Retching occurs when a child tries to vomit but can’t (as in children who have had a Nissen or fundoplication surgery), or when a child tries to vomit but has nothing to vomit. If retching is occurring, you may need to vent the stomach more often.
Retching with a Fundoplication
In theory, retching after a fundoplication occurs because the fundoplication stops the child from vomiting, meaning that any attempt at vomiting will lead to persistent retching since the gastric contents are not able to be released upwards out of the stomach and mouth. While this may be true for a child with a fundoplication who has a stomach virus, it does not explain why some children retch continuously after a fundoplication.
Doctors have begun to realize that persistent retching after a fundoplication may instead be the result of either a preexisting hypersensitivity or changes in the gut from the fundoplication. Children who vomit or retch before a fundoplication usually continue to retch afterwards. Most of these children have a hypersensitive emetic reflex or visceral hyperalgesia.
In some cases, a motility problem or other condition like eosinophilic esophagitis was mistaken for reflux pre-operatively, and was only discovered after the fundoplication failed to eliminate symptoms. Unfortunately, surgery not only does not improve symptoms in children with motility or hypersensitivity issues, but it also makes them worse in many cases.
Some children begin to retch after surgery even without pre-surgical vomiting. While this is not entirely understood, researchers have hypothesized that this retching may be due to sensitization of the emetic reflex from vagus nerve damage during surgery, or development of gastric dysrhythmia or uncoordinated gastric contractions as a result of surgery.