The image
above to the left is that of a healthy esophagus. Note the color and texture.
The image to the right shows esophagitis. Here also, note the color and
texture.
There are only a few reasons for a fundoplication to be
done. Most GI doctors and surgeons prefer that all medical options be exhausted
before resorting to a fundo. The main reasons for the fundo are:
Respiratory complications: Often refluxers
will develop respiratory problems related to the reflux such as apnea or ALTE's,
asthma, chronic cough or chronic pneumonias. When these cannot be controlled
with medications then a fundo is an option.
Esophagitis: Some children will get
erosive esophagitis from the acid when they reflux when this happens it can be
very painful and can even eventually lead to barretts Esophagus or even
esophageal cancer. If this cannot be controlled by medications then a
fundoplication may be needed to prevent further damage and allow healing.
Weight loss or FTT: Some refluxers have a
difficult time eating and even a harder time keeping what they eat in. Sometimes
these children fail to gain weight or even loose and need more help than what
can be found in medications for these kids a fundoplication is a viable option.
Recurrent pain: Almost all refluxers have
some pain associated with their reflux but some are in constant pain and even
the best medications available cant control it. These kids are often tired and
lethargic from pain and many sleepless nights when this is the case it is often
in their best interest to look into a fundoplication as their quality of life is
compromised. As you can see the fundo is not always the best option for
the majority of refluxers and is a last resort when all other treatment options
have failed.
The graphic above shows many of the reflux-related problems that can
indicate surgery.
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Please note: the information provided on this
website is a combination of research and experience of parents. Please discuss
any concerns with your doctor. The goal of this page is not to push or dissuade
anyone in regard to the Fundo, but only to paint a broader picture.
