Considering surgery to repair Hiatal Hernia

Greetings everyone,
My name is Robert and I'm new to the club. I am 26.
I was diagnosed with a hiatal hernia in August, 2011, after experiencing extreme heartburn following a violent vomiting/dry heaving episode. I literally felt my stomach rise into my esophogus, and try to drop, but it didn't. It got stuck, and it dropped me to my knees in pain. It took months before I realized that episode was what caused it. I thought it was from the Orange juice and vodka I had drank the night before.

My first doctor (now retired) passed it off as GERD and encouraged me to change my diet. I did that, and after 4 months with very little success using OTC's like Prilosec, I went back and he forwarded me to an endoscopy center, which did a scope. The doc found a hiatal hernia, and all of my tests (Barretts, H Plori, and others) came back negative. They gave me a 10-day supply of Dexilant and sent me on my way. Told me to eat healthy, raise the head of the bed, etc. I took OTC Prevacid for a while since it was the closest thing I could find to Dexilant. I eventually ended up back at the doc and requested a script for Dex. Dexilant was an incredible savior for me at the time...working very well. However, after a $20/month promotion ran out after a year, I couldn't afford the nearly 300/month for it anymore. I went back to my old doctor and he put me on generic Protonix (Pantaprazole) 40 mg a day. It gets me by but by no means would I consider it a success.

My old doctor just retired so I recently got to meet and greet my new doctor, who is much younger. When I told him about these issues, and my ongoing pain with heartburn and the feeling of me constantly choking on my stomach, he upgraded me to Protonix 40mg twice per day, and said maybe it's time to consider surgery. He has forwarded me to the surgeon to see what they think.

At this point, I think surgery could be in my best interest, since I'm really getting tired of taking PPIs for the past 2 years. However, when I asked my old doctor about it, he basically said no way because of its lack of effectiveness over time.

I'm wondering everyone's opinions on the Nissen Fundoplication surgery (my most likely option). I'm very concerned about the inability to vomit, and also the issues with bloating and not being able to burp. I do drink beer/alcohol, which concerns me more about some of the complications. Also uber scared I could end up one of those people eating out of a feeding tube. I have a 2-year old daughter and I want to be there for her every step of the way.

Thank you everyone!!

Hi Robert.

How bad is the hernia? Most older people have a little one and don't even know it.

Have you had any tests to see if there is another cause for the reflux? Barium swallow is quick and easy, no sedation. Having someone look down inside the esophagus (endoscopy) is another thing that should be done to see what damage there might be.

If you get referred to a surgeon they will do other tests, not fun but essential to finding out if surgery is the best recourse.

As for burping, that may be possible especially after the swelling goes down and depending on how tight the wrap had to be done - which depends on the tests! You probably won't be able to vomit, which isn't awful. I can't and just carry around a small anti-nausea med in case.

Stopping beer just for now is a really good idea. Besides the bubbles which would be a problem post-op, stopping would indicate if you might have a sensitivity to it. I do! If I don't eat any of my "trigger foods" I don't get symptoms. Before I needed surgery (car wreck) I got all my reflux stopped, also a bunch of other symptoms, just from finding my "food intolerances." (Look up some of the threads on "food logs" or "food journals.") I had been considering surgery, but didn't need it until my accident.