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Hiatal Hernia Question

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Posted 4/2/2012 1:28 PM (GMT 0)
Good morning

The results of my Barium Swallow apparently show a small sliding hiatal hernia with slight reflux.   I have a followup appointment with my Doctor in a month, once my initial supply of PPI's runs out.  Perhaps I will learn more then, and more treatment or test options.

My assumption is that my GERD/LPR issues are caused by that , but I've not had that confirmed yet by by Doct.


I do not seem to have may 'classic symptoms' of heartburn, most of mine are throat related, hoarseness from time to time, a lump when I swallow etc.

I am curious if anyone else on the board has a small hernia and how've you managed it?

Thanks

 

Posted 4/2/2012 2:28 PM (GMT 0)
Good Morning Cylon,

Heartburn is the symptom of acid reflux and GERD; however, not everyone with acid reflux has heartburn and not everyone with heartburn has acid reflux. The symptom of heartburn can also be caused by other unusual things such as intestinal motility problems. I started out with nasty heartburn but then had problems with swallowing or the lump in my throat feeling, then reflux.  I have been controlled well with PPIs and diet changes. 

I am sure you will hear from members that have a small hiatal hernia.  Keep on talking with us here and know we all experience GERD in our own unique way.

Kindly,

Kitt

Posted 4/2/2012 5:59 PM (GMT 0)
Thanks Stkitt

I appreciate your feedback.

I am , as I'm sure others have been, just frustrated with how it all works.  It's been nearly 3 weeks, and I still don't see any real consistent improvement in my throat issues.  It seemed like the 'lump' sensation when I swallowed had abated a bit on the weekend (wasn't always as noticeable), but seems to be back again today.  I still don't have any real heartburn feeling, or bile, or pain, just the throat feeling.


I've changed my diet (no spice, little fat, no fried food, reduced coffee to 1 a day, no acohol), got a wedge pillow, and still I don't see much in the way of improvement.

 

Posted 4/6/2012 1:48 PM (GMT 0)
Hello Cylon,

I found out that I have a small hiatal hernia a little over a month ago. I've done a lot of research on this subject and found that quite a few people are estimated to have a hiatal hernia. However, most people never know they have one because they do not experience symptoms. Lucky us, right? Like you, I have the lump in throat feeling, but I also have pressure in my abdomen and burping, regardless of what I eat or drink. I've also noticed some difficulty swallowing liquids. My GP put me on Prilosec (20mg- the OTC doseage) for a month and a half. It did absolutley nothing; in fact, I think it made things worse. This is my 4th day on Nexium, and I seem to be doing better with it. The symptoms aren't gone, but I hear this takes a while, especially if you have damage to the throat; it is more delicate than the esophagus, so it takes longer to heal.

I've done the same things as you- elevated the bed 6" and changed my diet. Didn't work on its own, or with the Prilosec OTC.

My doctor told me the best thing I can do is lose weight. Right now I'm about 8 lbs overweight, so I'm hoping that getting in a healthy BMI range will ease or maybe eliminate these symptoms. I've read that this has worked for others.

I'm only 25, and I don't want to deal with this for the rest of my life. I would love to have the Linx surgery that just got approved by the FDA, so I plan to see a GI doc to discuss this option.

Did all of this come seemingly out of nowhere for you?

Posted 4/7/2012 12:27 AM (GMT 0)
Half the people over 50 have a small hiatal hernia and don't know it because it doesn't cause a problem. I lived for 15 years with one and just took acid reducers. I had no problem except for some specific trigger foods.

I eventually needed Nissen surgery, but that was due to an accident that pushed my stomach into my chest.
Posted 4/7/2012 12:42 PM (GMT 0)
@kitkat

Thanks for the reply.

Now that I'm past 3 weeks on the Dexilant I'm fearing it isn't working and my symptoms won't go away.

It's hard to know what is going to work and what isn't - I wonder if the restricted iet, raising myself up in bed, etc . haven't seen much improvement , so is any of it doing any help at all?

My symptoms did pretty much come out of no where. Right before Christmas, I remember one episode where it felt like I had a crumb or piece of bread stuck in my throat, but it went away after a few hours, then a few weeks after the holidays that feelng returned and persisted to where I went to my doctor.

I haven't spoken to my ENT since my barium tests, so I am wondering if that will change his diagnosis, or treatments now that it seems I do have a hernia.
Posted 4/7/2012 4:25 PM (GMT 0)
Cylon-

I definitely would schedule a follow-up with your ENT. I have yet to see a specialist, just a GP and an internist, which I think of as a glorified GP. I have lost faith in these doctors at the point because they seem to just write prescriptions and send you on your way as quickly as possible. An ENT should be able to look at your throat and tell you what kind of damage has been done. This could help alleviate your fears about the Dexilant not working; the greater the damage, the longer the healing process. I don't think it will change the form of treatment, unless something completely new is found. The hernia can be repaired surgically, but I understand that this is only done in extreme cases.

I have an appointment with an ENT next week, and after that I plan to see a GI doc. I'm afraid that the Nexium isn't working after 5 days of taking it; unfortunately my swallowing issue just seems to get worse.

I also am hesitant to blame all of this on the hiatal hernia; a family member discussed my health issues with her doctor, and the doctor thinks that I must have been born with the hernia. So why would it suddenly start causing trouble?

As far as the diet is concerned, I have read so many different theories that I can't keep them all straight. Some suggest low carb diets because carbs cause gas and bloating as they are digested. Then there are the recommendations to stay away from tomatoes, chocolate, citrus, etc. I'm sure you have read the long list. I will say that I burp no matter what! I never have the regurgitation issue that so many sufferers mention.

I bought a mattress wedge that elevates the mattress 6" at the head, but even when my bed was flat I was able to sleep through the night. In fact, I usually feel best in the mornings and things go down-hill as the day goes on.

Right now I'm looking into a theory about low stomach acid causing all of these problems. I was incredibly stressed before all of this started, which can supposedly lower your stomach acid. I also had a viral infection, which further lowers the acid levels, as far as I can tell. I read about a study of otherwise healthy college students that came down with the flu. It took 2 months for their stomach acid levels to return to normal. I've talked to a chiropractor who seems to think this is the issue. It explains why my symptoms have gotten worse since starting the PPIs.

I've also read that a magnesium deficiency can be linked to the lump in throat and difficulty swallowing. Don't know how credible this is though.

There is so much information out there that it is hard to figure out what is useful and what is just bunk!
Posted 4/8/2012 12:15 PM (GMT 0)
@kitkat

I agree with everything you've said. I do have an appointment with my ENT next month
During my initial appointment with him, he did use an endoscope (through my nasal cavity) to check my thoat, vocal cords, etc and told me it was a bit inflamed, then he ordered the Barium Swallow and a followup appointment.

There was no discussion about diet change or raising the bed - just the prescription for a PPI.

Everything else I've tried has been from reading online journals, and message boards - the diet restrictions, wedge, manuka honey etc.
And to be quite honest it feels like I'm chasing a ghost at times since nothing seems to have gotten rid of the symptoms and it's hard to tell what combination of things may work.

What drives me a bit mental is that until the throat issues started in January I had not apparent symptoms or warning signs - no heartburn pain, nausea, food sticking etc - just started with a lump feeling that went from very slight on and off to then being everytime I swallow and then my voice would get horse or sore after a long day.

Like you, I don't wake up with pain or relux.

Not sure what to do, but I am worried I'll have this feeling for the rest of my life.
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