Hiatel Hernia and its Size????

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Regular Member

Date Joined Mar 2008
Total Posts : 149
   Posted 1/4/2010 5:49 PM (GMT -6)   
Im confused. Why is the size of your HH a determining factor as to what medical procedure you get done?Or if you get it done? Usually isn't the HH responsible for the Gerd problems? If there is a large HH for example why can't they just fix that and than continue to the procedure? I fond this so frustrating. I have HH and gerd and what annoys me is that there are procedures out there to help me but I can get examined by a physician and he/she can tell me that Im not a candidate for an operation. That would mean PPI's again!! What does one have to do with the other????

Elite Member

Date Joined Apr 2007
Total Posts : 32602
   Posted 1/4/2010 5:52 PM (GMT -6)   

I am sorry to hear about your frustration. Did you ask the Doctors this question as they should have given you more indepth explanation as to why you are not a candidate?

I know some of the members will have info for you.

Take care,


Forum Moderator

Date Joined Feb 2009
Total Posts : 7188
   Posted 1/4/2010 6:06 PM (GMT -6)   
Hi tracks83,
Believe me, I understand your frustration. The hiatal hernia question is a good one. It must be that when the hiatal hernia is combined with a poorly functioning LES, the GERD surgery (Nissen Fundoplication, etc.) is required. I wonder if a simple hernia fix would work.

I went to a GI doc who did NOTHING for me, and I was told more than once that the surgery was not for me. (My first GI doc didn't seems too keen on it for anyone, and had lots of negative comments about any of the procedures out there.)

If you doctor isn't helping you solve your problem, I'd recommend that you shop for another doc. It took me some time, but I finally found a GI doc who would listen and respond honestly to my questions and concerns.
Many here have been thorough what you're dealing with, and I'm sure you'll get lots of support and information. Be sure to continue to ask questions.
Best wishes,

Regular Member

Date Joined Mar 2008
Total Posts : 149
   Posted 1/4/2010 6:13 PM (GMT -6)   
Thanks Denise,
Sometimes things so simple don't make any sense. I have a non-functioning LES and HH. I need surgery....period. I read on this site how some people have a a 1 or 2 cm HH and they're good to go for an operation. But what about me? What if mine is slightly bigger? Now I'm screwed??? I would like for someone to explain the rationale behind this?
Just a FYI: I do not know the size of my HH but from what my DR. said its a substantial one.

Elite Member

Date Joined Jul 2009
Total Posts : 14475
   Posted 1/4/2010 6:20 PM (GMT -6)   
I had a HH that was too big for the EsophyX TIF. The surgeon I went to said if I did that surgery it would pull up into my chest crowding my lungs and heart.
He had developed his own form of the Hill (a 270 degree wrap) that worked for me.

Sometimes when you go shopping for a car you wind up with a truck. :)
It's not what you wanted to begin with, but it works better for you.


Regular Member

Date Joined Dec 2009
Total Posts : 186
   Posted 1/4/2010 7:25 PM (GMT -6)   
I've been living with a HH for many years.  I have reflux/gerd, les as well.  How fun is that??  Whee!!!  Do you have any other symptoms? Like, I can just burp and bring up food.  I can sleep and aspirate the stomach acid and get pneumonia.  I've also burned my vocal cords to hell and back and have a hard time getting a full breath which made me suicidal.  I go back to my gastro Dr on the 14th and I'm gonna flat out tell him to refer me to a surgeon. 
Rapid Cycling Bipolar Disorder (and about a dozen other things)
300mg Lamictal
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Veteran Member

Date Joined Oct 2009
Total Posts : 5028
   Posted 1/4/2010 7:32 PM (GMT -6)   
Hi Tracks -
It's not just the size of the hernia that determines whether you need surgery.  There are many factors, including whether the surgeon feels you need it.
There are two types of hiatal hernias.  Sliders,  the ones that go up and back down again, unless they are huge, generally don't cause symptoms bad enough for surgery.  Paraesophageal hernias, the kind where a part of the stomach is stuck in the chest, on the other hand, will never get better on their own and can strangulate, and you generally die from that.  So PEH needs the operation.  That was t he type I had.
Other important factors include things like whether your swallowing reflex is working properly.  There are different operations for that.  Mine wasn't working well, but still not a nutcracker case, so I had the partial wrap known as Toupet Fundoplication.
You need lots of tests to prove whether you are a candidate for a wrap.  Read all the stuff in the permanent posts at the top of the forum!  One I sent in has good descriptions and pictures of the different types of operations.

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