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Thread: Post Nissen Chest Pain

  1. #1
    Join Date
    Feb 2006
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    40

    Post Nissen Chest Pain

    Hi,

    I'm 30 and just had the Nissen done on 1/9.

    I had a hiatal hernia and had issues swallowing, moderate heart burn, and some chest pain. My surgeon was very experienced and recomended that I have the surgery now due because:

    1. the hernia
    2. tests showed me les wasn't working
    3. due to 1 and 2 chances are the problems would have worsened over the years.

    The surgery seems to have mostly gone well. I don't feel any reflux and I am swallowing better.

    I am still experiencing issues with chest pain. It is mostly a dull pain that comes and goes and is focused on my left side. Sometimes it can give me a short sharp blast of pain. This is driving me crazy, I've been to the ER and they did an EKG and found no problems.

    My surgeon says that the pain is "normal" and should go away in time. I don't find this to be a satisfactory answer because the pain is limiting my life. When I hurt I am just not myself. He has recomened that I see a gastro specialist.

    My pcp seems to think the pain is stress related. I actually dumped him because of this. I wouldn't be stressed if I was not in pain.

    Can anyone offer some insight as to what is going on or what I should do?

  2. #2
    Join Date
    Jan 2003
    Location
    California
    Posts
    2,917
    Welcome! It's great to know that your surgery went well.

    My surgeon says that the pain is "normal" and should go away in time.
    This is right on. You are just a few weeks past having your GI system rearranged, and you want no pain? Not something that can happen. Your muscles are busy figuring out how to work with the new configuration. Pain is normal, and actually something you want -- it lets you know when to slow down, eat easier food, and so forth. Getting past this stage takes time.

    Give yourself another two months at least before you start thinking that pain might be something to be concerned about. Meanwhile, don't get too worried -- that PCP was correct in pointing out that pain is aggravated by stress. And recovering from a lap Nissen is plenty stressful, I know.

  3. #3
    Join Date
    Jan 2003
    Location
    Montreal
    Posts
    4,216
    HI What pre surgery tests did you have ? What do you mean by the LES wasn't working right ...? there are different dysmotility problems .

    Did you have a 24 hour ph test prior to surgery ? Did the chest pain correlate with reflux events ? Many times we attribute all symptoms to GERD but it isn't always the case.

    DID you have a manometry test pre surgery? Esophageal spasms for example cause chest pain , they can only be detected on manometry test ---- and are not cured by a fundo .

    Sliding Hernias never get worse or grow bigger over the years by the way . .... and many people with hernias don't have GERD.

    It is a long recovery period though , way too soon to tell. If you feel you can't live with it , you should ask for some GI tests . Have you tried PPIS for the chest pain to see if they help ? Latest studies show as many as 65 percent of people still need PPIS after fundoplication.

    Also..... An EKG is not the best test for the heart ... you would need a stress test . Take Care

  4. #4
    Join Date
    Feb 2006
    Posts
    40
    Thank you so very much for your replies!!!

    Pre surgery tests:

    1. Barrium x-ray
    2. Manometry
    3. Camera down the throat... what ever that is called.

    The test of my LES showed that the presure in that area was very low and it wasn't closing properly.

    Manometry showed that my esophagus was working properly on the upper end, but closer to my stomach was not contracting or acting properly.

    No 24 hr PH test.

    The surgeon did not think the hernia would get worse... he thought that in time the reflux would.

    Yes there seemed to be a connection w/ the chest pain and reflux... but I don't feel the same reflux pains now... it doesn't seem like I have the reflux, but I have the chest pain.

    Since this all started I've had 4 ekg's done, x-rays and blood tests. I'm 30, in general good health and have no family history of heart disease. The Dr's seem pretty convinced my heart isn't an issue.

    I will consider trying Nexium again... it did help a fair amount in the past. It didn't make me 100% but I could feel the difference.

    Thistle, did you experience the same chest pain? If so how long did it last for you?

    Thanks again for your insight!!!

  5. #5
    Join Date
    Jan 2003
    Location
    California
    Posts
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    Thistle, did you experience the same chest pain? If so how long did it last for you?
    The pain I had was esophageal spasms -- very painful. They lasted for months, about a year, but as time went on they became less frequent and less gripping. They started my third week post-op and seriously interfered with my ability to eat for about 10-12 weeks.

    Manometry showed that my esophagus was working properly on the upper end, but closer to my stomach was not contracting or acting properly.
    I am not sure why your doctor suggested a lap Nissen if your tests showed this. Did you get a second opinion before you proceeded? If surgery has complicated your motility problems, and that is what your pain is a result of, I think you need to see another GI specialist for an impartial assessment of what's going on. I'll leave it to Tricia to respond to this also. She knows more about motility issues than I do. (I had none and thus didn't bother to learn a lot about what they mean.)

  6. #6
    Join Date
    Nov 2004
    Location
    US
    Posts
    165
    I am over a year post-op for my 2nd Nissen. I have the chest pain also. I had it for months after the surgery, it went away for awhile, and then came back around last November. The only thing that has helped is taking Carafate every six hours. It honestly has helped a lot though. I do not feel like I am having reflux either. I have had an endoscopy and a barium swallow that indicates the wrap is fine. The doctor said I can still have too much acid in my stomach though, and may also have inflammation in the stomach lining, causing the pain. I have had two EKG's and they looked fine. It does seem scary though since it is in the chest area. I am 26, no risk factors for heart disease, and no family heart problems either. I also use a heat patch from the drugstore on the area when it hurts a lot- it helps also.

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