Does Peristalsis/motility improve following nissen fundoplication.

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Trotters
Regular Member


Date Joined Jun 2014
Total Posts : 329
   Posted 8/22/2014 4:31 AM (GMT -6)   
Morning
Does anybody know if oesophagus motility/failed Peristalsis can or should improve following nissen.

I had the procedure performed 5/14 and it was quite obvious very early on that the op hadn't been successful in reducing my reflux and LPR symptoms. If anything, they are worse than before as I was on quite high dose ppi prior to surgery and was told not to take them following surgery. Anyway after a big battle my surgeon reluctantly agreed to repeat PH and manometry which I have recently had performed. I haven't had the official results but I was told that it looked like my swallows failed about 50% of the time. My previous manometry was performed 5 months ago with no problems whatsoever. I'm devastated that in such a short period of time and after having nissen that I've deteriorated so much. I'm not sure what the situation will be regarding a re-do, I hope they can perform a redo. Does anybody know if this is reversible and if high ues pressure can be reversed?

Many thanks

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 8/22/2014 7:57 AM (GMT -6)   
Trotters

I don't see the nissen reversing this type of issue, but I do question the validity of one or both of your manometries.

A huge issue post surgery with the nissen is to have food and such sit at the wrap area for extended time. This mimics reflux and can even feel worse. It happens quite often and usually corrects itself with time as the wrap heals and settles in. Sometimes they do need to dilate an overly tight wrap, but that should be reserved for the very bad case of this.

I know this sounds wrong, but it happens very frequently with full wraps. Until it settles in and loosens a bit it can cause exactly the reflux issues you've had and possibly the motility too.

The PH numbers would be better to have to see if it is reflux or not, as there is a slight chance it is. A better test is actually a barium swallow. It shows what is happening as you swallow and if there is anything sitting at the wrap or refluxing. This is how they determined I was having food and liquid sitting there about 6 months post op and even longer with my 1st one.

Please read a couple of the recent threads on people who have had the surgery in the last week or so. LD had problems early on and really didn't believe what we said could be causing the troubles. LD's response in one of the threads explains this and how things did work itself out with time. LD also explains to some newly wrapped members about how everything will take you to the conclusion the wrap has failed when it's very likely it hasn't.

If you get the numbers from the PH it will be of more help.

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

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

Trotters
Regular Member


Date Joined Jun 2014
Total Posts : 329
   Posted 8/22/2014 8:40 AM (GMT -6)   
Hi

Many thanks for your reply.

I agree with you and did very early on wonder if it was the case with food sitting a the top of my wrap. Since the op I have never really had any discomfort eating even in the very early days. The only sensation I get is an awareness of tablets/vitamins travelling down. I was reffered by ENT for barium swallow and I was told there was no sign of any hold up at the wrap, barium travelled through the valve with ease and quickly apparently. So I guess you are right, I'm just going to have to wait and see what the PH readings show. Its reassuring to read from your experiences that it is possible to have successful redo and obtain some form of relief. I live in hope. Thanks

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 8/22/2014 5:44 PM (GMT -6)   
Trotters,

Hope this helps you.

www.hon.ch/OESO/books/Vol_4_Prim_Motility/Articles/ART404.HTML

Pink

Post Edited By Moderator (dencha) : 8/23/2014 8:59:11 AM (GMT-6)


Trotters
Regular Member


Date Joined Jun 2014
Total Posts : 329
   Posted 8/23/2014 8:05 AM (GMT -6)   
Thank you pink. Very informative.

Guess it's all just a waiting game at the moment.

Hope you are ok. Take care

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7181
   Posted 8/23/2014 10:03 AM (GMT -6)   
Hi Trotters,

I totally agree with Bill's comments. At your early stage of recovery, you've got lots of healing to do, so it's way, way to soon to reach any panicked conclusions.

Healing takes lots of time. Six months for most of the healing, and a year for the rest. Your wrap will relax in time, and if it doesn't, then it is time to consider dilation.

It is most likely that you've got food/drink/even meds pooling at the wrap site. The fact that you haven't had discomfort swallowing doesn't mean that all the food is making it through the wrap.

Hang in there, and give your body time to heal. Try to have patience and trust in the process.
Hang in there!

Happy healing!
Denise

GERD/Heartburn Moderator
Nissen Fundoplication 2/09
Allergy/Asthma

"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.”
Eckhart Tolle

venu gopal raju
New Member


Date Joined Sep 2014
Total Posts : 1
   Posted 9/26/2014 4:56 PM (GMT -6)   
Hello All,

I have joined the forum recently. Would like to give background of my suffering. I am 35 and suffering from Lax les from the age of 16. On ppi from past 15 years. I feel comfortable only when i take at least one tablet (lansoprazole 30 mg) a day. But the side effects are horrible. Like IBS(at lease 10 times i have to go to wash room,most of the time immediatly after consuming any solid food even a biscuit will triger the sensation of emptying the Bowl),Flatunace,severe gas problem,head ache, throught the day i will be irritated. Mood swings and so on. Went through some of posts on this forum went throgh LF on 04/07/2014. Was able to drink full glass of Tender coconut the same day of the surgery. Did feel any pain but IBS got worsened. Now after 5 months Post operation Heart burning is back the way it was not sure what has gone wrong, surgeon is asking me to continue on ppi at least for 6 months. The surgeon is famous Barriatric surgeon in Bangalore with loads of experience more two Gastroentrologists recommended him. Not sure the operation is failure or my body needs more time heal. Any suggestions would be of great help.

Trotters
Regular Member


Date Joined Jun 2014
Total Posts : 329
   Posted 9/27/2014 2:53 AM (GMT -6)   
Sorry wished I could be of help but unfortunately I'm experiencing the same as you. I sympathise with your side effects due to ppi as I too also don't react well in them but they are the only thing that's keeping the heartburn and lump in throat under control. Stuck between a tick and a hard place. Hope you get some answers soon but I insist on seeing surgeon again soon and explain your reasons for not taking ppi. Maybe insist on a test to see if the surgery has done the job. Take care.
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