Giant hiatus hernia without gerd

Hello, does anyone have any experience of surgery on a hiatus hernia where the stomach has gone almost completely into the chest cavity please? In this case, there is no apparent acid problem,  just occasions where food 'jams' .

rabbitrabbit-
Welcome to Healing Well. Joy is correct Alcie did have this problem after a car accident if I remember correctly. I am sure she will be along shortly also.

Take care,
Bill

Yes, I did have this happen due to seatbelt and airbag in a high speed wreck.

Because I was already on PPIs I had had non-acid reflux for at least 25 years and no bad acid erosions, I would not have had surgery but for the accident. I already had a small hiatal hernia, but those are of no significance normally and just about everyone gets them at some time. I have a weak swallow due to having polio as a child, so I can't swallow large pills and have had trouble with chunks of meat that were not chewed well enough.

However, a paraesophageal hernia, where the stomach stays in the chest, is dangerous. If the stomach rotates it can start dying immediately and you have to be rushed into surgery with only a 50% chance of survival. Since it will not correct itself, a paraesophageal hiatal hernia is a clear indication that surgery is necessary.

This surgery is done exactly like the Nissen fundoplication, laparoscopically. Since the stomach has to be pulled down from the chest carefully, it takes a good bit longer (mine took 4 1/2 hours), but is probably no more dangerous in the hands of a top, experienced surgeon. I was not the best candidate for any surgery because of a previous heart attack and my age, but my surgeons are tops in their field here in Pittsburgh, and I had a good outcome.

I wouldn't recommend going to a surgeon who hasn't done thousands of these procedures for a paraesophageal hernia. Less esperience is probably fine for routine surgeries, but this one takes a bit of doing to get it right. Since I don't have a strong swallow, the procedure selected for me was called a Toupet fundoplication. It's a partial wrap done in the same manner as the Nissen.

Let the surgeon choose the procedure based on your tests, but there's no question that surgery is necessary for a stomach stuck in the chest.

Pittsburgh's a good place to get this surgery done. 3 docs in different hospitals have enough experience here. Mine was done at Presby.

JAS - If the stomach spasms didn't go away or they come back, check into food triggers. Keep a food log. With paraesophageal that alone causes serious problems. You aren't far enough along yet to know.

JAS - Are you still on PPIs? I was on for 2 weeks post-op, then allowed to go off if I didn't need them. My only complaint was the 2 week post-op check was the only one. Patients are dumped. I called about diet, but they're only interested in whether they can put my surgery in the success column. But then my GI doc has been useless for anything about diet too. He just wants me to go to his clinic for my next colonoscopy, and I'm not sure I want to.

Hello again. Thank you all for your replies. Sorry for the delay. Im in Uk so things may be different I dont know . The first specialist my husband saw , told him surgery was absolutely necessary because the whole stomach was in the chest. He told us it was 'urgent' because if it strangulated , it reduced survival rates significantly . He told us open surgery was necessary in this case because of scar tissue from a previous triple A op, and that he recommended a thoracic surgeon to do it because it was big and tricky ---- he would get things moving.
We waited weeks. Nothing. Then we found out that surgeon had retired without making the necessary requests to get my OH an urgent appointment, so it was just too bad, we had to wait till now , today for one.
This specialist today, was totally laid back. Yes it was huge,already flipped back on itself in the chest cavity, needed doing, but no, it would wait another month or two, yes he fully intends to do it keyhole way-hes done other giants that way, and dont worry, strangulation rarely happens in reality , and even if it did, OH would just come in straight away, have a tube inserted down the oesophagus to deflate stomach, and then a normal hernia op would be carried out. No it wouldnt increase mortality rate. What the heck are you supposed to believe!