Can a Too Tight Abdominal Repair Cause GERD?

Question

I have previously described how I ended up with two abdominoplasties and still did not have good results. It feels like all my guts were crammed up under my breasts and sewed in place. Since that last surgery, I have had laryngeal reflux and GERD. I've never had it before. Could it be a complication of the muscle repair? I also no longer bloat in the lower abdomen but up under my breasts. Can this be fixed? At the time of a hysterectomy, my GYN said there were metal staples in there.

Hayley Brown, MD, FACS · Answer

GERD is not a reported complication of Tummy tuck. Certainly, it is possible after 2 abdominal wall surgeries, to have aggravated your symptoms. Whether it is a result of the surgery or a natural progress of your disease is hard to say. It would be straightforward to undergo a surgical procedure to remove any muscle tightening sutures, however, the muscle layer may bulge slightly more as a result.

Otto Joseph Placik, MD · Answer

There are trade-offs to any surgery. The fastest solution would be to undo your muscle repair. Are you willing to do this and accept your full belly. The best solution would be to control the cause of your GERD. This can be due to a lax lower esophageal sphincter and may require a different surgical repair called a Nissen fundoplication. It may involve losing weight. It could require medications. You may benefit from avoiding certain foods or medications that increase the symptoms GERD. In any case you should have it evaluated by a gastroenterologist because chronic GERD could lead to a more serious condition called Barret's Esophagitis.

Peter A. Aldea, MD · Answer

Regarding : "Can a Too Tight Abdominal Repair Cause GERD?
	I have previously described how I ended up with two abdominoplasties and still did not have good results. It feels like all my guts were crammed up under my breasts and sewed in place. Since that last surgery, I have had laryngeal reflux and GERD. I've never had it before. Could it be a complication of the muscle repair? I also no longer bloat in the lower abdomen but up under my breasts. Can this be fixed? At the time of a hysterectomy, my GYN said there were metal staples in there."

	As you may recall, I answered one of your previous questions. I have done many Tummy tuck procedures and have definite opinions on this topic.

	I do NOT think a Tummy Tuck surgery causes gastroesophageal acid reflux (GERD) or heart burn, but it definitely can make it more symptomatic. The prime cause of GERD is a poorly functioning sphincter of the lower food tube, the esophagus, which allows the very caustic, acidic contents of the stomach to come through the sphincter into the esophagus as high as the mouth causing severe irritation and eventually shortening the esophagus, changing its lining (Barrett's esophagus) which may degenerate into cancer.

	A Tummy tuck CANNOT take a normal sphincter and make it abnormal. But, it could potentially increase the pressure in the abdomen to where an already incompetent sphincter can perform worse and allow more fluid (chyme) from the stomach to go into the esophagus and higher. In most women this high abdominal pressure gets better with within a few months as does the reflux. The fact that it did not get better in you suggests that your lower esophageal sphincter is very poor and thereby I seriously doubt that undoing the muscle repair would stand a chance to somehow reduce the amount of acid contents going into the esophagus.

	Instead, you may benefit from having the lower esophageal sphincter made better and this can be done with an Endoscopic Nissen Fundoplication. When done by good endoscopic surgeons the operation is done in less than 2 hours through small openings and the improvement is immediate.

	I would consult a gastroenterologist to study your lower esophagus and refer you to a good endoscopic surgeon IF needed.

	Dr. Peter Aldea

Can a Too Tight Abdominal Repair Cause GERD?

Answers (3)

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