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organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 3/27/2014 1:26 PM (GMT -6)   
Hi,

I am just over two weeks post Nissen surgery. My surgeon asked me to cut my Esomeprazole and Ranitidine by 50% as soon as I had my surgery. He then said to start taking them every other day after two weeks.

For the last few days I have had reflux. Is this due to rebound from cutting my medication by 50% or a sign that the wrap has failed?

Should I hold off taking them every other day until the reflux subsides? If it doesn't subside should I go back onto what I was originally on until I see my surgeon? I am not due to see him until the 14th April.

I appreciate your thoughts.

TonyG
Regular Member


Date Joined Apr 2013
Total Posts : 254
   Posted 3/27/2014 1:46 PM (GMT -6)   
Hello!

Congratulations on getting wrapped! Hopefully you'll start to feel the benefits of the procedure soon.

You may not be experiencing true reflux, but only discomfort masked as reflux. The esophagus is a dumb organ. The only way it knows how to communicate pain or discomfort is to make it feel like reflux or heartburn. I can assure you that this soon after surgery, with the amount of swelling that you're currently experiencing that you are definitely not having reflux.

After surgery, my surgeon told me to stop all PPI's immediately so I didn't get the opportunity to wean myself off of them but I found that I didn't even need them. Keeping warm liquids (green tea and tepid water were my friends after surgery) handy helped soothe my esophagus and keep the reflux-like symptoms away. Obviously if your symptoms get worse (to the point where you were pre-surgery) you should call your physician.

Be well and take care,
-TonyG-
-TonyG-
Nissen Fundoplication April 30, 2013
Pain-Free, Reflux-Free, Sleeping on my back!

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 3/28/2014 3:22 AM (GMT -6)   
Thanks for your response Tony.

How have others come off PPIs and H2 blockers after Nissen surgery? Did anyone get rebound? How did you deal with it?

I have read a few posts on here suggesting it is better to stay on these medications until the wrap has healed. Anyone have experience of that?

Thanks.

Sleepyb
Regular Member


Date Joined Feb 2014
Total Posts : 27
   Posted 3/28/2014 9:36 AM (GMT -6)   
Hi O-A,
Doc told me to use the ppi's for 2 weeks after surgery, but since I was almost out, I just stopped. Had no issues.

TonyG
Regular Member


Date Joined Apr 2013
Total Posts : 254
   Posted 3/28/2014 11:00 AM (GMT -6)   
I think it's all dependent on the surgeon's opinion and experience. I didn't get any rebound at all and almost a year later, haven't had any.

Be well!
-TonyG-

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 4/1/2014 9:46 AM (GMT -6)   
I had the worse night with a stuck pill and swallowing difficulties. I seriously thought I was going to have to go to A&E.

I have just been to see my GP to get all my medications in liquid form.

How long do the swallowing difficulties and swelling usually last?

Tomorrow Ill will have made it to 3 weeks post Nissen surgery.

Thanks for everyone's help.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5013
   Posted 4/1/2014 11:09 AM (GMT -6)   
3 weeks is very early in the course of Nissen recovery. It can take weeks to several months to get pre-op swallowing back. There is swelling for a long time. How well you swallowed before the surgery determines what you can expect - and should have been tested before surgery. I have polio throat, so my wrap was a partial.

Don't complain too much about swallowing too soon, unless you can't swallow liquids. Some docs will immediately want to do a dilation. I had one resident who wanted to do a scope and insisted that he would do a dilation also, even though I refused it! So I said no scope. I could not convince that dunce that I was swallowing as well post-op and I had pre-op, due to the polio. There is no point in wrecking a perfectly good wrap unless after a very long time you still get soft foods stuck. Actually, some soft foods can stick before they ever get to the wrap. I can feel toast bits in my throat, well above the valve, for as much as half an hour and have to wash them down with my coffee. My problem is not due to the wrap. Part of the problem, besides a weak swallow as tested, is pain meds that keep my throat very dry. So, consider that as something that can affect you also.

If you can't stand to chew meds and don't have them as liquid, one secret is butter. They're tasty that way too. Check what the manufacturer allows. Some capsules can be sprinkled on applesauce. Don't mess with time-release if the method involves the pill or capsule shell like a tiny hole for release. But, Nexium says their coated granules can be sprinkled. Crushed meds that are bitter - try putting them in strawberry jam. I just chew my tramadol and ignore the taste.

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 4/1/2014 2:32 PM (GMT -6)   
I understand it is normal to have swallowing difficulties after the operation especially with eating and taking pills. I presume these normally get better with time.

But I also have swallowing difficulties the rest of the time. It feels like a lump in my throat, it is painful when I swallow and I am having to clear my throat often. Is it normal to have that after the operation? Or could it be caused by rebound from cutting my meds by 50%? My GP said maybe my wrap was too tight?

Thanks.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 4/1/2014 10:07 PM (GMT -6)   
OA-

It is normal to have swallowing issues period during this recovery. It will get better, but as Alcie said it can be a few weeks to months. This is a slow recovery and it takes a lot of patients to get through it.

It's WAY to early for anyone to say if the wrap is to tight. that can't be determined until 6 months minimum and maybe more like a year.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 4/2/2014 1:47 AM (GMT -6)   
Thanks for the reassuring comments.

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 4/11/2014 1:41 PM (GMT -6)   
I am 4 weeks post Nissen. I am trying to make the transition from mashed + pureed food to light foods with more texture e.g. stews.

I am finding I get the same feeling like I did when I couldn't swallow pills. It feels like the food is stuck above the wrap. I also feel like I cant swallow and experience a minor pain in my chest. I have tried using soda water to wash the food down but it doesn't seem to be budging.

Did others experience similar problems when they tried to eat foods with more texture? I am supposed to be able to eat toast and salads at this point too but I cant imagine being able to eat them if stew is so difficult.

Altair
Regular Member


Date Joined Aug 2013
Total Posts : 39
   Posted 4/11/2014 2:42 PM (GMT -6)   
I am a week and a day post Toupet fundoplication. I was advised to stop all medication immediately after surgery (domperidone and Nexium). I definitely have swallowing issues with anything beyond liquids at the moment. I have pills (no idea why I was given solid pills and not dissolvable or a liquid formulation), and I have to cut them up into 1/4ths or even smaller to swallow them. And even then, they feel like they get stuck and sometimes I get a reflux-y like sensation. I too panicked and thought my wrap had failed, but I think it's probably just the digestive tract not being very happy with what it has gone through, and still in the process of healing.

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 4/11/2014 7:38 PM (GMT -6)   
OA-

Remember to chew your food extremely well. You are still very early in recovery. Chew to a liquid still and small bites. Be sure to drink somewhat room temp water, it helps keep things from constricting.

Every time you advance your diet expect some set backs as your body adjusts to the new food.

It will get better with time.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn, Kidney disease

Nissen 6/06 and 5/09
#3 8/24/11

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 5/10/2014 12:40 PM (GMT -6)   
opnwhl4 said...
OA-

Remember to chew your food extremely well. You are still very early in recovery. Chew to a liquid still and small bites. Be sure to drink somewhat room temp water, it helps keep things from constricting.

Take care,
Bill


8 weeks post Nissen.

Lost 30lbs and off all medication.

The food is going down ok now as long as I remember to chew.

I am still struggling with drinking cold or room temperature water. It feels uncomfortable when I swallow a normal amount. Do I need to sip instead like after surgery? Does this get better over time? Warm drinks go down ok.

Thanks.

JulieUK
Regular Member


Date Joined Apr 2014
Total Posts : 27
   Posted 5/11/2014 12:58 PM (GMT -6)   
I thought I had reflux problems too after the Nissen, but it was due to me trying to eat too much, once I cut down the size of portions, it was so much better. I stopped my meds straight away with no probs. sometimes I thought I had heartburn so took some Gaviscon and it disappeared.

It does take a long time to feel better, you will get there.

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 5/26/2014 8:03 AM (GMT -6)   
10 weeks post Nissen.

I am travelling in America and the swallowing issues have come back.

It has been harder to control what I eat while away from the UK.

I have transitioned from soups to harder to eat foods like sandwiches, salmon, chicken, baked potatoes, pasta etc. while away. It now feels like a constant lump in my throat.

I have also been drinking a lot of the US style percolated coffee thinking it is harmless as it is weaker than UK coffee. I wondered if both of these have aggravated my symptoms?

Should I go back to softer foods like soup and lay off the US coffee? Is the general consensus when you struggle post Nissen to go back to where you were comfortable in the post surgery diet?

Thanks.

JulieUK
Regular Member


Date Joined Apr 2014
Total Posts : 27
   Posted 5/26/2014 9:57 AM (GMT -6)   
Hi

I still drink decaf coffee, it seems to help. Certain foods definately irritate, but it does pass. Enjoy your travelling and try not to eat too much bread, that also makes it worse

Julie
Julie
Post Nissen surgery

organic_addict
New Member


Date Joined Mar 2014
Total Posts : 12
   Posted 5/29/2014 1:06 PM (GMT -6)   
Thanks for your comments Julie.

I know post fundoplication swallowing difficulties or difficulties getting food pass the wrap are common. When did these improve for people?

When were people able to eat regular meals and bread?

Do most people start drinking coffee again?

Or do people stay on the anti reflux diet to allow the wrap to heal? If so for how long did you stay on the anti reflux diet post op?

Thanks.
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