Anti-reflux surgery - discharge

  • Alternative Names
    • Fundoplication - discharge; Nissen fundoplication - discharge; Belsey (Mark IV) fundoplication - discharge; Toupet fundoplication - discharge; Thal fundoplication - discharge; Hiatal hernia repair - discharge; Endoluminal fundoplication - discharge

  • When You Were in the Hospital
    • You had surgery to treat your gastroesophageal reflux disease (GERD). GERD is a condition that causes food or liquid to come up from your stomach into your esophagus (the tube that carries food from your mouth to your stomach).

      Your surgeon probably repaired a hiatal hernia with stitches. A hiatal hernia develops when the natural opening in your diaphragm is too large. Your diaphragm is the muscle layer between your chest and belly. Your stomach may bulge through this large hole into your chest. This bulging is called a hiatal hernia. It may make GERD symptoms worse.

      Your surgeon also wrapped the upper part of your stomach around the end of your esophagus to create pressure at the end of your esophagus. This pressure helps prevent stomach acid and food from flowing back up.

      Your surgery was done by making a large incision in your upper belly (open surgery) or with a laparoscope (a thin tube with a tiny camera on the end).

  • What to Expect at Home
    • Most people go back to work 2 to 3 weeks after laparoscopic surgery and 4 to 6 weeks after open surgery.

      You may have a feeling of tightness when you swallow for 6 to 8 weeks. This is from the swelling inside your esophagus. You may also have some bloating.

  • Self-care
    • When you get back home, you will be drinking a clear liquid diet for 2 weeks. You will be on a full liquid diet for about 2 weeks after that, and then a soft-food diet after that.

      On the liquid diet:

      • Start off with small amounts of liquid, about 1 cup (240 milliliters) at a time. Sip. DO NOT gulp. Drink liquids often during the day after surgery.
      • Avoid cold liquids.
      • DO NOT drink carbonated beverages.
      • DO NOT drink through straws (they can bring air into your stomach).
      • Crush pills, and take them with liquids for the first month after surgery.

      When you are eating solid foods again, chew well. DO NOT eat cold foods. DO NOT eat foods that clump together, such as rice or bread. Eat small amounts of food several times a day instead of 3 big meals.

      Your doctor will give you a prescription for pain medicine. Get it filled when you go home so you have it when you need it. Take your pain medicine before your pain becomes too severe.

      • If you have gas pains, try walking around to ease them.
      • DO NOT drive, operate any machinery, or drink alcohol when you are taking narcotic pain medicine. This medicine can make you very drowsy, and driving or using machinery is not safe.

      Walk several times a day. DO NOT lift anything heavier than 10 pounds or 4.5 kilograms (about the same as a gallon or 4 liters of milk). DO NOT do any pushing or pulling. Slowly increase how much you do around the house. Your doctor will tell you when you can increase your activity and return to work.

  • Wound Care
    • Take care of your wound (incision):

      • If sutures (stitches), staples, or glue were used to close your skin, you may remove the wound dressings (bandages) and take a shower the day after surgery.
      • If tape strips (Steri-Strips) were used to close your skin, cover the wounds with plastic wrap before showering for the first week. Tape the edges of the plastic carefully to keep water out. DO NOT try to wash the Steri-Strips off. They will fall off on their own after about a week.
      • DO NOT soak in a bathtub or hot tub, or go swimming, until your doctor tells you it is ok.
  • When to Call the Doctor
    • Call your health care provider if:

      • Your temperature is above 101°F (38.3°C).
      • Your incisions are bleeding, red, warm to the touch, or have a thick, yellow, green, or milky drainage.
      • Your belly swells or hurts.
      • You have nausea or vomiting for more than 24 hours.
      • You have problems swallowing that keep you from eating.
      • You have problems swallowing that do not go away after 2 or 3 weeks.
      • You have pain that your pain medicine is not helping.
      • You have trouble breathing.
      • You have a cough that does not go away.
      • You cannot drink or eat.
      • Your skin or the white part of your eyes turns yellow.
  • References
    • Peterson RP, Pelligrini CA, Oelschlager BK. Hiatal hernia and gastroesophageal reflux disease. In: Sabiston Textbook of Surgery, 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 44.

      Stefanidis D, Hope WW, Kohn GP, et al, SAGES Guidelines Committee. Guidelines for surgical treatment of gastroesophageal reflux disease. Surg Endosc. 2010;24:2647-2669. PMID 20725747