Q.Two months ago I had a Nissen fundoplication for severe heartburn. After the surgery, I had minimal swallowing problems and my reflux is actually better now. But the results of an upper GI today show that my Nissen has somehow come undone. Although my heartburn is not actually troubling me right now, am I correct in assuming that it is only a matter of time before it returns?
Also, have you heard of having this procedure done again if it come undone the first time? Drugs and lifestyle changes haven’t worked in the last 20 years, and I don’t want to be left with no options.
A.A Nissen fundoplication is an operation performed to help prevent gastroesophageal reflux. The procedure involves bringing the upper portion of the stomach up to wrap around the bottom of the esophagus. The operation is successful about 92 percent of the time.
A. The primary measure of success is relief of heartburn. That has occurred in your case. The operation comes undone only when it has not been properly placed; this is not to imply a mistake on the surgeon’s part, but simply to indicate that it was nothing you did that caused it to fail. If the operation comes undone, symptoms usually return fairly quickly — usually within weeks or months.
Though an upper GI can suggest the wrap has “slipped” or come undone, it does not provide a definitive diagnosis. The best way to verify that you are having reflux after unsuccessful operation is to have a prolonged esophageal pH monitoring study, in which the amount of acid refluxed into your esophagus is measured over a 24-hour period. Ask to be referred for this test. You may be worrying needlessly.
If your operation has come undone, it can be redone, but the procedure should be performed by a surgeon who specializes in this field. First, though, be checked to be sure it is really undone. You may be pleasantly surprised.