How sucssefull is reflux surgery

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Just wondered how successful surgery is for reflux I have been told I am a candidate for surgery as I have significant reflux my lower esouphgal splinter is not good I don't seem to get any where with meds are the side effects from surgery just a couple of weeks or are there permanent side effects I know deep down I need the surgery just bit worried any advice would be much appreciated

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  • Posted

    Hi Russ,

    I had reflux reduction surgery by Laparoscopic Nissen Fundoplication 8 years ago. It was the best thing I ever did.

    PPIs are great at reducing acid but not reflux.

    I had originally been offered the surgery 20 years ago but it would have been open surgery and I was too scared. I was on very high dose (80mg) omeprazole for years inducing hypochlorhydria resulting in malabsorption of iron; I was anaemic and unable to walk 50 yards. And the PPI hadn't reduced my extra-oesphageal reflux symptoms. I was scared of all the horror stories but was desperate to try anything. The operation took about an hour and I went home the next day. Only felt a bit of bruising. Soft foods for a couple of weeks and then I was back to cycling building up fairly quickly to 20 - 30 miles a day before breakfast.

    Unfortunately my wrap came loose following 5 hours violent retching due to norovirus. About 18 months ago, I had laparoscopic Collis-Nissen revision that is more permanent. ^ months after that I cycled over the Andes.

    Check out DownWithAcid org uk and scroll down the contents list for links to the following: fundoplication (below the main Reflux heading) and right down at the bottom, the second appendix, NICE option grid.

    There's a link to "20 years later: laparoscopic fundoplication durability." a study published recently which concludes, "Long-term results from the early experience with LF are excellent with 94 % of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up."

    The NICE option grid compares lifetime PPIs vs fundoplication.

    If you want to read my personal blog of the operation, find my personal website: ChrisRob co uk, click on the Barrett's link and select The Laparoscopic Nissen Fundoplication operation from that page's contents.

    Good luck. PM me if you want actual lins.

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  • Posted

    Hi Russ

    Just out of interest can I ask how you managed to get told you were a good candidate for surgery. Was it your gp, gastro doc or ent doc? My GP isn't really taking me seriously bit I would be interested to know if I was a candidate I just dont know where to go!

    I feel for you with your predicament, I cant really give advise I just think if you are not getting anywhere with the meds you probably never will do, I would think if you have been offered the surgery then its probably the right option for you. It must be a very hard decision xx

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    • Posted

      Hi Laura I persisted with my gp he referred me first for endoscopy which showed scarring of my esouphagaus then tried the ppi meds to no avail then referred back to gi for ph monitoring which showed the problems i was having I think your right the surgery is prob for better I will discuss with the surgeon I suffer with ibs as well I don't know if that makes a difference .You really have to persist Laura pushing docs my go also didnt take me serious I just had enough change docs if you have to hope you get sorted you will be ok x
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    • Posted

      Hello Laura , I went to my GP and she wrote to the upper GI unit in my local hospitalwith my medical history ( Royal Berkshire Reading) after a few weeks they wrote back and said I would be a candidate for FUNDIPLICATION.. I've had gastro camera, 24 hour acid test and manomatory test.. I get results Tuesday at hospital appointment then after that I guess FUNDIPLICATION..
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  • Posted

    Quite frankly the worse mistake I ever made. I suffer from LPR and my symptoms are worse now. There are a lot of papers published that say Nissen is not so good for this type of reflux. I now also suffer from regular upset stomachs/bloating which can be a side effect. You need to weigh up the pros and cons = some people say the op was great and some regret it. I unfortunately thought it would help me but it hasn't. Good luck
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    • Posted

      Hi moonbuggy.

      So sorry to hear about your unsuccessful surgery.

      I too suffer with lpr, I have never had heartburn!!

      Was it the nissen you had? Are you back on medications now?

      What symptoms returned to you? I suffer with pain to talk, mucas at back of throat, wheezing and breathlessness and a chronic cough were these your symptoms too?

      Sorry for all the questions its just I been starting to consider if surgery could be an option for me, bit your post has thrown a spanner in my thinking lol.thanks x

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    • Posted

      Sorry your Laparoscopic Nissen Fundoplication didn't work for you. I get about half a dozen abstracts of new research papers in this specialised fielld every day and have never seen any that suggest fundoplication is not good for LPR, in fact the reverse.

      Refluxing matter from the stomach via the Lower Oesophageal Sphincter can continue fill column and breach the cricopharyngeal muscle that serves as an upper oesophageal sphincter. This is correctly termed extra-oesophageal reflux and commonly refered to as LPR. Reducing reflux at the LOS will prevent full column reflux and reduce any chances of extra-oesophageal reflux. (That, incidentally, was my main problem.which LNF cured.)

      If you have achalasia whereby the food remains in your oesophagus with no peristalsis to propel it to the stomach, LNF won't help. But that's why a manometry test is carried out in the work up assessment before the operation.

      How long ago did you have your operation? If the stomach bloating is due to it, and it is continuing after a few weeks, it is likely the wrap was done too tight. This could also account for any continued LPR symptoms since, as with achalasia, you may be retaining some food stuffs in your oesophagus which may push back to breach the cricopharyngeus. If this is indeed the case, you may need dilation whereby a balloon is inserted into the LOS via endoscope and either inflated with gas or mercury.

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    • Posted

      Dear Barretts

      I had the op a year ago and quite frankly have felt unwell since. I saw the ENT guys earlier this year and they said my throat was red (although a more recent scope said it was OK!). I feel uncomfortable when lying in bed and can only sleep semi upright. I have been wondering whether the HH has come back (along with the breathing problems). I also seem to have started uncontrollable sweating. I was thinking maybe vagus nerve damage may be the culprit. 

      This nightmare has been going on for 4 years and I really have had enough now. 

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  • Posted

    This is the abstract of one of the research papers I received today: "Antireflux Surgery and Risk of Esophageal Adenocarcinoma: A Systematic Review and Meta-analysis." by Maret-Ouda J. et al, Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden - Section of Gastrointestinal Cancer, Division of Cancer Studies, King's College London, UK.  published in Annals of Surgery.

    It concludes: "Antireflux surgery may prevent EAC [Esophageal AdenoCarcinoma] better than medical therapy in patients with Barrett's esophagus. The EAC risk after antireflux surgery does not seem to revert to that of the background population."

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  • Posted

    Russ, Mr Singh and his team from Frimley Park performed my surgery 3 months ago. I am feeling at least 10 years younger & I can now eat a good & varied normal diet.  I have to take extreme care & find 4 small meals suit me best but it's still early days. I can eat all the " tricky " foods like bread & home made pizza. I still have a little abdominal pain, some wind but no reflux & best of all no vomiting. I had giant hiatus hernia with some rotation so I had to have the op really.

    i am pleased to say that I am so much better in myself I can't believe it. My key holes are small & I can dine out & join in social activities again. I have not yet tried alcohol but that is such a small part of my life it's not a problem for me. I may risk a small glass of bubbly at a party we have been invited to but, general bubbles are best avoided !

    i wish you the very best.

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