Adult Open Nissen Fundoplication

WHAT YOU SHOULD KNOW:

• An open Nissen fundoplication (fun-do-pli-KA-shun) is surgery to treat gastroesophageal reflux disease (GERD). GERD occurs when the lower muscle of the esophagus, called the lower esophageal sphincter, does not close properly. The esophagus is the tube that carries food and liquid from the throat to the stomach. GERD causes the stomach acid and food in the stomach reflux (back up) into the esophagus. When the acid irritates and damages the esophagus, it may cause a burning feeling called heartburn.
  
  
• With an open Nissen fundoplication, an incision (cut) is made in your abdomen to show your lower esophagus and stomach. During this surgery, your caregiver wraps the upper portion of the stomach around the esophagus. This is done to put pressure on the lower esophageal sphincter and prevent reflux. With an open Nissen fundoplication, the symptoms of GERD may be relieved and damage to your esophagus prevented.

INSTRUCTIONS:

Medicines:

• Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
  
  
• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Bathing: When you are allowed to bathe or shower, carefully wash your stitches or staples with soap and water. Afterwards, put on a clean, new bandage. Change your bandage any time it gets wet or dirty. If you cannot reach the bandage, ask someone else to help you change it. You may have steri-strips (thin strips of tape) on your incision. Keep them clean and dry. As they start to peel off, let them fall off by themselves. Do not pull them off.

Diet: As you recover from surgery, you may be given soft foods to eat or thickened liquids to drink. You may be placed on a full diet as your swallowing gets better. A caregiver, called a dietitian, may talk to you about your feeding and nutrition. A swallowing therapist may also help if you continue to have trouble swallowing. This person has special training to help people learn safer ways to swallow. The swallowing therapist will also help you learn which foods and liquids are safe to eat and drink. You may also need to do the following to prevent swallowing too much gas (air) and keep your stomach from swelling:

• Avoid drinking carbonated beverages, such as sodas, colas, sparkling water, lemonade, and fruit punch.
  
  
• Do not suck sweets, chew gum, or use a straw when drinking.
  
  
• Eat slowly, take small bites, and chew your food well.

Rest: You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your surgery, condition, or care.

SEEK CARE IMMEDIATELY IF:

• You feel so full and cannot burp or vomit (throw up).
  
  
• You have pus or a foul-smelling odor coming from your incision.
  
  
• You have severe chest pain and trouble breathing all of a sudden.
  
  
• You have trouble swallowing.
  
  
• Your abdomen becomes tender and hard.
  
  
• Your bandage becomes soaked with blood.
  
  
• Your bowel movements are black, bloody, or tarry-looking.
  
  
• Your vomit looks like coffee grounds or has blood in it.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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