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Hiatal Hernia Repair

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Posted 3/27/2015 12:16 AM (GMT 0)
This question is directed to those of you who have had a hiatal hernia and diaphragm repair. I have a large paraesophageal hernia, about a third of my stomach is in my chest right now. I get some reflux that seems fairly well controlled with PPIs but rarely anything like some people here experience. However, I've had a few occurrences of feeling just plain awful- pressure in my chest, back ache, lots of bloating, a fair amount of burping and more than usual fatigue. Unfortunately, today and yesterday are such days. This usually lasts 3 - 4 day and subsides to a more livable level. I've had a preliminary discussion with my surgeon who thinks a toupet or, pending a few more tests results, maybe a NF is warranted.
My question for those who have had such a hernia repair, does it do away with the chest pressure and bloating? Or might I be trading one set of problems for another? I'm trying to be reasonable in my expectations and your experience will be helpful.
Peg
Posted 3/27/2015 2:53 AM (GMT 0)
Peg,

I had a large paraesophageal hernia repaired 23 days ago. A little background, I experience really bad acid reflux for about 30 years and about 5 years ago I stopped experiencing the acid reflux or at least it was a lot more mild. What happened is that over the years the hernia got worse and a large portion of my stomach ended up above my diaphragm. I had a lot of trouble swallowing and at times food got stuck. I ended up in the emergency room with terrible chest pain which ended up being food stuck. Spent the night in the hospital and the surgeon on call told me to have the hernia repaired. My subsequent barium swallow showed reflux from my abdominal stomach to my thoracic stomach (the part below the diaphragm to the stomach above the diaphragm). However, reflux into my esophagus could not be induced. The esophagus had been pushed aside and my new anatomy did not allow much acid back up into the esophagus. However, given constant chest pains, shortness of breath, and potential risks of a large hernia strangulating surgery was necessary.

I found a surgeon that claimed to have done about 2,000 hiatal hernia repairs and went with him (he was highly recommended by another surgeon). So far the recovery seems to be on schedule. I experience some of the same post-surgery issues that others have written in this forum. However, as of now, I am tentatively glad I had the surgery. As would be expected, eating normal and swallowing has not been easy. However, it is starting to improve and I am no longer having chest pain. I am optimistic that the surgery was a great idea. The surgeon did a toupet (Mass. General Hospital in Boston). Let me know if I can provide any other information,

-Tim

-Tim
Posted 3/27/2015 2:59 AM (GMT 0)
Peg,

The following article (pdf) is about repairs done at the Cleveland Clinic. I believe the procedure I had done was the same or similar to the procedure discussed in this article. It really is important to have a good experienced surgeon.

http://www.ccjm.org/fileadmin/content_pdf/ccjm/content_70_511.pdf

-Tim
Posted 3/27/2015 4:38 PM (GMT 0)
Tim,
Thank you for your reply. I've never quite heard it described as you have, having two stomachs, but that is what's happened, isn't it? And hearing it put that way, it seems clear that I need to get this repaired. My doctor also said that he may have to pull my esophagus down because over the years it's been pushed up higher than normal by the movement of the hernia. If I might ask, how long was your surgery? My doctor estimated 5 hours which seems quite long but he was indicating there's a lot of repair to do. Also, how long were you kept in the hospital?
I'm glad to hear your recovery is moving along. I hope you heal quickly.
Peg
Posted 3/27/2015 8:57 PM (GMT 0)
Peg,

I received a copy of the written report from my barium swallow and it is the radiologist who described it as a abdominal stomach (portion of stomach below the diaphragm) and thoracic stomach (portion of stomach above the diaphragm). I followed the advice of doctors in deciding to have the surgery--my GI doctor; the surgeon I spoke with when I ended up in the emergency room; and the 2 surgeons I spoke to about doing the surgery. All of them thought I should have the surgery.

The actual surgery took about 2 and 1/2 hours. The surgeon originally told me it would take about 2 hours and potentially longer depending what needed to be done (thus, it is possible that it could take up to 5 hours). My surgery started at about 2 pm on a Tuesday and I was released from the hospital about noon the next day; thus, just one night in the hospital. I walked the hospital floor at about 11 pm the day of surgery and I walked it a few more times the morning after surgery. I went into surgery in fairly good physical condition. When I had an endoscopy done several months ago, it did show some inflammation of both the esophagus and the stomach. I am having more trouble swallowing than I expected based on talking to the surgeon; however, given the pre-surgery inflammation, I guess that could be expected.

I am optimistic and look forward to how I will feel in several months. The recovery does take time. Hope this helps,

-Tim
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