Is HIATAL HERNIA GENETIC?

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efit
Regular Member


Date Joined May 2011
Total Posts : 127
   Posted 1/24/2012 7:28 PM (GMT -6)   
Hi everyone,

I just met my biological father for the first time today. When I asked him about his health, he reported having a hiatal hernia and acid reflux for which he takes prilosec. He states his grandmother also has HH and GERD. I am 30 and my reflux started 8.5 months ago and I found out that his GERD began in his 30's as well.

Does hiatal hernia typically have a genetic predisposition? Guess there's not a lot of hope mine with resolve on it's own then, eh?

Is hiatal hernia repair a major surgery? How long does a repair hold up? What do they do to repair it?

Thanks,

Liz

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4831
   Posted 1/24/2012 8:23 PM (GMT -6)   
Liz-

I don't know if it's genetic or not, but my father also had severe GERD and both my kids also have reflux. I started to have issues at about 18 or 19 and my son started at 17, my daughter started at 15. I do know that a hiatal hernia is very common and most people probably don't even know they have it. I have been tols that basically everyone with GERD usually have a HH, but evryone with a HH may not have GERD.

As for the repair, a lot of times they combine the repair with a nissen. I am sure they can just repair the HH and that should be easier to recover from than a nissen, I think.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

imstarryeyed
Regular Member


Date Joined Nov 2011
Total Posts : 95
   Posted 1/25/2012 2:02 AM (GMT -6)   
Liz, I had a very large hernia. A lot of my stomach was in my chest. I wasn't really suffering from GERD but my surgeon said my hernia was dangerous. He said the nissen surgery enforces things so your are less likely to have the hernia return and that's what he did. It is major surgery although it's usually done laparoscopically As far as I know, no one in my family has had this problem.

Starry

efit
Regular Member


Date Joined May 2011
Total Posts : 127
   Posted 1/25/2012 3:45 PM (GMT -6)   
Bill,

Did you have a HH repaired at the same time you had your Nissen(s)??

Starry,

Did you surgeon tell you to get a Nissen b/c that would hold better than an isolated HH repair? I have googled it and it seems like the HH repair by itself may not hold for long especially if you lift heavy items. I don't know how I can avoid that since my children are 3 and 1 and I lift weights as a hobby and for health, etc. My job requires that I am able to lift 75 lbs sporadically so can't avoid that there either. Since I do suffer from GERD, the Nissen could be in my future.

Thanks guys,

Liz

oh one more thing...could they have missed a small HH on endoscopy?? I've had 2 of those and the doc didn't mention seeing a HH either time...

mudmagnetmum
Veteran Member


Date Joined Apr 2011
Total Posts : 1523
   Posted 1/25/2012 4:02 PM (GMT -6)   
Hi Liz,

Bruce commented recently that it's possible for them to miss a small hiatus hernia on endoscopy because of the position you are in and because they fill your stomach with air (he said). I have had 2 (3 years apart) and there was a hernia on the second but not the first. I am very suspicious because my symptoms were identical each time and the second one was done by a very experienced consultant, whereas the first was done by a GP led service. My hernia is small and may not account for any of my symptoms in reality, but I have wondered if it was missed on my first scope.

MMM
New stuff: GERD, Recurrent cystitis/Overactive bladder
Lifelong stuff: Food allergies/intolerance, eczema, asthma

DJIAREP
New Member


Date Joined May 2009
Total Posts : 7
   Posted 1/25/2012 7:47 PM (GMT -6)   
Many Hiatal Hernias are considered "sliding hernias" because they slide in and out of the diaphram. Many people have these and most don;t even know it because they have no symptoms. If you do have symptoms there things you can do to reduce the GERd symptoms.....Same things you have heard before...no eating 3 hours before bed, eat smaller meals, raise the head of your bed, watch your diet. There are some self treatments for HH. Do a google search.

imstarryeyed
Regular Member


Date Joined Nov 2011
Total Posts : 95
   Posted 1/26/2012 12:40 AM (GMT -6)   
Liz,
My surgeon didn't really give me a choice. I mentioned to my surgeon that my previous doctor said he would not repair the hernia because it would just come back. My current surgeon said there is not a guarantee it will not return but the nissen helps to prevent that from happening.

I had a large paraesophageal hernia with my stomach migrating into my diaphragm pretty quickly. This was initially found in an x-ray of my lungs. An endoscopy confirmed. Paraesophageal hernias can become life threatening if they twist or fold so getting it repaired was necessary. Unlike sliding hernias, they do not move back and forth. Do you know what type of hernia you have?

The doctor said mine may have started in pregnancy with the pressure of a 10 lb baby. Lifting over 25 lbs ever again is not advised by my surgeon. I'm limited to 5 lbs for 3 months. I don't know how a nissen would hold up to heavy lifting. I've heard of them coming undone with strain.

Starry

Post Edited (imstarryeyed) : 1/26/2012 9:40:53 AM (GMT-7)


opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4831
   Posted 1/26/2012 1:09 AM (GMT -6)   
Liz-

I did have the HH repaired with my 1st nissen. They said the HH repair was still good during my 1st redo. The last redo in August my surgeon said the wrap was completely torn apart and the HH was torn open and larger than the first time. All is good now though.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 384
   Posted 1/26/2012 9:21 AM (GMT -6)   
Mild to moderate hiatal hernias are a normal aberration in older patients, and there hasn't been a proven connection with reflux. (I don't have an exact number, but I would say up to 2.5 to 3cm.) Once they progress beyond this size, they can become problematic.

Because the hiatus in the diaphragm gets looser as we get older, sliding hernias are a result. Most of the time, the esophagus stays in place, but under certain conditions can slip above the diaphragm. If the GI is inexperienced, or not trained to expect this result, he can overfill the stomach with gas during an EGD which will force the fundus to balloon and push beyond the hiatus. This is true in my case. In the past I was measured with a 2.5cm. hiatal hernia, then on a later EGD, none was located.

A few weeks ago, PPI-LESS posted a link to a YouTube video of a doctor performing a Nissen. During the procedure, the doctor commented on the three most common indications for a failed Nissen, which I would assume would also be true for a failed hiatal hernia correction. The first he called the "Aunt Bea" body type, or a woman with a stocky build and large abdomen. The second was weight-lifters, and the third was those who had been in car accidents.

GIs aren't usually concerned with a hiatal hernia if it is within the range that I described, and there are no other indications. As far as a genetic connection goes, that sounds logical. I'm sure OSHA would be interested in you having to lift 75 pounds on the job...

-Bruce

aeshleyrose
Veteran Member


Date Joined Jul 2011
Total Posts : 655
   Posted 1/26/2012 9:53 AM (GMT -6)   
Wow, Liz. What a milestone. I hope it was a good experience :)

stkitt
Forum Moderator


Date Joined Apr 2007
Total Posts : 32602
   Posted 1/26/2012 10:01 AM (GMT -6)   
Liz,
 
To answer your original question, Genetic propensity - if either or both of your parents had a hernia you are more likely to develop one.
 
Sorry I am late responding to you.  blush
 
Kindly,
Kitt

lanab
Regular Member


Date Joined Nov 2011
Total Posts : 136
   Posted 1/26/2012 12:13 PM (GMT -6)   
True, yes it is genetic, my doctor asked if anyone else had it in the family.

efit
Regular Member


Date Joined May 2011
Total Posts : 127
   Posted 1/26/2012 3:01 PM (GMT -6)   
Bruce,

I almost cried when I read your post referring to the You Tube video of the surgeon citing "weightlifting" as one of the 3 main reasons for a failed Nissen. It's just so much a part of my life that I cannot imagine giving it up. I lift weights 5 days per week not including the weight training classes that I teach 3 times a week. When I say I love fitness, I REALLY love fitness. As much as I hate PPI's, i would hate to give up lifting even more so I hope they continue to work decently well for me until I'm old enough where I don't care about lifting anymore. Even then, I know there's absolutely NO way I could ever give up cardio. When I don't work out, I'm not a nice person. Uhg this whole thing just seems way more trouble than I ever could have imagined "reflux" to be. The choices seem few when it comes to treatment.


Bill,

You lift heavy items at work and such, don't you? Didn't you say you lifted weights too or maybe that you used to...


Thanks guys,

Liz

bcfromfl
Regular Member


Date Joined Nov 2011
Total Posts : 384
   Posted 1/26/2012 3:12 PM (GMT -6)   
I'm so sorry, Liz -- I didn't mean to make you cry! I should've clarified when I said that...the surgeon meant power-lifting. I think that careful bodybuilding exercises are excellent and healthy to engage in. I don't know to what extent weights are in your routine, but I would carefully consider if things like squats, bench presses, and dead lifts have any place in your program. Anything else...IMO you're good to go!

Yes, I was a weight-lifter until about three years ago when this condition really sapped my energy...much of it due to lack of restful sleep. I have a nice gym in my garage, so there's otherwise no excuse.

Sorry about that lack of clarity in my post! :(

-Bruce

efit
Regular Member


Date Joined May 2011
Total Posts : 127
   Posted 1/26/2012 3:21 PM (GMT -6)   
Bruce,

Thanks for clarifying. Unfortunately, bench press, squats, and deadlifts ARE in my training repertoire. I am not a powerlifter though I do tend to push myself when working out. I hope that after you are healed with a Nissen or whatever avenue you choose, that you will get back into your fitness routine as it does provide you with so much more energy and pep in your day. Nice to have a gym at home isn't it? Mine is in my basement so I can go down there at 5 am without makeup and with my teeth unbrushed and just pump it out.

Take care

Liz

opnwhl4
Forum Moderator


Date Joined Dec 2008
Total Posts : 4831
   Posted 1/26/2012 10:14 PM (GMT -6)   
Liz-

Yeah I have to lift a lot of heavy stuff being a mechanic. when I worked at the food plant I had to lift gearboxes and motors that weighed 75 10 125 lbs. Infact we had to do a lifting test to get back to work after a long illness. Had to lift a weight off the floor turn and place it on a shelf. Started at 25lbs and went up in 5 lb increments until we hit 75lbs.
With autos we get in the worst possible lifting positions and have to lift heads, intakes, etc. Very hard on the back.
I don't lift weights as often as I used too, but do get very involved with the drills and such with the ladies I coach in softball. Diving for balls, diving back to bases, smashing into fences to catch a fly ball, etc.

Take care,
Bill
opnwhl4
Moderator: GERD/Heartburn
Nissen 6/06 and 5/09
#3 on 8/24/11

ChrisJ
New Member


Date Joined Jan 2012
Total Posts : 17
   Posted 1/29/2012 1:03 PM (GMT -6)   
Just to add to the knowledge/experience database built in this website :)

Both my parents have a hiatal hernia.
My dad can easily control it with omeprazole (the symptoms I mean)
My mom lost some weight and watches what she eats and when she eats, and she can carry a very normal life without any pills or antiacids (to the point I didn't even know what hiatal hernia could cause until I got GERD myself)

A half brother who is obese, did get a hiatal hernia as well with sypmtoms but by loosing weight he doen't have a problems anymore.

I'm 27, I was not overweight at the time I got one, I was actually quite fit. And anyways I still got it ... (probably due to improper form power lifting for way too long..). I thank god can control it now with Nexium 40 and lifestyle changes.

So, I believe there is indeed propensity to get a hernia if your parents have one.
I'm sure I got the hernia from improper lifting, but I'm sure as well I was predisposed to it (because I see so much other people who do the same as me and still get nothing)
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