Burping after Nissen Fundoplication

Burping after Nissen fundoplication

Question from Dianne in North Houston:

“Had lap fundoplication for GERD 8 weeks ago and am still burping a lot and having epigastric pain, no nausea, vomiting, bowels not back to baseline normal am worried about gastroparesis. Is this normal and is gastroparesis common or rare. Surgery was a redo of same surgery 25 yes ago.”

Dear Dianne,

I tell all my Nissen fundoplication patients at Houston Heartburn and Reflux Center that they should have almost no pain 2 to 3 days after surgery. Laparoscopic Nissen fundoplication is a minimally invasive procedure performed through tiny incisions. Consequently, recovery is fast, and it is associated with very little discomfort. Epigastric pain 8 weeks after laparoscopic Nissen fundoplication, primary or revision, is not common. Burping after Nissen fundoplication is not common either. Patients may have small burps results from small amount of air trapped above the wrap. However, “big burps” after Nissen fundoplication may indicate wrap failure. Gastroparesis is not common at all following Nissen fundoplication performed by expert hands. The risk of injuring the vagus nerves may be higher in revision surgery. I typically order a baseline gastric emptying study prior to revision Nissen fundoplication surgery to make sure there is no vagal nerve injury to start with. Gastroparesis symptoms include postprandial epigastric pain (pain after eating), bloating, nausea and vomiting.

At Houston Heartburn and Reflux Center, we ask our Nissen fundoplication patients to report back to us for any question or concern after surgery. Thorough evaluation, good physical exam and comprehensive symptom evaluation can help guide additional treatment if needed.

Healthy Regards,

Dr Darido