Nissen Fundoplication or TIF for GERD

[mtngrl55]

Hi! I'm new to this board and have been in remission for the better part of 15 years. I've had a resection, right after being diagnosed with Ileitis/Crohn's. Then 5 years ago I had another surgery to repair a stricture. The Crohn's was in remission but the pain of the stricture was as bad as the disease when it was active.

It looks like I'm not the only one with GERD as a result of this disease. Has anyone had a Nissen Fundoplication for Acid Reflux and Hiatal Hernia? If so, how are you faring? Has it been worth the effort?

I have had acid reflux since I had my gall bladder out, another wonderful side effect of Crohn's. I had tiny crystals that took 4 years to build up enough that they could be seen by ultrasound. I had a lot of pain and vomiting before diagnosis. Since then I have had GERD and my childhood Asthma has returned. I have been on Nexium for two years. A couple of months ago I started to have a lot of serious side effects. My surgeon wants to do a Nissen Fundoplication,( wrapping the top of your stomach around the esophagus to create a valve). I have read a few horror stories on another board and a few positive results too. However, the possibility of totally uncontrolled diarrhea, bloating, not being able to burp or vomit ever again has me very concerned about this procedure.

There is a new procedure called TIF Transoral Incisionless Fundoplication. The scope goes down your throat and the esophagus is used to make a valve. This one looks better but I haven't been able to find a lot of people talking about the results.

How many of you are using PPI's when needed and relying on Zantac in between? Does it work long term? Are you on strict diets?

I spent the first 20 years of my Crohn's on a very strict diet, severe pain and diarrhea for all of that time, and think I might like the diet better than the surgery. Please give me your insight on this. Thank you

 

[steve55]

I had the TIF procedure. It was not worth it. I think you have to come to terms with the fact that the Crohn's is causing the heartburn and not necessarily the hiatal hernia which can be fairly common and asymtomatic on its own. If you have the Crohn's in remission and still have heartburn or in my case constant "burning", perhaps TIF might help. I did it with Dr Garber in Long Island NY and was not happy with post op care. He dodged all my phone calls after the surgery.

Like I said, don't rush into it. Also, I think it was somewhat negative because now I have more pressure and this barrier that keeps it down causing perhaps more disturbance. Let me know if you want to know anything else.

 

[mtngrl55]

Thanks Steve, I am still researching and plan to see a gastroenterologist for more testing. Even on PPI's I have had night reflux so am thinking it is bile and pepsin reflux too. I had hoped a TIF was a better option so maybe I will just go back to the bland diet idea.

 

[SugarberryGA]

I had the Nissen Fundoplication in 1997 and while it may work for some, it did not work for me. Please keep in mind that after the procedure, you will never be able to vomit again, unless the wrap comes undone like mine did. I spent 10 years not be able to vomit and it was pure torture. Finally, about five years ago, my wrap came undone on its own and if I sound relieved, I am. There's nothing worse than not be able to vomit!! I spent countless hours heaving uncontrollably over the toilet and always wound up in emergency rooms hooked up to IV's full of Zofran and/or Phenergan to try to stop the nausea. I wouldn't wish it on my worst enemy. I strongly recommend sticking with a bland diet and eat several small meals a day and staying away from surgery (just my opinion). Hope you're feeling better!