Deciding whether to get Partial Fundoplication (Surgery for GERD/Reflux) (pain, hernia)
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So, I've been suffering with reflux for about 4-5 years now (I'm 30 years old). I've typically just managed it with Nexium, and tried to keep a reasonable diet. Lately, though, it has gotten worse. Long story short, my gastro set me up with a consultation with a surgeon today. He was awesome - very knowledgeable.
Because of a manometry I had a few years ago that indicated that I have some swallowing/motility issues, the surgeon recommended a partial wrap (also including a fix to my hiatal hernia). My concern with the partial wrap would be effectiveness; he said that the full wraps have been shown to be more effective in American trials, but not in European trials (He also said that he's not sure if there's a difference). He also mentioned durability/lasting issues with this surgery (i.e. how long it lasts, for how many people it gets undone for, after how many years, etc.).
Anyway, my surgeon wants to some other tests, but basically recommended the partial fundo surgery for me. On the one hand, I want to have the quality of life that I once had before...GERD restricts what I do in my life, and makes and has made work and school harder. On the other hand, I want to make sure I'm not exchanging my current problems for some other problems (God forbid, even worse problems), to the point where if things go bad that I would wish for my old problems back again.
So, it's a major surgery. You are basically changing your insides/anatomy. You wouldn't do this unless you are totally sure that you need it. I'm going to be needing to do a lot of thinking. If anyone has any thoughts, it would be very helpful and appreciated.
Boy, I would get other OPINIONS before embarking on a major Elective surgery. A lot of people have gerd, acid reflux issues and I never had these and who knows why, could be the supps I take etc. I've heard enough negatives about nexium, isn't that the little purple pill.
One knows what they have now but after a surgery, too late to change anything.
There are MANY alternative remedies for this gerd reflux stuff. I would check every avenue before doing the surgery. There are MILES of alternative supports for your issue.
Oh I know nothing about the surgery recommended for you, and wonder just how it's changed your life so much, many people live very well with acid reflux/gerd and many I'm sure do alternatives for this issue.
I feel this way with any ELECTIVE surgery.
Last edited by jaminhealth; 07-21-2017 at 04:21 PM..
I'll be honest, it can be pretty severe. Sometimes, I get the classic "burning" symptoms, which actually aren't that bad. Sometimes I get these severe, deep, aching pains in my chest (these have sent me to the ER/Urgent care a few times, they ruled out any heart issues and are pretty sure it was/is reflux), sometimes I get nausea. I wouldn't be considering surgery if I could manage it.
Have you worked on your diet. MY dad drank alcohol all of his life and when he started to get that "burning" he stopped all whiskey and stayed with beer. He ate everything all his life but never heard anything beside this "burning"...never mentioned it after he quit the booze. Still drank some beer to his end at almost 96.
I would recommend doing a LOT of research on your own prior to taking this step.
My sister just had a Nissen Fundoplasty (probably complete, though I'm not sure) in April. It was a major, major surgery. She had complications and was in the hospital for 10 days. Now they say she is totally recovered from the surgery, but she has bad diarrhea more days than not, she can only eat small amounts of food at a time, and she is on a bland diet and is unable to eat many of the foods she used to enjoy. She had to have this surgery, because of a life threatening gastric torsion, but IMO the only reason to have it would be if your life is in danger.
I used to have GERD the way you describe it. (I got rid of mine probably 95% by slightly changing my diet and making sure I didn't lie down for at least 2 hours after eating.) The pain is intense. But it goes away and then you are yourself again. After this surgery you may never feel like yourself again. IMO, this surgery is NOT something to have electively unless you are literally going to die without it.
So, I've been suffering with reflux for about 4-5 years now (I'm 30 years old). I've typically just managed it with Nexium, and tried to keep a reasonable diet. Lately, though, it has gotten worse. Long story short, my gastro set me up with a consultation with a surgeon today. He was awesome - very knowledgeable.
Because of a manometry I had a few years ago that indicated that I have some swallowing/motility issues, the surgeon recommended a partial wrap (also including a fix to my hiatal hernia). My concern with the partial wrap would be effectiveness; he said that the full wraps have been shown to be more effective in American trials, but not in European trials (He also said that he's not sure if there's a difference). He also mentioned durability/lasting issues with this surgery (i.e. how long it lasts, for how many people it gets undone for, after how many years, etc.).
Anyway, my surgeon wants to some other tests, but basically recommended the partial fundo surgery for me. On the one hand, I want to have the quality of life that I once had before...GERD restricts what I do in my life, and makes and has made work and school harder. On the other hand, I want to make sure I'm not exchanging my current problems for some other problems (God forbid, even worse problems), to the point where if things go bad that I would wish for my old problems back again.
So, it's a major surgery. You are basically changing your insides/anatomy. You wouldn't do this unless you are totally sure that you need it. I'm going to be needing to do a lot of thinking. If anyone has any thoughts, it would be very helpful and appreciated.
I had Nissen Fundoplication performed about six weeks ago. It was the culmination of about sixteen years of trying to treat GERD with acid blocking and acid neutralizing medication. I eventually reached a point where when I would lie down, the valve between my stomach and esophagus would open and I would end up with a sore throat every morning.
The surgery is effective. I have been able to stop taking acid blocking medication (but not all my acid neutralizing medication).
The major downside I have noted is that I develop gas in the afternoon. The nice way to put it is that fundoplication restricts your ability to expel gas in one direction, so it has to go in the other.
There is some pain associated with the surgery, but I got over it reasonably quickly. In my case the surgery was done and I was released the same day. Some people have to spend overnight in the hospital. The surgery should be done through a laparoscopy(small openings).
Some advice for you.
1. Look up the procedure on youtube I found a video posted by a local surgeon who showed exactly what he did.
2. Talk to more than one surgeon. I spoke to two after doing research on the internet. One obviously had a lot more experience than the other doing the procedure.
3. You will probably have to do at least two tests before they will do the operation. Probably an EGD where they put a tube down your esophagus and examine it carefully. An upper GI series would probably also be done. This test involves swallowing a barium solution, so that a radiologist can examine how the valve between your stomach and esophagus is working. If these tests show problems, you are candidate for surgery.
4. Has anyone warned you about a condition called 'Barrett's Esophagus? Its a pre-cancerous condition in the esophagus. If you are on the verge of this condition, the surgery is appropriate. I was fortunate. Despite all the problems I had, no one ever noted Barret's Esophagus. I understand the desire to avoid surgery, but avoiding cancer is a goal that is even more important than avoiding surgery.
GERD is an extremely common problem. Most people treat it successfully with acid blocking medications like Pantoprazole. However, occasionally someone has a particularly severe case.
I had Nissen Fundoplication performed about six weeks ago. It was the culmination of about sixteen years of trying to treat GERD with acid blocking and acid neutralizing medication. I eventually reached a point where when I would lie down, the valve between my stomach and esophagus would open and I would end up with a sore throat every morning.
The surgery is effective. I have been able to stop taking acid blocking medication (but not all my acid neutralizing medication).
The major downside I have noted is that I develop gas in the afternoon. The nice way to put it is that fundoplication restricts your ability to expel gas in one direction, so it has to go in the other.
There is some pain associated with the surgery, but I got over it reasonably quickly. In my case the surgery was done and I was released the same day. Some people have to spend overnight in the hospital. The surgery should be done through a laparoscopy(small openings).
Some advice for you.
1. Look up the procedure on youtube I found a video posted by a local surgeon who showed exactly what he did.
2. Talk to more than one surgeon. I spoke to two after doing research on the internet. One obviously had a lot more experience than the other doing the procedure.
3. You will probably have to do at least two tests before they will do the operation. Probably an EGD where they put a tube down your esophagus and examine it carefully. An upper GI series would probably also be done. This test involves swallowing a barium solution, so that a radiologist can examine how the valve between your stomach and esophagus is working. If these tests show problems, you are candidate for surgery.
4. Has anyone warned you about a condition called 'Barrett's Esophagus? Its a pre-cancerous condition in the esophagus. If you are on the verge of this condition, the surgery is appropriate. I was fortunate. Despite all the problems I had, no one ever noted Barret's Esophagus. I understand the desire to avoid surgery, but avoiding cancer is a goal that is even more important than avoiding surgery.
GERD is an extremely common problem. Most people treat it successfully with acid blocking medications like Pantoprazole. However, occasionally someone has a particularly severe case.
Thanks for your thoughtful and detailed response. It's hard to really decipher what the right answer is, as people with problems will go on the internet to vent, while those that are happy may likely keep to themselves.
My surgeon wants me to do a Barium Swallow test, which isn't a really big deal. I've had a manometry before, which was horrible. Looking at the results, he determined that a partial wrap (I think it's called a touplet) would be the only thing he'd agree to do for me. As a matter of fact, even before doing the Barium Swallow (I'm having the test tomorrow), my surgeon already said I'm a candidate for this surgery (based on my past tests), and this is an HMO, so I don't think he's motivated by extra customers.
The thing that's scariest about this procedure is that it's permanent. It's not like I can just reverse it if I'm having problems. I'm most worried about potential swallowing issues and not being able to burp or throw up. I rarely throw up, but if you're sick, it could sometimes be hard to stop the urge.
Thanks for your thoughtful and detailed response. It's hard to really decipher what the right answer is, as people with problems will go on the internet to vent, while those that are happy may likely keep to themselves.
My surgeon wants me to do a Barium Swallow test, which isn't a really big deal. I've had a manometry before, which was horrible. Looking at the results, he determined that a partial wrap (I think it's called a touplet) would be the only thing he'd agree to do for me. As a matter of fact, even before doing the Barium Swallow (I'm having the test tomorrow), my surgeon already said I'm a candidate for this surgery (based on my past tests), and this is an HMO, so I don't think he's motivated by extra customers.
The thing that's scariest about this procedure is that it's permanent. It's not like I can just reverse it if I'm having problems. I'm most worried about potential swallowing issues and not being able to burp or throw up. I rarely throw up, but if you're sick, it could sometimes be hard to stop the urge.
I had most of your concerns and now that I have had the surgery, I realize that I worried too much about most of them.
You have trouble burping, but yes you can burp. I do it everyday. Compared to how I used to burp though its quite minimal. Since you can't burp you will expel gas another way
I wouldn't worry too much about being unable to throw up. You may even decide that its an improvement in your life.
I would encourage to accept the idea that sometimes the most conservative approach to medical care is not the best. By being extremely conservative, we deny ourselves many of the benefits of modern technology and medicine.
If you haven't spoken to at least one more surgeon though, you should.
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