Nissen Fundoplication Post-Op Care

Your child recently underwent a Nissen Fundoplication, a procedure that wrapped the upper portion of the stomach around the lower portion of the esophagus, to treat Gastroesophageal Reflux. It is important to follow your surgeon’s instructions regarding diet and treatment of gagging, retching, and/or vomiting to promote long-term integrity of the wrap.

The first 2 weeks after the surgery, the patient should consume a “soft, slippery” diet and avoid food that may get stuck.

Diet
Safe foods Foods to avoid
Applesauce Meats
Pudding Bread, Noodles, Pancakes, Pastries
Smoothies/Milkshakes (well blended) Carbonated beverages
Strained soups Chunky or hearty soups/stews
Mashed potatoes Peanut butter
Yogurt (without fruit seeds) Nuts/seeds
Cream of wheat Hard cheeses
Scrambled eggs Fried foods
Soft cooked Vegetables Raw fruits and vegetables

At your post-op visit, your surgeon will discuss advancing your child’s diet to include more solid foods. It is essential for your child to take small bites, chew well and drink frequent sips of fluid in between bites. If your child experiences a sensation of food getting stuck, stop eating and continue to drink frequent sips of fluid. This can be normal sensation following surgery. Consider avoiding the offending food for a week. IF fluid does not pass, call your surgeon’s office immediately.

Gagging/Retching

When your child gags, retches or tries to vomit, increased pressure is placed on the wrap. This pressure may cause the wrap to loosen or even come apart completely resulting in a return of your child’s reflux symptoms. It is important to use medication to stop any episodes of gagging, retching or vomiting. If your child is less than 6 months old, Benadryl is used to stop these symptoms. See the following table for dosing.

Benadryl dosing table
Weight in pounds Amount
6-8 pounds 1 ml every 4-6 hours
8-10 pounds 1 ½ ml every 4-6 hours
10-13 pounds 2 ml every 4-6 hours
13-15 pounds 2 ½ ml every 4-6 hours
15-17 pounds 3 ml every 4-6 hours
17-19 pounds 3 ½ ml every 4-6 hours

For children over 6 months of age, a prescription medicine called Zofran (Ondansetron) is used. You should always have this medication on hand. Please follow the dosing instructions on the label or call our office at 303-839-6001 for a prescription. If this medicine is not alleviating your child’s symptoms, seek medical treatment.