What you're experiencing is totally normal. At four weeks, you're at the very beginning of a healing process that takes six months for most of the healing and a year for the rest. My surgeon told me that the esophagus is a dumb organ, and that it interprets all pain as reflux. You're getting healing pain/swelling pain, and your brain is getting the signal from your esophagus..."reflux".
Even though you're swallowing fine, your wrap is likely irritated and swollen. If you have Carafate suspension, I suggest you get as many doses in each day as your eating and meds allow. Be sure to drink plenty of water after taking other medication.
Take the Carafate two hours before or after medication. Take it an hour before or two hours after eating. After taking it, wait to drink water for at least 10 minutes, to give it a chance to adhere to the esophagus and wrap. It should help calm things down. I know that it's hard to get doses in. If you generally wake up in the middle of the night, it's a good time to get a dose of Carafate in.
Generally at 4 plus weeks, people start introducing more challenging foods into their diet, which is rougher on the wrap. All in all, you need to remember that you are at the very beginning of your recovery, even though it feels like it has already been a long time. Try the Carafate for the gnawing pain. Liquid antacids like Maalox coat and can relieve the gnawing, but Carafate coats and lasts longer.
I well remember worrying greatly about the possibility that I was having reflux and that my surgery was failure. That is not what's happening here. It's totally normal to worry, but what you're experiencing is definitely in the realm of the normal.
Even when your swallowing seems fine, you can be getting things held up a bit at the wrap site and irritating your lower esophagus and wrap. Take sips of water or tea after eating to ensure that the last bits make it through and into your stomach.
Hang in there! It'll get better...
Nissen Fundoplication 2/09
"Whatever you fight, you strengthen, and what you resist, persists.”
“Worry pretends to be necessary but serves no useful purpose”
“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”