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Hiatal Hernia Partial Wrap


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#1 Kamlesh

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Posted 30 September 2007 - 05:28 PM

All,

I believe this topic has been discussed in past, but I do not have the link to the topic as well as I thought I may benefit experiences of many new members.

I am looking in to surgical option for acid reflux.

My GI specialist and surgeon are considering partial wrap.

I understand it is laparoscopic procedure and can be undone (with surgery).

Has anyone gone through the procedure?

Anyone has experience with undoing the surgery. I remember from one of the discussion that undoing surgery is lot more complex than the initial surgery itself.
Kind regards,

Kamlesh


#2 Shelley Ensz

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Posted 01 October 2007 - 06:21 PM

Hi Kamlesh,

My husband had a Nissen surgery a few years back, in preparation for his lung transplant listing. It worked perfect for him, he hasn't had reflux since. He had an excellent, experienced surgeon with a great track record at a major medical center.

But, Barbs had the surgery and ended up in the hospital for a year and on tubal feeding.

If you are contemplating it, one of the most important factors is finding an outstanding surgeon who specializes in this procedure and has a great success rate. Otherwise, you are probably playing with fire and should leave well enough alone -- because most of the surgeries done by my husband's doctor entailed correcting Nissen's that had been done wrong.

Gene had to have the surgery in order to qualify for the transplant listing, otherwise he more than likely would have never had it.

Good luck in figuring this out and in making your decision on the matter.
Warm Hugs,

Shelley Ensz
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The most important thing in the world to know about scleroderma is sclero.org.

#3 Kamlesh

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Posted 01 October 2007 - 07:53 PM

Shelley,

Thank you for your input.
My GI specialist and surgeon both are against full wrap. But, they may consider partial wrap based on all tests.
I may have to reconsider some of my decisions. Also, I may think about taking a second opinion.
Kind regards,

Kamlesh


#4 Joel

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Posted 03 October 2007 - 12:21 PM

Kamlesh,

I had a Partial Nissan Fundoplication about 4 years ago. My doctor's opted for the partial because of the dismotility of my esophagus. I have to be careful when I eat to make sure I have something to drink, sometimes food gets stuck. Nothing serious, just uncomfortable. The surgery definitely stopped my reflux. However, I am going to have it checked again in about 2 weeks. My doctor wants to put in a 24 ph probe.

My pulmonologist at the UW Med center feels very strongly that reflux is causing pulmonary fibrosis in a lot of people. So, having SSc he has been extra protective of my already compromised lung condition.

All in all the surgery was successful. Oh, when the doctor tells you not to eat solid food to soon, believe him!

#5 Kamlesh

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Posted 03 October 2007 - 03:25 PM

Joel,

Thank you for your response. I have a dilemma to have surgery or not. I have acid reflux which is under control by using Aciphex. However, fluid from stomach is going up in esophagus and lungs causing severe, but manageable cough.

I have gone through all testing required for GI specialist/Surgeon to give an opinion. I have an appointment with the surgeon on November 1st.
So, I have few weeks to think about it.
Kind regards,

Kamlesh


#6 CFMBabs

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Posted 06 October 2007 - 10:09 PM

Sorry! it's taken me time to reply but I was waiting to hear the outcome of my recent GI appointment -- my 6 month follow up.
Shelley is right about my surgery and the repercusions that followed! I had Nissen Fundoplication surgery in Aug 2005. What followed was from my point of view a nightmare! The surgeon did the wrap too tightly and I simply couldn't eat or drink anything. Also my swallowing had worsened in any case whilst waiting for the surgery to be performed (Waiting lists are very long on the NHS) To complicate matters further. They thought that I had developed Angina so delaying the surgery further. I had tests for this which also meant another lengthy wait, so all in all I waited 2 years before they went ahead with it.
I had a second op six months after to loosen the wrap but my swallowing had deteriorated so much that I still couldn't eat or drink properly. I was losing too much weight so they placed a feeding tube in my stomach and I began enteral feeding, unfortunately to date!
I had a 3rd op six months after the other where they took down the wrap and undid all the work. It was at this time that I developed pancreatitis and the reasons for my chest pain at the beginning was not angina but gall stones! So during the corrective surgery they took out my gall bladder as well. The procedure was an "Open procedure" meaning I now have a huge scar across my abdomen.

Present day! I visited my GI last week and to be honest I've been suffering bouts of choking. They are usually worse during the night and very frightening. I've had a few chest infections -- thought to be caused by my reflux!
My rheumatologist is very concerned about this so she wrote to my GI to ask if anything further could be done. My visit last week was one of dilemma's. My GI is willing and has advised me to have another op, this time a partial wrap to stop the acid/ contents rising into my esophagus at night. He won't do the procedure unless I'm 100% certain that I want to go through it all again! it will be another open procedure but not as dangerous as the last op.
I have 6 months to make up my mind and no doubt when I visit my rheumatologist she will have something to say about it!
As for me -- I don't know what to do? I'm really stuck between a rock and a hardplace with this one -- If I don't, I could choke or develop pneumonia again. If I have the surgery, it may mean another lengthy recovery. I've only just gotten over the last bout of surgery and my stomach muscles have never recovered.
Time will tell and I'm sure that whatever decision is made it will have been thought through very carefully. I think it will be the same for you!
I know of people with sclero who have had the procedure and have been more than happy with the result -- I was just a one off!
Good luck with your decision!

Best wishes
Barbs x

#7 Kamlesh

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Posted 07 October 2007 - 04:55 PM

Barbara,
Thank you for your response. My GI specialist is rightfully very careful. I consult two pulmonary specialists. One of them, a well-known specialist for lung cases in scleroderma insisted that I seriously consider surgery as the fluid (even though non-acidic) is going in my lungs and damaging my lungs. I have gone through esophageal manometry tests which showed I have no elasticity in my esophagus and food passes through esophagus through gravity. My gastric emptying test showed I take significantly more time for empting my stomach and shows clear indications of food backing up in esophagus.

My surgeon and GI specialist have completely ruled out full wrap. They may consider partial wrap. I have been careful what I eat and have been able manage reflex well using Aciphex. Aciphex works much better for me compared to Nexium.. I have an appointment with a surgeon on November 1st to decide further.

It has been really challenging fighting at three fronts – GI problems, Scleroderma, and Depression.

Sometimes I think without all these challenges my life would have been so boring. Just kidding!

Good luck to you for your adventure for partial wrap. I hope things will be much better for you this time.
Kind regards,

Kamlesh


#8 Sheryl

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Posted 07 October 2007 - 10:57 PM

Barbara, sorry to hear that you may be going through more surgery. Especially, having the open surgery. Maybe thedocs can do a better job that way. I wish you the best in your decision. I guess if things keep happening you won't have a choice. The decision will be made for you. Hopefully, you are building up your strength, toning muscle and what ever it takes to prepare yourself for time in the hospital. Sometimes it seems a waste since your muscles loose their strength and elasticity quickly while laying in a hospital bed. You go girlfriend, you've been there and done that. Experienced it all. You know what's coming. We will be here to help you emotionally or however we can. You should come on more often. I miss you. Others haven't gotten a chance to know anything about you. Or any of your mishaps. You are a stitch. I for one miss your antics here on the forum. Sheryl
Strength and Warmth,
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#9 autoimm2much

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Posted 08 October 2007 - 05:37 PM

I have a hiatal hernia, but I don't get acid reflux when it goes into the attack mode. Help, does anyone else have this: mine are like labor pains -- a sharp pain starts down in stomach area and moves up the throat, the pain gets sharper as it comes up. Then it goes back down for a few seconds, then moves back up again. It feels like a very sharp knife moving up my throat. After a few minutes, my mouth starts to salivate profusely, and I can't swallow it; there is too much pressure in my throat. There is no stomach acid involved at all, it' very scarey and painful though.

I have Bentyl for IBS and found that if I melt the capsule in my mouth and somehow force it down my throat, it will stop the horrible episode. That has worked for years.. till just recenlty. So I asked my GI doctor what to take for it, he said Nexium, and listed off a bunch of antiacids. I am really fearful of my next hiatal hernia attack right now, as I take Nexium daily, and have for a long time. I get an acidy stomach sometimes, but no reflux.

What's happening to me?? I hope someone can identify with this bizarre type of hiatal hernia attack and tell me what they do to stop them.

#10 eah

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Posted 09 October 2007 - 02:01 PM

Kamlesh,

I was told by GI & Pulmonary to consider the wrap. My scleroderma specialist said it was not a good idea for sclero patients to get the surgery because if you have a motility problem, it might make it worse later on. Everyone is different with the disease. What is good for one person may not be good for another. I would however recommend that you check with a sclero specialist before you consider surgery. Most GI doctors are not specialized in sclero. My rheumatologist is the scero specialist. Hope this helps.

EH
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#11 Sheryl

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Posted 10 October 2007 - 01:25 AM

A2, Reglan is what I used in conjunction with Nexium. Reglan helps me with the sharp pains and seems to stop an attack within minutes. Hope you find something that works. Sheryl
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#12 autoimm2much

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Posted 10 October 2007 - 05:47 AM

Thank you Sheryl, I will ask for and RX of Reglan.