Personal experience
This page is a lived-experience story, not proof of what will happen to anyone else. It is here because reflux can be minimized for decades, and because a good redo operation can still work beautifully.
Severe reflux began in childhood and was effectively ignored. By age 18, endoscopy showed Barrett's esophagus. A fundoplication a few years later helped, then suddenly failed after about a year.
The next 15 years were lived on double-dose PPI therapy. Eventually a second fundoplication by an experienced surgeon worked perfectly: no PPI needed for about 10 years.
After redo surgery, severe dumping-like symptoms appeared: diarrhea about an hour after eating, then dangerous hypoglycemia around two hours later, sometimes below 2 mmol/L.
After several endocrinology dead ends, DOTATATE PET imaging showed an insulinoma. Removal fixed the hypoglycemia. That is unusual, but unusual stories are sometimes the ones that remind people to keep testing when the facts do not fit.
Because anti-reflux surgery can be underdone in people who remain on PPIs for life despite mechanical reflux, regurgitation, Barrett's risk or poor symptom control. Also because redo surgery should be in the hands of someone who does a lot of foregut revision work.
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