009 9:23 AM (GMT -6)   
hi again,
bill, can I ask you a few question, since you are the only person i have found that felt the same thing? did the post op burning that you felt mimic the pre-op reflux? for example, mine is always there, but seems to be aggrivated at night when lying down, just like before. Also, did you have your wrap redone because of this/ because it did not work? or for other reasons? did anything calm it down for you and how long until it was gone? I would love to get more details if you don't mind. The intensification of night burning makes me suspicious that it did not work. still concerned
lstek

opnwhl4
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Date Joined Dec 2008
Total Posts : 4961
   Posted 8/8/2009 9:18 PM (GMT -6)   
lstek-
I had to have a redo because the first one was done wrong. It took 3 years before they figured out why I always had dysphagia even after they dilated it about 12 times. I do remember it feeling exactly as it did before surgery, but that only lasted a couple weeks. By week 4 I was so caught up in why I couldn't get anything past the wrap that I can't say for sure if I still felt the heartburn sensation or not. I don't think I did though. After 4 weeks they dilated the wrap and I know for sure I didn't have any of the heartburn then. Also, I was told that the nerves they mess with there can cause some issues like this also. If the antacids aren't helping and they did prior to surgery, I would think it is something other than acid.
My whole ordeal with the redo is long and drawn out. It would take me a day to write it all. If you want to just back search on the " Where in the world is Bill" thread. I think that will have most of the story. It is probably somewhat entertaining too. Anyhow, I hope things get better.

Take care,
BIll

beareilly
Veteran Member


Date Joined Mar 2009
Total Posts : 553
   Posted 8/9/2009 8:42 AM (GMT -6)   

H Istek,

 I hope ur felleing better.

Hii denise & Bill,miss u guys hope al is well

B


lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/9/2009 8:42 AM (GMT -6)   
Ah ha, I see Bill. What a story. You really had a tough go with the first wrap. I am glad to hear the second round has been better for you. I really appreciate you sharing your story. It gives me the lift I will need to wait out the next month or so post-op. I must say, it does seem as though my nerves got jumbled in there. I still get a bit of that shoulder pain from the diaphragm repair and get jumpy--like restless leg, but actually restless body--- at night. I will update soon. Thanks again.
lstek

PedsRN1
New Member


Date Joined Aug 2009
Total Posts : 9
   Posted 8/11/2009 8:39 AM (GMT -6)   
I am 11days post Nissen and have had the same burning feelings... my dispair was put to rest when I followed up with my surgeon yesterday. It IS normal because he said the esophagus is healing and food/drink stay there longer than normal due to swelling and swallowing slower since surgery and this should resolve. I got to advance to a soft diet last night for supper... fish and green beans... what a nice change, it went well just supper small bites and chew WELL. I hope that you are feeling better... keep in touch since we are 2 newbies :)

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/11/2009 9:10 AM (GMT -6)   
that is encouraging to hear. I have my follow up this coming thursday, and hope to have my fears put to rest as well. I am still very suspicious of mine, since is does seem to feel worse when I lay down for bed at night....just like the old days. I also have this burning all the time, with variances in intensity only. I still have very little luck with antacids, so I have that going for me. I look forward to keeping in touch. I am at the 2 week mark tomorrow and have burning since leaving the hospital. I hope the surgeons are right!
lstek

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/11/2009 4:11 PM (GMT -6)   
Hi Lstek,
Do you have your bed elevated and/or are you using a wedge pillow? It might be helpful during the healing stages. I always noticed that there was more pressure on my wrap when laying flat, so took to continuing with the raised bed/wedge. You're still healing, and I don't really think it's unreasonable to take the pressure off when sleeping.
Just a thought. It has been helpful to my recovery, so thought I'd share it with you.
Hopefully your surgeon will provide you with some reassurance.
Don't worry!
Denise

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/12/2009 8:35 AM (GMT -6)   
Yes, I do still have my bed jacked up, and even added in the old wedge pillow last night for a bit extra. Same thing...lay down at night and it revs up. same old pattern. perhaps they should have looked deeper into the root cause of the reflux. I will continue to wait, and plan on the ph test in a few weeks. I go to the surgeon tomorrow, and hope to be inspired. thank you for the thoughtful comments.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7188
   Posted 8/12/2009 9:07 PM (GMT -6)   
Good luck with your visit with the surgeon. Two weeks is still pretty early in recovery, and you could have swelling that is, indeed, allowing acid to slip through. That doesn't mean that your wrap isn't successful. Everyone's recovery is different. I did have some reflux feelings from time to time, and it did scare me. My surgeon warned me that as the wrap heals, reflux feelings and even real reflux can occur. It's variable, depending on each individual experience.
I hope you get things straightened around soon. Don't jump to conclusions. Try to relax and trust.
I wish you all the best results!
Denise

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/14/2009 10:03 AM (GMT -6)   
Well, I had my surgeons appointment yesterday. He does feel that my surgery was successful, given the fact that I can not burp and have gotten some food stuck in my throat. So, that is encouraging. I asked about the continued burning and he mentioned 2 options.......acid not passing quickly enough through the esophagus, and some type of nerve/muscle response due to trauma over time. I will wait another 4 weeks and call for a ph test if burning persists at that time. He gave me a perscription for ativan to try as a smooth muscle relaxant, hoping it would help the burning. I tried 1/2 a pill last night and felt nothing....not even the relaxation it is supposed to offer. I will try a higher does tonight to see.

But, here is where I would like anyone's thoughts. I woke in the night about 3 am with the usual burning. Decided to try gaviscon again. about 10 minutes after taking it, I did get some relief. But, strangely, this relief was short lived, and about 10-15 minutes later the burn was back. It would seem to me that this means it soothed the esophagus as it worked its way through, but when it had all entered the stomach, it no longer helped. Make sense? I am trying to decide if I should bother with the gaviscon since it does cause some lower GI symptoms that I'd rather avoid if I can right now.

As always, thank you for your comments. They have been very helpful thus far. happy weekend to all. I am off to the beach with the kids to try to forget about this stuff for a bit.
lstek

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 8/14/2009 10:06 AM (GMT -6)   
ps--the condition when the esophagus empties slowly is called achalasia. I was tested for this before surgery with 2 motilty tests and came back as not having it. Can surgery cause this?

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 8/14/2009 1:32 PM (GMT -6)   
lstek-
True achalasia is a nerve/ muscle problem with the LES. The surgery can cause a similar issue because the wrap tightens the LES. IT is designed to do that to stop the reflux. It is common to have a tight wrap for several weeks after surgery. Quite often it loosens or relaxes I guess is a better term, and things move through easier. In some drastic cases they may have to dilate it if things cintinue to get stuck.
Since it wasn't indicated before surgery I wouldn't think you have true achalasia, but durphasia caused from the wrap being a little tight yet. Giving it about 4 more weeks sounds about right from what I have been told by the surgeons in the past.

Take care,
Bill

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 9/13/2009 8:55 PM (GMT -6)   
I am back with an update. I am almost 7 weeks post-op and still burning. I have a ph test scheduled for next thursday, so that should tell me more about the reality of what i am dealing with. is it still constant reflux, or is it this visceral nerve sensitivity from prolonged acid exposure. I am wondering about others experiences with the post-op reflux and how it felt. mine is constant and fluctuates only in severity. It seems to be worse at night, but not good during the day. Often the burning is high in my throat and even seems to irritate my nostrils. All this is the same as before surgery. Is it possible for overwrought nerves to make your nostrils burn? I am skeptical of that. I would love any feedback available.
thanks
still burning
lstek

rlopez75
Regular Member


Date Joined Jul 2009
Total Posts : 199
   Posted 9/13/2009 9:37 PM (GMT -6)   
lstek, I too have been feeling the "burning" since the 3rd day of my surgery. Tomorow monday will mark 5 weeks. I have no other symptems of GERD though. No flem, bad taste, or that fluctuating burning pan that I used to feel. I can lay donwn flat to sleep or rest too which is something that I could never do before. What I feel is more of a consistant inflamed type of burning pain. Like a stretching type of pain, I guess would be the best way to describe it. It still hurts to take a deep breath and feels like there is some resistance there. Swelling I guess...? I dont know if that is some thing like what you're feeling. I have days that it actually goes away but returns a day or 2 later and lasts for weeks again. I had verry sever inflimation because of the erosive esophigitis I was dealing with so for now I'm passing it off as severe damage that is taking long to heal because of food and drinks that I consume dayly.

I hope we are both just still experiencing part of the haling process but please keep us posted. it would be nice to know what to look for and ask the doctor is it persists as long as your has. Its still 3 weeks before I see my surgeon again so hopefully by them this will subside or deminish.

Best wishes,

Rafael

lstek
New Member


Date Joined Aug 2009
Total Posts : 17
   Posted 9/13/2009 9:56 PM (GMT -6)   
Hi rafael,
Well, it is nice to talk to someone else who is still burning. I never had much in the way of regurgitation, so that does not present a problem. My symptoms now are essentially the same as before the surgery.......constant throat burn both at the top and often down low by the les. It does still feel like it gets worse at night, and when i lay down....that is why i am most suspicious that I do indeed still have reflux. The pain wakes me in the night. I suppose it could all just be the damaged tissues still transferring pain in the same way as before( as I have read about online). I did have a lot of tissue inflammation at the time of surgery. unlike you, i am pretty convinced I still have reflux........especially with my nostrils burning. hope i am wrong. you sound a bit better off, with days of no burning and it not getting worse at night. i suspect you indeed do just have the inflammation.
lstek
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