Coping With Nissen Fundoplication

The Nissen Fundo procedure uses a twist and suture which causes access to the esophagus to be closed off during a stomach muscle contraction. The stomach contraction tightens the twisted sutures and closes off access to the esophagus durring the contraction, however in between stomach contractions the access is open allowing food and liquid to come down and enter the stomach.

If a feeding tube is hooked up it can force fluid into the stomach, in between stomach contractions, when access to the esophagus is open and can cause an overfilling of the stomach thereby sending stomach acid and contents into the lungs. Stomach compacity itself is decreased because of the Nissen Fundoplication making overfilling of the stomach even more likely.

This Pump induced overfilling of the stomach will not show up on typical refux tests where the feeding tube is disconnected and formula is given orally and all the mechanisms that help cause a stomach contraction are in place such as salivation, swallowing etc. A feeding tube bypasses some of these mechanisms pumping formula directly into the stomach.

High pressure in the feeding tube lines between the pump and the stomach can also keep the stomach from contracting properly, making overfilling of the stomach more likely.

If a moniter which uses an electric current to moniter vital signs is connected near the stomach it can cause the stomach to not contract properly. When an electric current travels across a muscle it causes the muscle to slightly contract. This slightly contracted muscle is more likely not to contract properly. This effect is greatly increased with premature infants in an NICU unit where vital signs must be monitered.

I hope this information is useful to others with similar problems because this information is not common knowledge.