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Any Advice for Hiatal Hernia Self-Treatment/Therapy, or HH Surgery Options?

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Posted 1/13/2014 2:52 AM (GMT 0)
Hello again,

Im Just waiting on results as to whether I have a type 1 or higher hiatal hernia from the barium swallow.  I am sure I do have at least type 1.  Althought there is a possibility I don't.  Who knows what the hell could be causing all this darn burping and indigestion at the gym...  

Does anyone know if its dangerous for me to workout and stress my heart unnecessarily with all these issues at the gym and still just lift the weights?  Its just messed u when people look at me as if im struggling breahing from this thing aggravated by some other possible thing like inflammation or an ulcer.

Does anyone know if type 1s are ever repaired?  I heard that by some key measures a person can reduce and strengthen those muscles especially with diet and timing of diet, early sleep, and some nights fasting and resting propped on an angle locks the stomach back into place after a while.  Is yoga also a way to strengthen the hiatus muscle?  If anyone knows of other ways, please kindly share if you know.

And if not, what is the best possible type of surgery for this type or other types other than the nissen fundoplication.  Once I saw a picure of these two white bio-pads inserted under the suture area as two joined together to also eventualy become part of the organism and absorbs organic material.  Does anyone have more info on this?

Also, is there other new surgerys out there called linx and some other one with lasers and another one with a ring of beads?   I really hope the techniques are improving because I am disturbed at the mortality rats I have read on HH surgeries on the net.  Are those reliable accounts?

But I am thinking of changing GI docs.  Why did my GI doc tell me "hiatal hernia's do not cause chest pain"?? Straight Quote word for word.  

On a bland as hell diet now because if it is a type 1, then will try to strengthen the LES/hiatus because it has weaned away in the past.

If it is a type 2 or higher I am not delaying a second more. But might not be that because its only this other thing going on causing burping that's making my chest pain/tightness more frequent possibly from a type 1.

But if someone can please guide me as to whether to just stop working out - are people with Hiatal hernias not allowed work-outs?  Or is that just type 2 or higher?   What is safe her because some days I can lift more and longer, other days I can barely walk up the stairs without chest tightness, burping air and indigestion, sometimes contents wanting to come up.   I wish this barium swallow result will tell me what the hell is going on here... but if anyone can provide quicker info that would help lots.

Thanks

 

Post Edited (7Stringer) : 1/17/2014 4:56:31 PM (GMT-7)

Posted 1/13/2014 3:24 PM (GMT 0)
Welcome to the forum 7Stringer.

Type 1 hiatal hernia is just a sliding hernia, where part of the stomach slides up through the hole into the chest and then back down. Most people who have this type never know they have it, but that doesn't mean they can't have pain, usually if the hernia is large, or if there is something else going on. I wouldn't dump the doc just because he generalized a bit.

The question is whether you also have a loose lower esophageal sphincter (the valve that sits at the top of the stomach). If acid can get squeezed past the LES and up to the esophagus, that's what causes most pain. The tissue in the esophagus is not the same as in the stomach. The stomach tissue tolerates acid, the esophageal tissue doesn't. There is no exercise to strengthen this valve. You should get the diagnosis for this from the barium swallow. Still, a bad valve is not an absolute reason for surgery.

Before you start thinking of surgery you should be looking at how to avoid it. I lived just fine on various acid reducing meds for over 20 years. Surgery was only needed after a bad wreck that got the stomach stuck above the diaphragm. I had reflux, but it was non-acid and caused no damage.

Diet alone will not stop acid reflux. Food triggers the stomach cells to produce acid, bland food or not. That said, some people do have "food triggers" (google or use the search box at the top of the page) that cause the stomach to heave and squeeze the stomach contents up. Lots of burping and indigestion may be telling you something! I'm one of those people, but still didn't need surgery, just learned to avoid my "trigger foods" and kept on the acid reducers (PPIs mostly for me). And my stomach valve (sphincter) was really bad! Keeping a "food journal" will tell you if you have trigger foods. Search that one too. Lots of posts.

As for exercise, ask your doc about the specific types you are doing. I'm old now but had no bad effects from a lifetime of heavy farm-type lifting. I didn't need surgery until the high speed wreck, which was the power needed to shove the stomach into the chest.

I agree that a paraesophageal hiatal hernia (type 2) can be a reason to get surgery. The only type of surgery for this, as far as I know (not a medical opinion) is one of the types of Nissen. The hole in the diaphragm needs to be sutured. You can't rush either. There are many tests the surgeon needs before doing major surgery like this. Not doing the tests can cause bad results you read about on forums.

Sorry, but there's no quick diagnosis from a forum. We're not doctors and can only describe our own experiences. Best wishes, and keep in touch.
Posted 1/13/2014 10:29 PM (GMT 0)
I appreciate the insights but why does everybody say acid? Its not the burning type pain. I only get that once in a while and that's what's called heartburn. Even the doc kept saying acid reflux and I have no clue why he would not provide a more sophisticated hypothesis of the specifics of my rare condition. But my main issue is not acid. Its just air stuck causing chest pain mostly at the gym and have to keep burping it out. And undigested food sitting there coming up also causing the chest pain. Not the burning type of acid at all. So this still makes absolutely zero sense.

The other thing that is not making sense is why the sudden pains beside the heart that come intense but quick especially after eating garlic. Is this from the substance of garlic going up into the paraesophageal hernia and the heart beating against it? But then is the heart pushing it back down? Or is that just a spasm in reaction to garlic?

Also having some indigestion in the days after the barium swallow even for bland foods. Is this normal?

And I'm not sure about PPIs. Those are just temporary to heal the esophagus from what I've learned. But I'm not sure if one should be on those regularily. But nonetheless I've been trying prevacid. But I have problems from prevacid or dexilant. I have ugly debilitating gas coming up because of those. Is it because I don't wait long enough before eating after taking it? Or is there some drug that is less problematic than that? With nexium food just sits there at night undigested. This is not an acid matter, its a lack of capacity of the system to digest and keep moving the food.

Post Edited (7Stringer) : 1/13/2014 3:43:51 PM (GMT-7)

Posted 1/13/2014 10:49 PM (GMT 0)
But I will check the trigger foods in the searches.
Posted 1/14/2014 12:32 AM (GMT 0)
Your condition may not be so rare. With my food allergy/intolerance/sensitivity (whatever they are calling it this week) I had years of feeling like I had a bubble stuck in my chest, usually after breakfast and certain other meals or foods and drinks. I could get the feeling to go away if I got a burp up, as in the "Valsalva maneuver." It took me years, and a good allergist, to figure out it might be related to foods and not activity or time of day or something.

If you've been taking PPIs, like I was, the refluxate might not be acid at all. If nothing's particularly wrong with the LES you might not even be having reflux.

Many of the foods considered "bland" contain chemicals, in my case sulfite, that trigger a reaction. You can search lists of foods containing known triggers such as salicylates, sulfites, MSG and more. I wouldn't do his until having a list of foods that seem to be triggers - if any come up on keeping a food journal. Garlic is on my list of sulfited foods.

What happens to me is called "cardio-esophageal reflex." That's reflex with an E, not a U. A chemical irritates the esophagus and/or the stomach, which then causes the heart to react via the vagus nerve. My heart reaction is tachycardia, very rapid beating, which can feel like just a pain.

You said you thought you had type 1, sliding, hernia. Have you since found it's paraesophageal, type 2? You can have a food intolerance without any hernia at all. Did the doctor prescribe PPIs for chest pain?

If you think the food isn't moving, have you had a motility test? Has the doctor given you any reason why or if food might be sitting in your stomach?

I could be way off base. I'm only going by what you've described and my experiences.

Your heart is incapable of pushing the stomach back into the abdomen.
Posted 1/14/2014 1:25 AM (GMT 0)
Thanks Alcie for further insights. Will look into that. Can a sensitivity just come on suddenly in life lime that or are you born with it? For me the chest discomfort became gradually worse since the initial minor sensations at 18 years old.

Sometime this week will have the barium swallow results.

And I have not had a motility test or any other gi test other than the still to be revealed barium x ray.

The barium has certainly made the left burn-type sensation under the left ribcage make more frequent and apparent when so.

I now just went into a walk in to get a prescription for doperimone since I told the doc its less acid related. Looks like the drug works. But now I see a warning from a health Canada article for cardiac arrest from this.

http://www.cbc.ca/news/health/domperidone-safety-alert-issued-by-health-canada-1.1233078

Also, I also had a suspicion it could be a polyp... But the general surgeon who would do my scope said stomach polyps are not removed due to the amount of blood that rushes to the stomach. And that the removal of ones down the esophagus requires "surgery". This is not too reassuring since I hear of people on forums saying they had those removed when they had the scope. I'm confused as to what this guy is getting at. Maybe I should just get a referral to a strictly endoscopy cinic. Not some general surgeon.

As for the garlic, how would it be containing chemicals? It's just a plant isn't it? Isn't it just the spice of it? (edit: ok now I can see it has natural sulphites occurring in it)

Might be time for finding an allergist.

And no they have not indicated why I am having good indigestion other than anxiety induced.

Post Edited (7Stringer) : 1/13/2014 7:08:53 PM (GMT-7)

Posted 1/14/2014 1:48 AM (GMT 0)
In addition, I want to share that during the holiday I ate merely one lindt brand hazelnut chocolate (very creamy textured) and 20 min later had large pains in my chest that lasted for a few min then had to vomit it... This is was more serious than my more regular chest pressures then burping. This time the Chest or esophagus really started to squeeze in on itself.... Was hard to burp and vomit. Called ambulance... Then the pain went away but then they still came inside hooked me up and the pain came back for a bit. Went to emergency but did not do tests because it just went away. I hope this was not a heart attack. Then a couple days later just a minor version of the same pain from orange juice. But the wierd thing is that Ferrero rocher hazelnut chocolates are fine with me and does not cause symptoms like that. Just Gerd if too many are eaten. Maybe the lindt one had sulphites. But it's confusing since lindt seems cleaner produced chocolates than Ferrero rocher.

Anyways I was lifting weights a few days later with my regular symptoms of gas.

The general surgeon/scope operator I had a consultation with told me if I have a paraesophageal hernia, then none of my incidents like this or the one on the tennis court would have went away on their own. Is he accurate?

And finally, I wonder if anxiety depression or stress causes all this.

Post Edited (7Stringer) : 1/13/2014 7:32:27 PM (GMT-7)

Posted 1/14/2014 2:44 AM (GMT 0)
Further update: domperidone is working but seems fatiguing. (later update: 10 mgs I took knocking me out early). And it's probably masking a stomach problem I believe exists.... I now realize also that the stomach problem must have been causing the chest tightness in turn for the past couple years (on and off, that is). If the stomach issue were gone then perhaps the sensation from the hiatal herniation might not be as prevalent. I hope these tests will answer that.

I would like to again express is my unending gratitude for all that have chimed in on the various threads I've posted in including Alcie in this one.

If I am ever fixed, I would make sure to dedicate some of my time to this and other forums to help any one out also in the future.... If I feel I am capable. But when I discover one thing - like the manuka honey or the like-glutamine, and then I think they are miracles, before I am about to jump on forum and share, they only work for a few days and stop working or barely work. Which sucks.

Post Edited (7Stringer) : 1/13/2014 8:18:44 PM (GMT-7)

Posted 1/15/2014 2:21 AM (GMT 0)
I'm not sure why you needed the domperidone.

Just because I call something a chemical doesn't mean it's not natural. Sulfites are natural in many foods, particularly yummy dark chocolate. :( It's also in wine, beer, grapes, onions and garlic, beef and pork, gelatin, maple syrup, brown sugar, anything made from corn, although not in any degree in corn itself.
http://www.learningtarget.com/nosulfites/index.htm

Not funny about the heart attack. I actually had one triggered by my sulfite sensitivity (a nice bowl of cereal with dried fruit) before I knew what was causing my feeling of stomach bubbles and chest pain. If you look up some of the papers on cardioesophageal reflex you'll find some describing how after the esophagus triggers the heart you can have coronary artery vasospasm, which can in turn cause a plaque rupture, blocking the artery - aka heart attack. I've been to the ER several times for tachycardia episodes that I couldn't get stopped myself. When the rate gets around 150 and I can't get it down with Valsalva maneuvers (Look it up!) and my cardiologist's prescribed meds don't work, then it's ER time.

Sulfite sensitivity can crop up or worsen just like other allergies.

What do you eat before working out?
Posted 1/15/2014 5:58 AM (GMT 0)
Domperidone is commonly prescribed for people who are aggravated by a hiatal hernia or a hiatal hernia syndrome. The drug causes downwards GI movement of contents, as opposed to the reverse. I am shocked you are not aware of the usage.

It is actually working and am actually just splitting the tabs in half to take 5 mg. 10 is too achy and drowsy.

(Speaking of splitting in half, can a nexium or prilosec dose be split in half if one wanted to? (Not that I am currently on any of that, had to stop prevacid due to severe burping and bloating of a hiatal hernia or hiatal hernia syndrome - (my guess).

Still don't have results from barium. Tomorrow I will push hard for them. I cannot live in constant apprehension as to whether this could be paraesophageal or not. How dare that technologist not inform me of at least that.

Also, a special hiatal hernia adjustment I see on youtube seems to be working.

I wasl also told that early sleep corrects it to some degree. And this is corroborated by the fact that nights that I slept early gave me much better following days now that I think about it.

And finally, does any one get help from magnesium or a multi vitamin or b-vitamin per se for this issue?

And last but not least, I was told I could just have a "hiatal hernia syndrome caused by stress and not a real hernia. Can someone comment on this? Because the fact of the matter is - I do have good days.

I assume this is not paraesophageal since episodes I had got relief from burping and now this maneuver I have discovered that can be self-adjusted.
Posted 1/15/2014 6:05 AM (GMT 0)
Also, that hazelnut Lindt chocolate episode had pain that lasted for like 30 seconds, then came again for 15 when paramedics got to me. That was messed up. Was that prolly just a spasm? And is there a way to check now if my heart did not suffer some sort of attach? I think I read somewhere that during this valsalva maneuver (not the same one I found on youtube for HH), that they can test you during the maneuver to check if the heart is messed up. Can someone confirm this?
Posted 1/15/2014 3:07 PM (GMT 0)
Can't confirm. It's always a good idea to see cardiologist if you have feelings of heart issues. Just don't expect them to have heard of C-E reflex.

I have figured I can have a few squares of milk choc, maybe a tiny one of dark.

I have a simple wrist blood pressure meter to check heart rate when I'm having an episode. The information, written in my food journal has been key to finding what's going on. Cheaper than another doctor visit, although does not replace one!

Next time you get a spasm you could try Valsalva. Hold breath, bear down hard for as long as you can. If that doesn't work, seriously, do see heart doc! I need meds to stop the worst events.

Read the links. Try keeping the food journal.

This may not be your problem. It's just a possible one.
Posted 1/15/2014 3:46 PM (GMT 0)
Hi 7stringer,

You seem to be doing a lot of self diagnosing via doctor google and working yourself into a state of anxiety. If you were having a heart attack the chances are you wouldn't be here. Also look at your family medical history before you start worrying. Do you have a history of heart attacks and stomach cancer?

I can clarify polyps can be removed by endoscopy if you have a good gi consultant . I had one removed while being scoped and I didn't die of blood loss so you cross that off your list. I don't think you have stomach cancer unless you are vomiting blood or having bloody tarry poos and rapid weight loss. Also the symptoms would be continuous you wouldn't feel bad then get better and feel bad again it would be downhill all the way.

I think they keep mentioning acid reflux which symptoms can range anything from heartburn, regurgitation, feeling like you are having a heart attack, throat burning , constant cough, chest and abdominal pain some of the symptoms which you are describing and also problems with swallowing.

The reason why your symptoms seem to be coming and going is you are inducing yourself into stress and anxiety by googling too much and also eating at all you can eat Indian buffets until you vomit... Any normal person would have serious heartburn if you ate until you were sick. People who have acid reflux and hiatal hernias should eat a controlled diet split into 5 or more meals a day . The idea is not it put a strain on your stomach. The bigger the portion the more work it needs to do in order to digest food.

I suggest you try eating a better bland, smaller portion diet and see how you get on and in the meantime wait for your results. You can console yourself that if you needed more urgent medical attention you wouldn't still be here suffering .

Have you tried diazepam for stress. Although I don't recommend it, it seems that you need something to relax as anxiety tends to make you tense up your abdominal muscles and your stomach which may trigger some symptoms . Try deep breathing once in a while and letting out some tension in the muscles .
Posted 1/15/2014 3:55 PM (GMT 0)
If you are interested, I have been trying out yoga by bks lyengar who has several exercises for hiatal hernias and digestive problems which I have found to be quite good and I have noticed less abdominal and chest pain after starting the exercises . Also, I have noticed that by trying to breathe correctly via the diaphragm there is some improvement to my hiatal hernia . When driving, I usually feel like there is a cork stuck in the middle of my solar plexis but since exercising using a combination of Pilates and yoga there has been an improvement .
Posted 1/15/2014 11:13 PM (GMT 0)
>>>>Who knows what the hell could be causing all this darn burping and indigestion at the gym...  

Ouch, I remember that. I used to suffer terribly before and after the gym, even on an empty stomach.

I'm in recovery from the op at the moment. I can't tell you how much I hope this problem has gone away.

Posted 1/16/2014 12:54 AM (GMT 0)
Thanks Jamosca. Tomorrow the results are given as my fam doc has them. Not sure what's with the GI place.

And no history of heart attacks or stomach cancer in the fam. And ya thanks for the insights.

I don't do the indian anymore. But the time I threw up and did, please note that I did take a dexilant after.

Idrunner: i don't really suffer before or after the gym as much as during. You only suffered before and after did you say??  But glad you made it well out of that surgery!  So before with your HH - was it inflamed?  That's my main concern if i have one.... how can they operate that if inflamed?  And do you expect to go back to weightlifting one day?  If so maybe start out very light and giver time.   For me, its something wrong with my stomach *during* the gym causing the esophageal pressure - or maybe the HH to act up I if there is one.  But I doubt its the HH causing the issue alone..  I don't suffer before or after the gym - only during - and other times with crapty diet. But it has to be this other stomach issue causing the stomach to heave up pressure into the hiatal hernia (if even there).  And even worse on meds - except for domperidone which seems to be tolerated well by me. But not PPIs. Nexium makes me worse, and dexilant or prevacid give too much burping.

Further update, nexium and domperidone and then bepto bismol later is not a good mix when eating high fat stuff and a chees croissant from tim hortons which has hydrogenated oil. Had more acid and regurgitation of bile and acid after that. I'm not taking nexium again because the other week I had that same croisannt without nexium and was more tolerated.

Will check out that yoga. I've been doing other yoga but when I do inversion poses and downdogs there is no problem so maybe its not a Hiatal Hernia.  Its only physical activity that is rigorous that causes the stomach to heave up air which then affects a HH which otherwise would not be such an issue, and might not even exist i was told by GI guy last visit).

But other days i can go to the gym, so this cannot be a HH that is alone causing this... has to be something else... but the blood and urea breath test still has not shown h-pylori... but i need the breath test again because It says no PPIs for three days prior.  And i did have dexilant the day before.   I am still convinced it is possible that these tests are not catching a possible h-pylori causing inflammation.  If not then can stress and anxiety really do this?  (makes sense because the night of that party a year and half ago where i ate a strange brownie, was a bad experience.  Over stressed myself,..  that's probabily what triggered the initial trigger to lead to the next series of symptoms for this past 18 months that are on and off...  who knows what the hell was in that brownie, but it was likely my reaction to it and not the actual brownie.  I wish i had never taken that bite.  it was a hell-trip that night for the mind which must have affected the stomach)..

And yes sometimes on the Lorazepam... you mentioned Diazepam.. same thing right?  But I need to figure out the anxiety issues... i have made improvements, but not fully.   But i have to figure them out before i get to the scope.. i am just concerned that the scope might cause a chest spasm or chest issue... and while im out that's just disturbing... 

Post Edited (7Stringer) : 1/15/2014 6:16:45 PM (GMT-7)

Posted 1/16/2014 7:37 AM (GMT 0)
7 stringer

Pick a ppi and stick to it. Then the ppi should be taken every morning half an hour before breakfast . It takes a few days for it to kick in. That is the correct procedure for it to be taken, you may notice unpleasant side effects at first but gradually should lessen. Give it at least 2 weeks ..
Posted 1/17/2014 2:07 AM (GMT 0)
Jan 16 update: I got the barium results today. But before I get to that, I want to mention that i woke up with a heavy feeling in my chest, tightness, pressure, a bit of pain, definitely not comfortable... heart was struggling to beat to get out of bed and get to the bathroom. In the bathroom, just comfortable palpitations or the vagus nerve hurting maybe? Symptom lasted for a minute or two then went away took an ativan as it went away to relax. Could this be from too much L-glutamine the day before in double the bottle-reccomended dose? I think i even still tasted glutamine coming up somehow a bit.. or was it maybe the nexium with domperidone from the day before? Is that a side effect? Or maybe its from the mix of all that with l-glutamine... i read to day that the glutamine should be accompanied by at least an adequate amount of protein in the diet et i have been having little these days... so confused.. Later at the docs office - since only one out of two very slow elevators were working, i walked up 4 flights of stairs with only one bupr in the middle. Is that possible if i had an angina-related heart problem in the morning?

Anyways, had the barium results given to me:

There was no sign of any hiatal hernia to be found. Hows that possible? I know I feel one that comes up sometimes... clearly thats why i cant workout! Or is it just esophageal pressure without a HH? or can the test like a barium miss the HH?

The diagnosis was GERD and "significant reflux" is what the fam doc said. Doc said its nothing more than anxiety.

I beg to differ and will be seeking other opinions. But neither my fam doc nor from what I am aware of the GI doc - neither feel a scope is necessary. But what if they are overlooking possibly h-pylori that the blood and breath test could have missed?

I also hope there are no significant polyps that the barium missed or covered up!

Or is this all anxiety-based? Is it because of a possible issues in my life that causes depression and an ever-present nervousness which just causes GI symptoms for no apparent reason other than those lacks showing their needs in some random fashion? (today i have experienced none of that other than the morning chest palps/heaviness - that was darn scary).
Posted 1/17/2014 11:55 PM (GMT 0)
I notice same feeling as buffets when eating at one carribbean place called sunrise which is a franchise up here.  Feeling full early and a bit full then possibly panic-induced burping... I simply then had to let go of the food.... then I realized something in common that the places I have frequented have developed symptoms in me all have - it al seems like they have MSG.  Could I have developed an allergy to MSG?   Because this doesn't happen if I eat hefty at home or at subway or at a good spot.   (unless I am all irritated like I was when I was at my worst then I had a problem with certain foods regardless).   but at the present moment I am able to see that any thing which seems to taste like it has msg and fills me up early, no way cant tolerate it.  has to come out. Can anyone relate to this or is this an over-sensitivity again on my behalf in other words mentally-induced?
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