Is HIATAL HERNIA GENETIC?

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

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

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

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)

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

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. 

Kindly,

Kitt

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

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

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)