Nissen Fundoplication: What to Expect at Home

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Your Recovery

You may be sore and have some pain in your belly for several weeks after surgery. If you had laparoscopic surgery, you also may have pain near your shoulder for a day or two after surgery.

It may be hard for you to swallow for up to 6 weeks after the surgery. You may also have cramping in your belly, feel bloated, or pass more gas than before. When you burp, you may not get as much relief as you did before the surgery. The cramping and bloating usually go away in 2 to 3 months, but you may continue to pass more gas for a long time.

Because the surgery makes your stomach a little smaller, you may get full more quickly when you eat. In 2 to 3 months, the stomach adjusts and you will be able to eat your usual amounts of food.

How quickly you recover depends on whether you had a laparoscopic or open surgery. After laparoscopic surgery, most people can go back to work or their normal routine in about 2 to 3 weeks, depending on their work. After open surgery, you may need 4 to 6 weeks to get back to your normal routine.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • For about 2 weeks, or 4 to 6 weeks if you had an open surgery, avoid lifting objects heavier than about 7 to 9 kilograms. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Do not do sit-ups or any exercise or activity that uses your belly muscles.
  • You can be active and do things around the house as you can tolerate it. Do not take part in any activity where you could be hit in the belly. This could be sports or playing with children.
  • You may shower. Pat your incisions dry. If you had an open surgery, you need to keep the incision dry until it begins to heal. Do not take baths until your doctor says it is okay.
  • Ask your doctor when you can drive again.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • For the first week, stay on a liquid or soft diet. This includes broths, soups, milk shakes, puddings, and mashed potatoes. When you can eat these without difficulty, try eating foods that are easy to swallow, such as ground meat, shredded chicken, fish, pasta, and soft vegetables.
  • Have 5 or 6 small meals each day instead of 2 or 3 large meals.
  • Chew each bite of food very well. Eat slowly. You may need to take 20 to 30 minutes to eat a meal.
  • Avoid crusty breads, bagels, tough meats, raw vegetables, nuts and seeds (including crackers and breads that have nuts and seeds), and other foods that are hard to digest.
  • If you feel full quickly, try to drink fluids between meals instead of with meals.
  • Avoid carbonated beverages, such as soda pop.
  • Avoid drinking with straws. This may help you swallow less air when you drink.
  • Gradually return to your normal foods. This usually takes 4 to 6 weeks.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor tells you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Continue to take your acid-reducing medicine for 1 month after surgery or as your doctor tells you.

Incision care

  • If you have strips of tape on the cuts the doctor made (incisions), leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your belly or chest.

Call your doctor or nurse call line now or seek immediate medical care if:

  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have loose stitches, or your incision comes open.
  • You have signs of a blood clot, such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.

Watch closely for any changes in your health, and be sure to contact your doctor or nurse call line if:

  • You have a cough that does not go away or one that brings up mucus.
  • You have shoulder pain that lasts more than 3 days.
  • You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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