Problems following Nissan Fundoplication procedure

Has anyone had Nissan Fundoplication and then experienced GI disorders, particularly with motility? I developed bacteria overgrowth up to 4 years following this procedure that I had for GERD. I suffer with daily stomach pain, alternation between constipation and diarrhea and have nausea. I have been on antibiotics for several months and a motility drug called metoclopramide. I'm better than 6 months ago but struggle daily with the above symptoms. My first GI doctor diagnosed me with IBS, however, none of the meds for IBS worked for me and in some cases, worsened my situation. I sought out another opinion and my current doctor gave me the meds I'm currently on which did help. She feels my vagus nerve was irritated during the fundoplication and now the motility of my colon is affected which is causing my current problems. After 4 months under her care, she says this is the best I'm ever going to be. A little disappointing as I have to work full time and I struggle with this every day. Any similar problems out there with some hopeful cures? Appreciate any discussion about this.

Suffering in Oshkosh, Wisconsin

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I am sorry that you are having problems since a nissen fundoplication procedure. It always saddens me deeply because I have also had trouble resulting from my own nissen fundoplication surgery to treat reflux and a loose lower esophageal sphincter. I did fairly well afterward for awhile, except that I found myself belching a lot more and at strange times. Then about five or so years afterward I started having trouble with swallowing which progressively got worse. It was eventually decided to take down my nissen and during the surgery it was found that a great deal of scar tissue had built up and was probably the cause of my difficulty in swallowing. It was in the fall of that year when I started my senior year of college that I started developing the symptoms of gastroparesis such as being unable to keep down food, nausea, loosing weight. I was then officially diagnosed. The doctor who made that diagnosis thinks that my nissen fundoplication may have been a mistake in the first place and that I may have had gastroparesis before it was first done and that the doctors at the time should have done more tests. I am not sure what the cause of my gastroparesis was, but it is hard not to think that the surgeries which were both open and not laparoscopically which has less risks may have aggravated my condition. How was your nissen fundoplication performed? I noticed that the motility of my digestive tract seemed to get worse slowly from the top, the esophagus, then to the bottom, as although I could tolerate j-tube feedings for about a year, it got to where I was no longer absorbing them like I should. I want to share the rest of my story not to scare you as I am among some of the rarer and more severe cases, but so that you may continue to have hope that there can be hope even in desperate circumstances. I would not give up. If you think that your doctor has given, perhaps it might not help to seek a second opinion. A different perspective might help provide some more insight. This certainly was my case when I had to put on TPN but in order to get the calories I needed, my sensitive liver became damaged. The situation continued to get worse, and my main doctors had no idea of what to do and had pretty much suggested that they had given up, but fortunately the doctors who I kept seeing in the hospital for line infections brought up the idea of a transplant. I eventually ended up with a new liver, spleen, pancreas, stomach, small and large intestine by chance on my 25th birthday, the best gift I could have ever gotten. Even though I still have some issues with which I struggle, I now have better hope for the future. So please do not give up.

Have you ever discussed with your doctor about any of the other motility medications such as Erythromycin or Domperidone to see if you might get better results with either of them? Some people have had success with the gastric stimulator. It does not actually make the stomach work, but through the impulses it sends, it may help reduce the symptoms of nausea and vomiting for some people. Have you asked whether it might help to take an antinausea medication if you are not already?

I hope that you can find some solutions that will help to improve your health. I will also be sure to keep you in my thoughts and prayers. I know dealing with this can be so overwhelming at times, but always know that there will be someone here to lean on. Many, many hugs.

Warm regards,
Bobbiejo

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Bobbiejo,
Thank you so much for your warm reply to my new discussion. I did have the laproscopic nissan fundoplication. I am so humbled by your situation. My troubles are small in comparison. I do hope your days are much better with your transplant. If I could turn back the hands of time I would have never had the nissan and I would have dealt the best I could with the reflux problem. At least I could function when I had reflux. In any case, I will try to make the best of my situation and I will question the doctor about the medications you suggest. I'm so grateful to you for sharing your story with me and I too pray your life is much better these days.
Blessings~
Connie

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I also had a nissen fundoplication and my gastroparesis started immediately after. I lost a lot of weight and could not eat due to nausea and trying to vomit but couldn't due to the nissen.

It now has been confirmed that my vagus nerve was probably severed in the surgery. Mine was also done laparoscopically.

I now have a j tube for feeding and a PEG tube for draining/venting.

I worked for about 6 years with all of the problems and at that time on TPN. I went on disability and that has helped my symptoms a lot due to less stress, etc. that goes along with working full time.

I am trying to live one day at a time and hoping that in the future there will be a cure for gastroparesis.

I have also heard of others that have gastroparesis after a Nissen.

Linda

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OMG....I hear ya, Seymore. I had the procedure 10 years ago. I dropped all the weight I had gained from the hiatal hernia and GERD. I wasn't digesting food and completely reguritating what food I did eat. I had to have my esophagus stretched a few times afterwards. Besides not being able to vomit or burp....I actually felt good. I didn't have heartburn and only occasionally would I have tightness in my esophagus. It was heaven to be able to eat veggies again and salsa. I'm Italian, and not being able to eat sauce and meat was killing my soul!!!!! So, it was nice to feel normal again, and not like some blubbering, crying ball of pain. All was well until about 2-2/12 years ago. I started to experience heartburn again as well as a multitude of other symptoms. Severe bloating and severe pain in my left side right under my breast. I was wondering if it could be adhesions...as when I would bend over or twist a certain way it was as if someone was raking a knife across my gut.
My days are now filled with pain pills & nexium. My stomach hurts before, during and after I eat. I live on a diet of rice, spinach & chicken...fake eggs and fake bacon in the mornings. I have cocktails maybe once a week and usually get horrifically ill after I do. My vino now is my enemy. I feel like someone is shoving a knife in my side. I haven't given up my coffee...and I just can't. I now mix it with my fiberone so that I can have a bowel movement as stool softners and laxatives kill me. My joints ache, my hair is thinning....I feel like an 85 year old and I'm only 34.

The GI I'm seeing now, upon my first visit said it was IBS. He had no interest in me whatsoever and rolled his eyes at me. Now I do have bowel issues from time to time....but I knew it wasn't IBS. My stools are either pencil thin or extremely loose. Pencil thin would indicate blockage or polyup. He put me on Hyoscyamine which only aggrivated my intestines more. I didn't have spasms, but after taking that I did...so I stopped. I had my follow up with him a few days ago and he actually felt a little bad that he didn't listen to me my first visit with him. I told him that I thought it disturbing that when I told him I had a fundiplication, that he didn't even want to talk to my old doctor or see any of the results. He thought I was faking it..even after seeing the 5 scars on my belly.
This last visit was good. I'm scheduled for my scopes this Friday.
I can tell you, I have never farted so much in my life than after this surgery. My boyfriend wants to call Ripley's or the Guiness Book of World Records. It's amazing, painful, embarassing and just down right weird. Thank God we both can laugh at it and he's not turned off by it. He's actually finding it endearing (what does that say about him? LOL) I thank the heaven's everyday for him.
The last 6 months have been the worst for me. I have finally found the man of dreams, getting my singing career going, we're redecorating our home, making a new start with my life and WHAM.....this starts up again. Some days are better than others. Some days it takes all I have to even get dressed and conquer basic daily functions. It's hard to keep up the morale....I know,Seymore. But I know that if I don't keep fighting and keep pushing....that I will succumb to worse afflictions. And I know it sounds hoakey and hippie, but remaining positive, and tuning into your body is the only way that you can beat this. By doing this, I now can literally feel the path of the food through my body. I have learned to feel everything and it's really helped me in getting my point across to my GI. I had to go into the appointment the other day with a badass attitude to make him listen...and he did. I told him that I want to keep my singing voice intact...and that the acid is destroying my opportunity. I want to stop hurting and want to start enjoying this beautiful life that I've finally be given. For the past two years I have been distant with my family and some friends....depressed by this problem.
Get second, third, fourth opinions...whatever it takes to find someone who will listen to you, believe you and wants to make you better.
Keep on your doc...don't let them feed you any crap. You know your body better than anyone. I will totally update you on the results of my scopes. Maybe in my diagnosis...we can get you on the road to finding yours.

Big hugs and hang in there!!!!!

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Mcmarie,
Thank you so much for sharing your story with me. I feel so much better knowing others out there understand what I'm going through and that I'm not losing my mind. Staying positive and being hopeful seems to be a common thread so I will do that. I will add you to my prayer list and hope for cures for all of us dealing with these motility issues....

Blessings~
Connie (Seymore)

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I had a nissen done and the GP worsened significantly immediately afterwards. I have a feeding tube for nutrition. I think the vagus nerve was injured during the surgery, but no one wants to admit that could happen. I'm not blaming anyone. The other surgery I had at the same time was celiac artery decompression and that's a very rare surgery so there may have been a lot of manipulation during the procedure. I didn't even know I had a hiatal hernia and after surgery, the surgeon said that I had one and he performed a nissen to fix it.

Mimi

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Well....I had my scopes done. I'm about to lose it! The wheel me into the room and the doctor didn't even remember why I was in there!!!!! I hate him!

They removed some pollyps and took some biopsies. I will get more results in the next few weeks.

I wanna shove a scope up his pooper and see how he feels that jerk! I'm laying there and he asks....so when was the last time I saw you, beginning of May?

I said, um no...4 days ago when you sheduled this procedure..... the nurses both rolled their eyes....fear immediately ran through my body. I couldn't get the morphine shot fast enough.

During the colon procedure I was screaming in pain...and he said that I shouldn't be feeling it...I told him to go F*&% himself that I was...and he kept shouting at the nurses to shoot me up with more meds....

He better start praying for my follow up visit...because he's gonna get it!

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I am another one on this site who had the nissan proccedure and ended up with GP. The proceedure was done as part of a larger surgery. I had a hiatial hernia that split my diaphram wide open after a fall off a horse. My stomach and intestines migrated into my chest and collasped my lung. The doc put the stomach and intestines back in place and sewed up the diaphram and also did the nissan. I was told that the proceedure went text book perfect. I had also been told prior to the surgery that there was a 10% chance that my vagus nerve would be damaged and GP could result. At the time I didn't think it was possible for that to happen on top of everything else (I couldn't be that unlucky!) and I forgot he told me that until months later when I was able to eat again but not able to have a bm. My surgeon had me sign a paper outlining all of the possible side affects of the surgery including death. But I was told that I had a 100% chance of dying without the surgery.

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Linda,
Did you have any medication before having a feeding tube? It seems that I'm not reading any results where people's GP was controlled through medication. I was doing well on metoclopramide and xifaxan for a few months but then the symptoms returned and now it seems worse. I wonder if the doctor will give me another line of antibiotics to help since I think my major problem is bacteria overgrowth in the intestines. That is what my only positive test resulted in. Did you have those things done?
Seymore

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Nancy,
How are you doing now? Are you on a feeding tube also like all these others I read about with GP?

-Seymore

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I was on Domperidone, Reglan, Erythromycin, and another drug that was taken off the market but I cannot remember at this time.

I had Botox injected 3 different occasions but it did not help. The 2nd injection did last about a week where I could eat.

I ended up with pyloric stenosis and had to have a pyloroplasty and that is when they put in the j tube while I was having surgery anyways. It was a good thing because I still could not eat.

It was thru many years of trial and error that I am now doing fairly well with the j tube for nutrition and the PEG tube for venting.

I do have small bowel bacterial overgrowth which was confirmed on breath hydrogen test. I alternate between Cipro, doxycycline, Xifaxin makes me sick and Flagyl. The Flagyl makes me sick so I don't use that much.

After all of this messing around, I finally had the 8 hour manometry test and that confirmed that my stomach is completely paralyzed probably due to the vagus nerve being severed during the Nissen.

The whole thing is just a bunch of trial and error in the early diagnosing of GP.

Mentally I am totally drained from everything, but at least I know exactly where I stand now and do not have to mess around trying to figure out what to eat, etc.

Hopefully this helps somewhat. Any questions, just let me know.

Linda/Ohio

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Hi Seymore,
I am doing OK. I am on liquid diet only. No feeding tube as yet.

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Linda,
How was it confirmed that your vagus nerve was damaged?

-Seymore

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Nancy,
How are you getting by being on a liquid diet only? Do you work, have a family to care for? All of this is so tough for me to deal with.

-Seymore

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There is no clear cut test that can tell exactly, but the motility doctor thinks that is what happened.

The surgeon said that it can also be caused from scar tissue building up around the vagus nerve, but I had symptoms immediately after the surgery and that is why they think it is from the nerve being severed.

Linda

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Hi Seymore,
I do understand how hard it is to keep going. And I know that is is harder for some then others. It is hard for me too. I do work. I sell real estate. It can be very demanding. Driving buyers all over, showing properties, constantly on the phone, lots of paperwork and computer work. I start my day with pineapple juice, frozen strawberries, miralax and soy protien powder in a blender. Lunch is Slimfast and then for dinner I have V8 juice and sometimes some type of broth soup, or another Simfast or cranberry juice. I drink Chrystal Light all day long. Sometimes have yougart or ice cream. I can tolerate chocolate OK and in the begining ate alot of it. But now I stay away from it as I have gained weight. I get a lot of sugar between the fruit juices and the slimfast. I have to push myself alot. I don't have very much natural energy anymore. I was walking a few days a week until I got sick (bad cold that went into bronchitis) about 10 days ago. I can't change what is going on with my body. But I can try like heck to make the most out of the life I have now. And that is what I am trying to do.

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I also had a nissen done 7 years ago and now experience pain under my upper left breast. I had an upper GI done and my stomach is not emptying, gastroparesis. I went to see a surgeon yesterday who wants to do a pyloroplasty. Anyone have one done yet? Any complications?

She also told me that since I do have gastroparesis, I no longer produce gastric acid, so I can discontinue taking nexium. The nexium is listed in the American Gastroenterolgist website as a reason for having trouble emptying the stomach. Catch 22. I hope you get better! There seem to be a lot of us in this mess.

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Lucy,
Is the pain steady or does it come and go when you eat? If it is related to your eating it could be when your stomach is full, it is putting pressure on a nerve. Have you ever been told you have a haitial hernia? If so it could be the source of the problem. Way before my nission my problems started out as left sided chest pain under my breast. I ignored it as long as I could until the pain got so bad I couldn't stand it. Now I wonder if I had gone to the doctor when the problem first started would I have had an easier surgery and not have the GP now. In any case chest pain should not be ignored.
Good luck and keep us informed!
Nancy

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I did have a hiatal hernia that was repaired with the NIssan, which has come undone, so the hernia is back. I think your right, the pain is caused from my stomach being full. I go for a CT scan on Wednesday to see if anything else is going on. Thanks!

Lucy

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I am the one that they removed the vagus nerve when I was 24 years old, I am and have lived through pure misery and hell my whole life. I am 61 and the DR'S tell me
they can't believe I've lasted this long. I am thankful, but
I am in excruciating pain, diarhrea and vomiting endlessly, fibromyalgia, chronic fatique syndrome, crash with my pancrease not knowing when to give me insulin,
passing out with no warning. The vagus nerve is one of 12 Main nerves that control the body and its function from the brain and goes throughout your body and controls and tells your body how to function. God gave us everypart of each thing that goes to the brain and tells the body what to do. Its like driving a car without a steering wheel. In 2007 they gave me a Gastric bypass surgery for my dumping syndrome because it was so bad. This was not for Obesity. Now the Dr's are telling me I needa Reversal to be able to Live. Because I am so Malnutrition from no absorption of any Vitamins, minerals,iron or anything to sustaine life. I am right now so weak I barely can walk, but I look like I am healthy when you look at me. My Primary care physician is wonderful, but tells me that the surgery would be very dangerous and risky. But I have no quality of life in my present condition. I talk to a Baylor Surgeon in Nov., may not find a Dr to do the surgery. No one understands my
condition. I have a wonderful supportive husband that
says he understands which helps tremendously. I'm
looking to God for a Miracle now. I have to believe that
by his stripes we are healed.

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