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Complications from a Nissen Fundoplication

Complications from a Nissen Fundoplication

Recent studies by the US Department of Health and Human Services have shown that Acid Reflux, or Gastroesophageal Reflux Disease (GERD), or Heartburn, affects approximately seven million people in the US each year. Approximately 75%, or a little over five million people can control their excessive stomach acid through medication or lifestyle changes. That leaves just under 2 million who have to seek more aggressive treatments. One of the more popular treatments is a surgical procedure called Nissen Fundoplication.

The first Nissen Fundoplication was performed in 1955 by Dr. Rudolph Nissen and initially was called “gastroplication.” As you can imagine, the procedure was done as an open procedure and had a long recovery time. The procedure started gaining popularity in the 1970’s and now has developed into a less invasive procedure using laparoscopic methods, which reduces recovery time, and more that 40,000 procedures are performed each year in the US.

What is a Nissen Fundoplication?

A Nissen Fundoplication is a surgical procedure which involves wrapping the upper part of the stomach around the esophagus. This is done in a full 360 degree wrap around, which differs from a few other fundoplication procedures which involve partial wrapping. However, sometimes there are side effects and complications to this surgical procedure that you may want to be aware of.

Nissen Fundoplication is generally a safe practice and there are generally few serious complications or mortalities from the surgery. The mortality rate is less than 1%, which is very low and promising for patients. Further investigation shows that after a 10 year period post-surgery, 89.5% of patients are symptom free. So the process can also be considered very effective and not experimental in any way.

Most Common Side Effects

One of the most common side effects is called “gas bloat syndrome”. During the surgery the surgeon wraps the stomach around the esophagus forming a pouch at the top of the stomach alongside the esophagus. The reason for this pouch is to trap the acid and stop the flow into the esophagus. “Gas bloat syndrome” is caused when this pouch traps stomach gases and the stomach no longer has the ability to deal with this trapped gas through burping. Therefore swallowed air creates a build up of gas in the stomach or small intestine. The exact data on the frequency of the occurrence of “gas bloat syndrome” is somewhat contentious. As different sources state different statistics, but a mean figure is at around 41% for the occurrence of “gas bloat syndrome”. The good news is that the condition is usually limited to a period of 2-4 weeks after surgery. However if it does not dissipate then lifestyle changes may be needed to minimize the effects of the syndrome. This can include reducing the intake of carbonated drinks and certain foods that create gases in the stomach.

In almost all cases the ability to vomit is affected and is almost always impossible at first. This is because the nissen fundoplication initially blocks the vomit from being able to be excreted. After time when the area settles vomiting is usually possible. However this is only in small amounts, and is still very difficult. This can be a severe problem as vomiting is the body’s natural way of flushing out unwanted toxins or materials from the stomach. If someone has food or alcohol poisoning the individual is in more danger because they cannot evacuate the harmful substance from their stomach.

One other side effect worth mentioning is that the Nissen Fundoplication may actually weaken and becoming ineffective. In these cases the surgery will need to be redone, otherwise the patient would still be suffering from the initial symptoms. This is not a common occurrence and happens in about 5-10% of the cases.

To sum it all up, the Nissen Fundoplication is fast becoming a popular surgery to control acid reflux. This is in part due to lifestyle changes and poor eating habits. The surgery is effective in almost 90% of patients and the complications are usually short lived. If you have acid reflux that you are unable to control through medication, you may want to have a conversation with your doctor about acid reflux surgery or a Nissen Fundoplication, and it’s side effects.