Experts say you should avoid chocolates after Nissen Fundoplication surgery. The question is, why can't you have chocolate after Nissen Fundoplication?

Chocolates are a happy food for most people. Be it a bar of chocolate, a chocolate dessert, or a chocolate shake. We can't decide which one is tastier and which one of these we can possibly say no to. But if you're suffering from GERD and are undergoing Nissen Fundoplication, you might have to refrain from chocolates for a while. Now, that hurts more than GERD, doesn't it?

Cocoa promotes the release of serotonin, which causes the gastric muscles to relax, which causes the gastric contents to rise the esophagus and cause a burning sensation. In chocolate, caffeine and theobromine can also increase GERD symptoms and deem the Nissen Fundoplication surgery useless.

The purpose of the Nissen Fundoplication surgery is to relieve the symptoms of GERD. Medications and diet changes often manage Gastroesophageal Reflux Disease, but if nothing seems to work, physicians opt for Nissen Fundoplication. Eating chocolate can result in the GERD symptoms reappearing and kill the purpose of this surgery. Cocoa in chocolate is acidic in nature, and physicians suggest not eating anything that may cause acidity following the Nissen Fundoplication surgery.

We bring you advice from the experts about what to eat and what not to eat following a Nissen Fundoplication surgery. If you love chocolates and can't seem to control your cravings, we can tell you one thing (you won't like it), you'll have to refrain from eating chocolates for some time! You'll know why very soon!

What is GERD?

Gastroesophageal Reflux Disease, more commonly referred to as GERD, is a condition when acid from the stomach flows back into the esophagus and causes a burning sensation in the chest (what you call heartburn). The backwash of acid irritates the lining of the esophagus, which is why you feel the burning sensation.

Most of the time, GERD symptoms can be managed with lifestyle changes and OTC medications, but in some cases, the symptoms are very severe and require a more aggressive approach.

Some of the most common symptoms of GERD include the following:

• Heartburn, especially after you eat. Heartburn usually worsens at night
• Difficulty swallowing
• Regurgitation of sour liquid
• You feel like there's a lump in your throat
• If you've got nighttime acid reflux, you might experience disrupted sleep, asthma, chronic cough, and laryngitis.

If you don't address the problem of acid reflux on time, there will soon be damage to the esophageal tissue, which can lead to scar tissue formation. This can narrow the esophagus, and you might face difficulty swallowing food. Acid reflux can also worsen to form an esophageal ulcer and esophageal cancer in the worst cases.

Nissen Fundoplication surgery is recommended for individuals whose GERD symptoms don't get better with medication.

Understanding Nissen Fundoplication

It's a surgery that's done to improve the symptoms of GERD, which medicines fail to do. In this surgery, the sphincter or valve between the stomach and esophagus, which is supposed to prevent the backward flow of stomach fluids into the esophagus, is tightened.

If for some reason, the sphincter isn't closing properly, the gastric acid will keep flowing into the esophagus. As a result, you'll constantly feel like your chest is on fire. The burning will be worse after you eat and when you're lying down.

Before the surgery is done, the surgeon runs some tests to make sure GERD has scaled up to the extent that only surgery can fix it. Some tests that your surgeon will prescribe are:

• Esophageal Manometry: The pressure on the esophagus is measured when you swallow.
• GI X-Ray: The x-ray is done to take the images of the stomach, esophagus, and small intestine to evaluate the extent of tissue damage.
• Upper Endoscopy:  A tissue sample is drawn from the upper part of the stomach to study the damage to the tissues and make sure it's due to gastric acids.
• A pH probe is used to collect evidence of the presence of acid in the esophagus.

Once the surgeon has got a clear picture of your condition, they can move on to the surgery.

What to Expect After the Surgery?

After the surgery is done, your throat will stay sore for a day or two. You may not be able to eat anything, and the only nutrition you'll get for a few days following your surgery will be through the IV line. You'll also get a nasogastric tube (NG tube) that will clear your stomach while you're healing from the surgery.

Depending on the type of surgical procedure you went through (laparoscopic or open), your doctor will suggest to you what you can eat. One thing is given; you can't return to your regular diet right away!

Why Can't You Have Chocolate After Nissen Fundoplication?

If you love chocolates and not a day goes by when you don't eat chocolate, you might be most heartbroken right now. Doctors discourage you from eating chocolates after getting the Nissen Fundoplication surgery. And they've got pretty good reasons for it.

The cocoa powder used in making chocolates is acidic in nature, and it can lead to the recurrence of GERD symptoms after the surgery. Not only is cocoa acidic, but it also promotes the release of serotonin. Serotonin results in the relaxation of the esophageal sphincter, and with that, gastric contents find a way out of the stomach and into your esophagus.

Then there are some other constituents of chocolate that can lead to increased acidity. Caffeine and theobromine in chocolate are known to increase the symptoms of GERD.

Now, if you've just had Nissen Fundoplication surgery, you should avoid anything that can cause acidity. Eating chocolates after Nissen Fundoplication will only deem your surgery useless. As long as you don't stop consuming chocolate, you can't expect the effects of the Nissen Fundoplication surgery to last very long.

What Should You Eat After Nissen Fundoplication?

The right question isn't whether you can eat chocolate after getting your surgery done, but it's 'what should you eat after Nissen Fundoplication?'

The first few meals after the surgery should be a clear liquid diet like chicken or meat broth and soups. You can then move on to liquid meals and continue taking a liquid diet for a few meals before starting the soft Nissen diet. A soft diet will include foods like pudding, yogurt, and gelatin that are easy to swallow and digest. This is because your throat may be swollen, and swallowing solids, or even semi-solids, will be painful.

Below is a list of all the foods that you should eat after getting the Nissen Fundoplication surgery:

Beverages

• Milk
• Decaffeinated tea
• Non-citrus juices
• Powdered drink mixes

Grains

• Refined bread
• Ready-to-eat cereal
• Plain white rice
• Crackers
• Pancakes
• Waffles
• Pasta

Meats and Beans

• Tender meat, fish, and poultry (baked, boiled, stewed, broiled, or simmered)
• Smooth peanut butter
• Tofu

Dairy Products

• Smooth yogurt
• Low-fat milk products
• Cottage cheese
• Other mild cheese

Vegetables and Fruits

• Soft, well-cooked, or canned vegetables
• Potatoes without skin
• Sweet potatoes (boiled, mashed, creamed)
• Raw fruits that are soft but without skin
• Canned or cooked fruits
• Fruit juices

Then there are foods that you must not eat after Nissen Fundoplication. It's important that you're familiar with this list. Otherwise, you'll continue to eat what you shouldn't, and your GERD symptoms will return even after getting the surgery.

• Chocolate and chocolate drinks
• Caffeinated drinks
• Carbonated drinks
• Coffee (even decaf coffee)
• Citrus fruits
• Alcohol
• Whole grain cereals and bread and anything with nuts and seeds
• Popcorns
• Anything fried
• Tough meats
• Sharp cheeses
• Raw, hard vegetables, and all those vegetables that may cause gas or gastric discomfort
• Fruits with skins
• Anything spicy

Tips to Prevent Recurrence of GERD Symptoms

While your diet is the most important factor that you should focus your attention on after Nissen Fundoplication, there are some other tips that will help you prevent the recurrence of GERD symptoms after your surgery.

• Take small meals every 2 to 3 hours to prevent the stretching of your stomach
• Eat foods that you can swallow and digest easily. You should only rely on a soft diet for a few days after the surgery
• Take small bites and chew well to prevent the build-up of gas
• Drink through a straw to make sure you aren't swallowing any air