Can GERD symptoms return after fundoplication surgery?

Question

I am a 50-year-old man who underwent fundoplication surgery three years ago to manage severe gastroesophageal reflux disease (GERD). While the surgery initially provided significant relief, I have recently noticed a recurrence of my symptoms, including heartburn, regurgitation, and occasional chest discomfort. These issues are starting to interfere with my daily life again. I am concerned that the surgery might have failed or that I could have developed a new issue, such as a hiatal hernia. What diagnostic tools, such as imaging, esophageal pH monitoring, or manometry, would you suggest to determine the cause of my symptoms? Additionally, what treatment options are available for someone in my situation if the surgery needs revision or additional management?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your symptoms suggest a possible recurrence of gastroesophageal reflux disease (GERD) or a complication such as a failed fundoplication, a hiatal hernia, or another esophageal condition (Barrett's esophagus, esophagitis, strictures, ulcers, etc).

I suggest you do the following tests:

1. Upper endoscopy.

2. 24 hours esophageal pH Monitoring.

3. Esophageal manometry.

4. Barium swallow study.

5. Computed tomography (CT) scan of abdomen.

6. Ultrasound of abdomen.

I advise you to follow these recommendations:

1. Continue proton pump inhibitors (PPI) for example Omeprazole, Esomeprazole, Pantoprazole, Lansoprazole,etc or H2 blocker (Cimetidine, Famotidine, Nizatidine, etc).

2. Antacids can give immediate relief but avoid long-term use.

3. Avoid triggering foods like spicy, fatty, carbonated foods & caffeine.

4. Avoid alcohol & smoking.

5. Avoid lying down within two to three hours after a meal.

6. Maintain healthy weight.

7. Stay hydrated.

8. Keep your head elevated by four to six inches during lying down & sleep.

9. Sleep on your left side.

If your reports show that the fundoplication wrap has loosened, slipped, or disrupted, a revision surgery may be required to restore the anti-reflux barrier.

If a hiatal hernia has developed it may need repair along with revision of the fundoplication.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.