Refractory Diarrhea After Dor Fundoplication: The Long-Term Impact of Proton Pump Inhibitor Therapy

Persistent diarrhea following hiatal hernia repair is a rare but noteworthy postoperative complication. In this case, we present a 62-year-old female with a longstanding history of gastroesophageal reflux disease (GERD) responsive to proton pump inhibitors (PPIs). After undergoing robotic-assisted hiatal hernia repair with partial fundoplication, the patient discontinued PPI therapy and subsequently developed chronic diarrhea. Extensive testing, including stool cultures, returned negative, and antidiarrheal medications provided minimal relief. Interestingly, reintroduction of PPI therapy resulted in a complete resolution of symptoms within days. This case suggests a possible correlation between cessation of long-term PPI use and gastrointestinal dysfunction, with chronic diarrhea manifesting as a withdrawal-like effect. Further investigation into the role of PPI discontinuation on gut microbiota and its clinical outcomes is necessary to understand this phenomenon better.