Just diagnosed with Gerd and Hiatal Hernia, now what?

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toughjourney
New Member


Date Joined Jan 2011
Total Posts : 5
   Posted 1/26/2011 8:15 PM (GMT -6)   
rolleyes  Hi all,
I am new to this forum. I have a few questions about my recent diagnosis of Gerd and Hiatal Hernia. I have suffered from IBS-D (diarrhea type) for over 10 years and was diagnosed with it by my gastroenterologist 3 years ago after having gone through numerous tests, colonoscopy being one of them. It is as manageable as it will ever be at this time. I take Lotronex and Donnatal for it.
Last month I had an upper g.i. barium xray done which showed a hiatal hernia. My doctor told me it is due to excess acid backing up into my esophagus. I was surprised because although I have terrible symptoms with IBS, I never really experienced "heartburn" or "acid reflux". It wasn't until 3 weeks ago that I started having terrible upper abdominal pain with pressure, burping alot, difficulty swallowing, and nausea. Last week, my gastroenterologist performed an upper endoscopy with an esophageal dilatation due to "a stricture" in my esophagus. He confirmed a "sliding"hiatal hernia during this procedure. I follow up with him next week. He put me on Acifed in the meantime. (my insurance wouldn't pay for Nexium).
First question is, how is sliding hiatal hernia treated? Will it ever go away? What is the best form of treatment (medicine) to take for it? With IBS, food never caused it, it just happens randomly. Will I need to watch what I eat now?  Can this stricture happen again?
Anything else I need to know or should ask my doctor?
Thanks for any input.

dencha
Forum Moderator


Date Joined Feb 2009
Total Posts : 7185
   Posted 1/26/2011 8:34 PM (GMT -6)   
Hi Toughjourney (and it is),
Welcome to Healing Well! In your post you say that your doctor blamed the hiatal hernia on excess acid backing up into your esophagus...I'm assuming that's a typo, or you misinterpreted his statement. The hiatal hernia allows acid to leak into the esophagus, not the other way around.

You were probably having "silent GERD" symptoms--with acid entering your esophagus without your awareness. That can create problems in the esophagus (as well as lungs and vocal chords) without you ever knowing it.

Strictures are evidence that you have reflux, and have had it for some time. I'm not sure, but I do believe I've heard of people having to have strictures dilated repeatedly.

Your hernia can be repaired through laproscopic surgery. I would imagine that your doctor would do some testing to determine the status of your reflux. Most here who have significant reflux with hiatal hernia have had a series of tests including, barium swallow, endoscopy, manometry, and 24 hr PH monitor.

Good luck finding answers and I hope you get feeling better soon!
Take care,
Denise

toughjourney
New Member


Date Joined Jan 2011
Total Posts : 5
   Posted 1/27/2011 11:13 AM (GMT -6)   
Dencha, thanks for replying. Maybe I did misunderstand my doctor. He may have told me that the the acid in my digestive system caused the narrowing of my esophagus due to scar tissue and not the hiatal hernia. If acid does not create the hernia, how does one get it? What actually causes a hernia? Why does part of the stomach move upward into the chest? (If I have that right).
How do the tests determine reflux? I have had an upper barium xray and an upper endoscopy, but what is a manometry? And a 24 hour Ph monitor? Are these questions that i should be asking my doctor when I go in to see him? Or do I wait to see what course of action (or none) that he will take?
What is Laporoscopic surgery? Is this the norm for taking care of hernia's? I don't want to have to "live" with this, as some people suggested that to me, but I am also not crazy about surgery either.
I am just so frustrated with not only having to deal with IBS-D, but now having Gerd and the Hiatal Hernia.  I'm sure alot of people have a lot worse, so I try to be optimistic, but it's still difficult to live with these physical conditions.

couchtater
Elite Member


Date Joined Jul 2009
Total Posts : 14475
   Posted 1/27/2011 9:51 PM (GMT -6)   
What actually causes a hernia? Why does part of the stomach move upward into the chest? 
My surgeon said a hernia is really a birth defect. The diaphagm hole that the esophagus goes through is too big therefore the stomach migrates upward into the chest area causing the hernia to develop.
 
 How do the tests determine reflux?
The pH test tells if reflux is traveling upward into the esophagus.
 
what is a manometry?
A manometry is a test to determine your swallowing reflex and pressure inside. A small catheter is run from your numbed nose down to your stomach. You then have to swallow 10 perfect swallows of water as the computer reads the swallows.
 
24 hour Ph monitor?
There is two kinds: ph wire test and Bravo.
PH wire involves having a small wire run from your nose down to your stomach. It stays for 24 hours and is then removed.
Bravo is a small capsule attached to the inside of your esophagus. It sends signals to a monitor for 24-48hrs. It falls off after a few days.

What is Laporoscopic surgery?
The surgeon makes five to six small cuts in your stomach and inserts special tools and a camera to do the surgery. You can google the Nissen surgery and watch a video of the surgery on you-tube. The cuts do not need stitches (usually glued) and heal within 14 days.
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