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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Nissen Fundoplication surgery cause pressure difference in the stomach resulting in severe acid reflux?

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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 1996 Questions

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Posted on Mon, 6 Aug 2018 in General Health
Question: Hi Dr. XXXXXXX

I apologize that is has been some time since we talked. I asked my Dr. about the medications you recommended I should take since my Nissen Fundoplication surgery has not helped my acid reflux at all. You recommended Levosulpiride or Domperidone & Acotiamide in combination.

When I mentioned these drugs to my Dr. he told me that those kind of drugs are only used for people with some serious physiological problems that I don't have. He said my body has no signs of a serious problem and that this is a quality of life issue in getting my acid under control.

I have one more follow up appointment with him and I have been asked to be referred to a specialist as well from the University of Utah. They are more on the cutting edge of science and can think "outside the box" so to speak. I hope they will be of some help. It could take 8 weeks before I can make an appointment.

I read some information once about how acid reflux can be due to the pressure differential in your body/stomach. Is it possible that the Nissen wrap procedure could be trapping gas down in my stomach (I can't release it by burping) and therefore causing more pressure down there which causes the acid to be pushed up my espophagus? I may be way off, but thought I would ask if that's a possibility?

Lastly, you recommended I take Rabeprazole 20mg twice daily. Do you think this would be more effective than the 80mg of Nexium I am currently taking daily (along with 400mg of Famotodine daily).

Thanks again for your time, and I'm sorry if you have forgotten any details of our previous conversations due to my absence. Sincerely, XXXXXX XXXXXX
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Answered by Dr. Ramesh Kumar 17 hours later
Brief Answer:
follow up.

Detailed Answer:
Hi,
Thanks for follow up,
See pressure difference created by gas can not be sufficient enough to cause severe acid reflux so i dont agree with that theory.
Rabeprazole if taken in combination with levosulpiride or itopiride would be better then nexium.
Thanks!
Above answer was peer-reviewed by : Dr. Yogesh D
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