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Surgery for hiatus( hiatal) hernia


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#1 lizzie

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Posted 09 April 2010 - 07:40 AM

When I saw my gastro doctor yesterday , she asked if I would consider surgery as at my last endoscopy they found I had a large hiatus hernia. I said that I wouldn't be keen. Just wondering if any of you have had this type of surgery and what the result was.

Lizzie

#2 kaykay

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Posted 09 April 2010 - 11:27 AM

My gastroenterologist (GI) said it's not for me or anyone whose GERD is caused by an autoimmune disease - esophageal dysmotilty. But I don't have a hiatal hernia and maybe you don't have the esophageal problems that I have.

The way he explained it in my case is that my esophagus doesn't push my food down in a coordinated way so sometimes it goes up and sometimes it goes down. He said if we did the surgery it might be harder to get it down through the surgically repaired section, because they narrow it to keep food in the stomach. then food and bile can sit in the esophagus for longer times, causing more damage.

If you have any form of systemic sclerosis (SSc) or any connective tissue autoimmune disease or (might have) and if the gastroenterologist isn't a specialist with those diseases, I'd get another opinion.

#3 susieq40

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Posted 09 April 2010 - 04:44 PM

Lizzie,

I've had the surgery. It's made my life better in a lot of ways... no more reflux, no more acid eating away at my esophagus. I was so so sick when they did the surgery though and that was way back in 1994. So the way they do the surgery may have changed, or the circumstances have to be life threatening?

I couldn't stand or shop or barely take care of my kids without feeling like I was gonna throw up. I was in a lot of pain. After several tests, upper GI's, Lower GI's, swallowing tests, and one that read the pressures in my esophagus, they determined I needed the surgery or the acid in the stomach was gonna eat away my esophagus.

Anyway they poke about 4 holes in your abdomen, and work laparoscopically. They take part of the stomach and wrap it around the part of the esophagus that attaches to the stomach, and make it about the size of a dime. I was all in for just feeling better. I was at a point I felt like I was going to die. I was 27. So anyway after the surgery, I had to chew every LITTLE bite of food really good to make sure it went down. It was really painful to eat chicken or anything that had chunks. I got so tired of chewing, so I would eat just little bits through out the day. I even had a hard time with anything carbonated like soda, it caused pain and pressure.

Burping is almost nonexistent, it's strange but true. Almost seemed like I had gastric bypass or something, but once I was able to eat, the weight came back on (unfortunately!). But everything I eat stays down!! One BAD side effect is that everything stays down, even water! I know that I just sounded really dumb but even when you get the flu, you can not puke. Which really stinks, cause sometimes you just want to get out whatever is making you sick. And I can't, so it has to go the other way.

Even with that, I'd do the surgery if, and ONLY if you are so sick it is life saving, or they can do it in a way that doesn't make more problems for you. Really research it and get a second opinion. I got a second opinion on my Sclero...and that made me feel better about what my doctor's were saying. Best wishes and if you have any questions please feel free to ask.

HUGS
Susieq40 :emoticon-hug:

#4 red

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Posted 10 April 2010 - 01:04 AM

I had surgery about a year and a half ago to fix a large hiatal hernia and also to reduce reflux (open modified Nissen fundoplication). My hernia was so large that most of my stomach was in the chest cavity and pressing against my lung. I also have cREsT and my esophageal motility test showed absent measurable activity.

Because of this combination, I had severe reflux, bleeding esophageal erosions, worsening of asthma/difficulty breathing. All 4 of my doctors -- GI, thoracic surgeon, rheumatologist, and my primary doctor -- agreed I needed the surgery. The surgeon said it needed to be done "open" (not laparoscopically) because the hernia was so large and also because he needed to modify the wrap of my stomach (the Nissen part) so that it was not so tight that I'd have worsening swallowing problems.

The surgery was completely successful for me - I no longer have any signs of reflux - no pain, heartburn. I still need to eat slowly and in smaller amounts so I don't get uncomfortable. I have to tell you though, that it was major surgery with a tough recovery period -- I spent 5 days in the hospital, the incision was from the bottom of the bra line to my navel, painful to take a deep breath for at least 2 weeks, and eating was difficult at first - only soft foods for a few months. Rough, but I have no regrets, would do it again if I needed to, the relief from the reflux has been well worth it!

You didn't say what problems you are having but if you are considering the surgery, I would suggest that you talk with a surgeon with experience in scleroderma patients, especially if you have esophageal motility problems.

red

#5 Sam

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Posted 10 April 2010 - 01:25 PM

I was told back in 2003 it wasn't an option for me, I so wish they would though I feel and look bloated all the time.
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#6 lizzie

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Posted 11 April 2010 - 10:50 AM

Thanks to everyone for their replies.Susie and Red: The surgery and after effects don't sound pleasant, but it is reassuring to hear that the op has been largely successful.Kay kay:I don't have the oesophageal problems you have, just reflux and intermittent problems with swallowing. Having read more about the surgery, I would certainly only consider it if there was a high risk that the hernia might strangulate. At the moment although I have reflux, it is pretty well managed by the PPI. The Dr has ordered barium studies, so I will consider whether or not to have the surgery once I have the results of those. My gastro has some experience with sclero patients, but I will certainly seek another opinion before committing to anything.
Sam- my gastro has prescribed Domperidone for slow emptying stomach/bloating-I haven't yet got the tablets so don't know how effective it is.

Lizzie