What fundoplication does
In fundoplication, the upper part of the stomach, the fundus, is wrapped around the lower esophagus and sutured in place. The wrap strengthens the barrier at the lower esophageal sphincter so that stomach contents cannot flow back into the esophagus. When a hiatal hernia is present, it is reduced and the hiatus is repaired at the same time. The same wrap that prevents reflux also makes it hard to belch or vomit, so swallowed air collects in the stomach and causes gas-bloat.
Gas-bloat syndrome
After the operation, air swallowed during eating and drinking cannot easily escape upward. The client feels fullness, bloating, and abdominal discomfort after meals and may be unable to burp. This is called gas-bloat syndrome. It usually improves over weeks to months as the wrap loosens slightly and the client adjusts. Temporary dysphagia is also common after surgery because of swelling around the wrap.
| Explanation | Accurate? | Reason |
|---|
| Laparoscopy gas stays for weeks | No | Carbon dioxide is absorbed within days |
| Stomach was made smaller | No | That describes bariatric surgery, not fundoplication |
| Swelling at the diaphragm traps gas in the chest | No | The repair does not trap gas in the chest |
| Wrap at the lower esophagus stops air coming up | Yes | Explains inability to belch and bloating |
Why the distractors are wrong
The carbon dioxide used to inflate the abdomen during laparoscopy is absorbed within a few days and may cause shoulder pain, but it does not explain an inability to belch. Fundoplication does not reduce the size of the stomach; that is bariatric surgery. The hiatal repair does not trap gas in the chest; the issue is air in the stomach that cannot escape upward.
Watch out! Postoperative shoulder pain from laparoscopy gas is a real and commonly tested effect, which makes the first option sound familiar. Match the explanation to the specific complaint: inability to burp points to the wrap.
Client teaching
The nurse teaches the client to eat small, frequent meals slowly, chew well, avoid carbonated drinks, chewing gum, and drinking through straws, which add swallowed air, and to walk after meals. Persistent difficulty swallowing or severe bloating should be reported. Key point! After fundoplication, the wrap prevents belching and causes gas-bloat; teach measures that reduce swallowed air.