Etiology and management of post-fundoplication dysphagia

J. M. Wo, John Hunter, J. P. Waring

Research output: Contribution to journalArticle

Abstract

Laparoscopic fundoplication is becoming more popular in patients with gastroesophageal reflux disease. Transient dysphagia is very common following fundoplication. Fortunately, dysphagia usually resolves spontaneously within 4 to 6 weeks. However, approximately two to 14% of patients develop significant post-fundoplication dysphagia. There are many different factors contributing to post-fundoplication dysphagia. The most common causes are improper surgical technique and surgery selection for each patient. Barium esophagram and upper endoscopy should be obtained to determine the integrity of the fundoplication. A slipped fundoplication is present when the wrap is around the stomach rather than the esophagus, indicating either that it was incorrectly placed at initial surgery or pulled out of its attachments. Endoscopic dilation should be attempted in all patients with severe or persistent post-fundoplication dysphagia. It will be effective in about half of the patients. Patients with evidence of a slipped fundoplication, previous multiple antireflux surgeries, or refractory dysphagia despite dilations beyond 4 months are predictors of poor outcome for endoscopic dilation, and they should be considered for re-operation.

Original languageEnglish (US)
Pages (from-to)145-152
Number of pages8
JournalGastroenterology International
Volume10
Issue number4
StatePublished - 1997
Externally publishedYes

Fingerprint

Fundoplication
Deglutition Disorders
Dilatation
Barium
Gastroesophageal Reflux
Patient Selection
Esophagus
Endoscopy
Stomach

Keywords

  • Antireflux surgery
  • Gastroesophageal reflux disease
  • Laparoscopic fundoplication
  • Post-fundoplication dysphagia

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Etiology and management of post-fundoplication dysphagia. / Wo, J. M.; Hunter, John; Waring, J. P.

In: Gastroenterology International, Vol. 10, No. 4, 1997, p. 145-152.

Research output: Contribution to journalArticle

Wo, J. M. ; Hunter, John ; Waring, J. P. / Etiology and management of post-fundoplication dysphagia. In: Gastroenterology International. 1997 ; Vol. 10, No. 4. pp. 145-152.
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