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Nissen Fundoplication Undone
Question
How do you know whether or not a Nissen has come undone? My son is now passing gas, burping, and gagging. He is also passing a lot of gas from his G-Tube site.
Answer of our experts
If he is gagging, it may be getting loose and he is refluxing. Either an upper GI or pH probe can be used to look at the Nissen. If it is loose, he may be able to just get by with reflux medications and may not need to have it redone. I would make an appointment with your GI Doctor
CP/TK 7-13-10
Approved byClinical Advisory Board (CAB)
Answer is checked and valid for
Recommendation(s)
Reflux
R32
Consider always gastro-oesophageal reflux disease (GORD) in any individual with CdLS owing to its frequency and wide variability in presentation, which includes challenging behaviour.
R33
Modification of nutrition and proton pump inhibitors (PPI) are the first-line treatments of GORD. Anti-reflux medications need to be used to their maximum dosage. Surgical interventions for GORD should be limited to those individuals with CdLS in whom nutritional and medical treatments have been unsuccessful or airway safety is at risk.
R34
If GORD symptoms persist, endoscopy should be strongly considered whilst an individual with CdLS is still in paediatric care.
R35
Surveillance for Barrett’s Oesophagus needs to be discussed with and decided together with the family, balancing the potential gain in health and burden for the individual with CdLS.
