Hiatal Hernia/GERD Repair Questions?

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purplepenguin
New Member


Date Joined Jul 2013
Total Posts : 6
   Posted 7/7/2013 6:11 PM (GMT -6)   
I'm new and hope someone can help me here.   Sorry for the length, I just needed to include some background info.
 
It was discovered last year that I have a medium-large size hiatal hernia and I'm not sure of its current size after the endoscopy I had last week.   I haven't met with the doctor yet.   After I was coming out of anaesethia a family member was with me and we discussed briefly a few options...one of which was a surgical repair.  
 
I have terrible GERD and reguritation.  I cannot take Reglan as I had severe side effects.   The doctor said I couldn't keep going like this (referring to my trip to the ER a few days prior to the endoscopy).   My other option besides surgery was a medicine that is not FDA approved and would cost more than I could ever afford a month, and with no guarantee it would work.  The medicine would only be a temporary fix and I would have to continue it long term until the hernia was surgically repaired.
 
My family and I have read about the surgery online so I know it's not an easy surgery, but I can't keep going like this.  I'm only 28 years old.   The GI told me I would have to lose 20lbs (I'm very overweight because of other medicine side effects) to have the surgery.  Is this true?   The surgeon who did a procedure on me last year doesn't fix hital hernias anymore but she didn't mention having to slim down for it.   
 
I'm trying to lose weight (switched one of the meds I am on suspected of weight gain) and am curious do I need to have a certain BMI range to have the repair done?   Also, if anyone has done the surgery, would you recommend it?
 
I can't afford to pay for this non-FDA approved medicine that isn't covered by insurance.   The money that I would spend on that would be more than my isurance costs for the surgery.  And I honestly just want it to be fixed.  (I know there is a possibility it can come back even with surgery, but I'm willing to take any relief I can get).
 
Thanks.

stkitt
Elite Member


Date Joined Apr 2007
Total Posts : 32602
   Posted 7/7/2013 6:49 PM (GMT -6)   
Hello and Welcome to HealingWell.  I am sorry to read of your problems.
 
From what I understand, theoretically weight loss decreases intraabdominal fat and reduces pressure and reflux symptoms and may modify the hiatal hernia. Improvement in muscle tone in the abdomen is also a factor.
 
I would look into obtaining a second opinion re surgery.
 
 
~~Kitt~~
Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.



"The wind blows, the sun rises, the snow falls and the ocean relentlessly pounds the shore. Life rolls on with fresh new possibilities at every turn."

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5028
   Posted 7/7/2013 6:56 PM (GMT -6)   
Welcome to the forum Penguin.

Do you know if your stomach is stuck in your chest? Paraesophageal hiatal hernia. If the stomach stays down in the abdomen where it belongs it's not as bad. But, yes, it sounds like surgery might be a good idea. Of course we're not doctors, just patients, so listen to your doctor, and if you do get the surgery find the most qualified surgeon in your area.

No, it's not an easy surgery. I've had it for stomach stuck in the chest (Giant paraesoph ... GPEH). My lower esophageal sphincter (look up the anatomy) was stuck wide open. I was only a little overweight, actually an acceptable weight for my height, but I wish I'd lost more before the surgery. What fat you can see under your skin is also packed around your heart and other organs. It makes it difficult for the surgeons and can make surgery take longer. You can lost it in a couple of months if you work at it.

My secret to losing weight is don't eat anything with wheat (bread, pasta, snacks) and do eat a LOT more vegetables - not rice and potatoes. I eat one meal a day of just vegetables, usually a microwave bag because I hate preparing them. As an added benefit, my cholesterol is really terrific now, and I have familial high cholesterol.

If you have an awful time with the reflux and your doctor recommends it, then you probably do need it. I'm really glad I got mine done. I was really scared my stomach would twist and I knew I only had minutes to get into surgery if that happened. GPEH does NOT go away by itself.

Search (box at top of page) many, many other threads on this.

purplepenguin
New Member


Date Joined Jul 2013
Total Posts : 6
   Posted 7/9/2013 3:05 PM (GMT -6)   
Thank you both for your replies. I'm not sure what type of hernia it is, I should have asked with the NP called me today. But the results from my endoscopy and the biopsies were not good at all. They were really bad. A lot of erosions and damage from acid even though I'm on the strongest antacid pill they make and I avoid acidic food and drinks. And a lot of inflammation too, they called it chronic inflamation. It's just a mess in my stomach right now, and has been, and it apparently is not getting any better.

I've been told I can't even take OTC advil, no NSAIDs period. (Not that I take Advil. I don't, I usually take Tylenol).

So the reflux is a nightmare and not getting any better despite lifestyle changes and medication. :( I still have problems with regurgitation and food coming back up due to the hernia. The NP is supposed to talk to the doctor today and I guess she'll call back.

Would the surgery (if we go that route) help with GERD as well as the hernia?

purplepenguin
New Member


Date Joined Jul 2013
Total Posts : 6
   Posted 7/9/2013 3:08 PM (GMT -6)   
Alcie, the hernia is pushed up about my diaphram right now, well part of my stomach is at least poking through.

stkitt, there isn't much more they can do for me with regards to the hernia and the GERD. My stomach looks pretty bad from the endoscopy and the biopsies.

My mom is very concerned with the erosions (I think that's what the NP called them) as they can lead to cancer later on down the line.

Things are not any better from my endosopy last year to this year, if not worse.

purplepenguin
New Member


Date Joined Jul 2013
Total Posts : 6
   Posted 7/9/2013 3:09 PM (GMT -6)   
*above not about. Sorry.

GC1pink
Veteran Member


Date Joined Nov 2012
Total Posts : 532
   Posted 7/9/2013 3:26 PM (GMT -6)   
Hi PurplePenguin,
 
May I ask how long you have had the reflux and regurgitation?
 
Has your Dr explained the different types of surgery to you and have you read up about them yourself? There are lots of people on here, who have had the nissen, linx and the Tif, may I suggest that you read some of their stories, and then arm yourself with information and questions for your next meeting with your Doctor.
 
I think if you have tried all the medications and that you are not getting any better then surgery sounds like an option for you, I too have a hiatal hernia and am considering surgery, another question to ask your doctor is if the hernia would be repaired with mesh or another substance to strengthen it - I know here in the UK some surgeons use pigs bowel, as your own muscle grows over it.
 
I wish you luck, and keep us all informed of your progress.
 

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/9/2013 5:27 PM (GMT -6)   
purplepenguin

From what info you have given it sounds like surgery is most likely needed. If you HH is large enough for part of your stomach to be going through it should be fixed. They usually like to do a nissen along with the HH repair. This would help the regurgitation as well.
I have read a lot of bad things about the use of mesh lately and would personally not go that route, but that is between you and your surgeon. I would also get a 2nd opinion with a reflux surgeon. You want a surgeon who has done 100s if not 1000s of these successfully. This is VERY important! I don't have data for it, but having gone through this surgery and knowing others who have been through it, under skilled surgeons seem to be the biggest reason for issues after surgery.

Please feel free to email me if you like about the surgery.

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

purplepenguin
New Member


Date Joined Jul 2013
Total Posts : 6
   Posted 7/9/2013 6:03 PM (GMT -6)   
GC1pink, I've had acid reflux since I was a teenager, but it has only gotten worse and the reason for some of it--the hernia--was discovered last year. I've had the reguritation since last year. I had my gallbladder out and that helped with the nausea a lot, but I still keep bringing food up. I can feel it coming up to the back of my throat even just by eating something like toast, and then sometimes it just ends up coming out. And it's especially worse if I cough, then everything just comes up. The burning has subsided a little from the GERD, but food just does not want to stay in my stomach.

I didn't know about any other type of surgery besides the nissen. Thank you for giving me a few types that they do. I will look those up.

Bill, thank you. I will be sure when I see the GI doctor next time, and if surgery is an option, I will make sure they send me to someone experienced. Would it be rude to ask the surgeon how many they have done and what their results have been? I've just always gone blindly with whatever the referring doctor has said concerning surgery (i.e. gall bladder).

opnwhl4
Veteran Member


Date Joined Dec 2008
Total Posts : 4961
   Posted 7/9/2013 6:35 PM (GMT -6)   
purplepenguin

Definitely would not be rude to ask. Remember you are hiring them to work for you. Think of it as an interview on their part.

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

bigmike2883
New Member


Date Joined Jul 2013
Total Posts : 5
   Posted 7/11/2013 2:10 AM (GMT -6)   
I also suffer from hiatal hernia and i was told also to lose weight and by doing so it could correct it self and needless to say a yr later i go back and see stomach doctor and had a upper GI done gain and was told i didnt have a hiatal hernia. I dont know if i had one at all or not but my weight was 305 before i got this hernia and GERD and im and now 215 lbs and im not sure what meds ur on but i was put on dexilant once a day treatment and it works great and it cost around 160 $ a month and i dont feel nausea everyday anymore but i do have my days still
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