Anti-reflux surgery - children - discharge

When Your Child Was in the Hospital:

Your child had surgery to treat gastroesophageal reflux disease (GERD). GERD is a condition that causes food or liquid to come up from the stomach into the esophagus (the tube that carries food from the mouth to the stomach).

Your child' s surgeon wrapped the upper part of your child' s stomach around the end of their esophagus.

The surgery was done in one of these ways:

• Through a large incision (cut) in your child' s upper belly (open surgery)
• With a laparoscope (a thin tube with a tiny camera on the end)
• By endoluminal repair (like a laparoscope, but the surgeon goes in though the mouth)

Your child may also have had a plyoroplasty procedure to widen the opening between the stomach and small intestine. The doctor may also place a g-tube (gastrostomy tube) in their belly.

What to Expect at Home:

Most children can go back to school or daycare as soon as they feel well enough.

• Your child should avoid heavy lifting or strenuous activity, such as gym class and very active play, for 3 weeks.
• You may ask your child' s doctor for a letter about the surgery to give to the school nurse and teachers to explain restrictions your child has.

Your child may have a feeling of tightness when they swallow for 6 to 8 weeks. This is from the swelling inside their esophagus. Your child may also have some bloating.

Recovery is faster from laparoscopic surgery than from open surgery.

You will need to schedule a follow-up appointment with your child' s primary care provider or gastroenterologist for about a week after the surgery.

Self-care:

After your child goes home, you will slowly get them back to a regular diet.

• Your child should have started on a liquid diet in the hospital.
• Once the doctor feels your child is ready, you can add soft foods.
• Once your child is taking soft foods well, talk with your child' s doctor about returning to a regular diet.

If your child had a g-tube (gastrostomy tube) placed during surgery, it can be used for feeding and venting. Venting is when the g- tube is opened to release air from the stomach, similar to burping.

• The nurse in the hospital should have shown you how to vent, care for, and replace the g-tube, and how to order g-tube supplies. See also: Gastrostomy tube care
• If you need help with the g-tube at home, contact the home health care nurse who works for the g-tube supplier.

For pain, you can give your child over-the-counter pain medicines such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin). If your child is still having pain, call your child' s doctor.

Wound Care:

If sutures (stitches), staples, or glue were used to close your child' s skin:

• You may remove the wound dressings (bandages) and allow your child to take a shower the day after surgery.
• If your child cannot take a shower, give them a sponge bath.

If tape strips (Steri-Strips) were used to close your child' s skin:

• Cover the wounds with plastic wrap before showering for the first week. Tape the edges of the plastic carefully to keep water out.
• Do NOT try to wash the Steri-Strips off. They will fall off after about a week.

Do not allow your child to soak in a bathtub or hot tub or go swimming until your child' s doctor tells you it is okay.

When to Call the Doctor:

Call your child' s doctor or nurse if your child has:

• A temperature above 101 °F
• Incisions that are bleeding, red, warm to the touch, or have a thick, yellow, green, or milky drainage
• A swollen or painful belly
• Nausea or vomiting for more than 24 hours
• Problems swallowing that keep them from eating
• Problems swallowing that do not go away after 2 or 3 weeks
• Pain that pain medicine is not helping
• Trouble breathing
• A cough that does not go away
• Any problems that make your child unable to eat