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Had hiatus hernia in stomach which is pushing to the chest. Observed short oesophagus and adhesions after cesarean. What is the next step?

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Hello- this is the situation I have with my mother. Any insight is appreciated.

-Mom had a very large hiatus hernia to the extent a large area of her stomach was out pushing the chest , she was suffering from reflux but they suggested her doing the operation due to the fact she was being anemic due to the fact of loosing blood perhaps bleeding on and off for few years.
-A year and a half ago made the operation
-Her operation was a Nissan Fundoplication , in the operation they discovered that the stomach was out for several of years they had a hard time getting her back in, they found also that she has a short esophagus and lots of adhesions since her operation after the cesarean .
-Now her stomach is out again with lots of pain and suffering.
-Her barium test also showed there was still food after 15 hours of fasting which made the doctor wonder if she is having a nerve damage that is not allowing the stomach to digest right.

What do you believe are the next steps for my mother?
Posted Tue, 29 Oct 2013 in General Health
Answered by Dr. Anjana Rao Kavoor 3 hours later
Brief Answer:
Feasibility of second surgery to be discussed.

Detailed Answer:
Thanks for writing in to us.

I have read through your query in detail.

Fundoplication surgery is the most common surgery used to treat GERD/ Hiatus hernia. This surgery strengthens the valve between the esophagus and stomach (lower esophageal sphincter) to keep acid from backing up into the esophagus as easily. It relieves symptoms and inflammation of the esophagus (esophagitis).

There are some facts about the surgery:

Laparoscopic surgery improves GERD symptoms in 8 out of 10 people who have the surgery. And surgery heals the damage done to the esophagus by GERD (esophagitis) in about 9 out of 10 people.

After 7 years, about 4 out of 10 people who had surgery either had symptoms come back, had esophagitis come back, needed to take medicine for symptoms, or needed another operation.

Surgery can cause new and troublesome symptoms. For example, in the longest study done so far, 7 years after surgery:

More than 1 out of 10 people had trouble swallowing.
More than 6 out of 10 people had increased flatulence.
More than 2 out of 10 people were unable to belch.
About 3 out of 10 people may still need to take medicine for GERD symptoms after surgery.

The fundoplication procedure cannot be reversed, and in some cases it may not be possible to relieve the symptoms of these complications, even with a second surgery.

In my opinion, the feasibility of a second surgery needs to be discussed with your doctor and you must proceed accordingly after knowing the benefits after a repeat surgery.

I hope this helps,
Any further queries are welcome.
Dr. A Rao Kavoor
Above answer was peer-reviewed by
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