Can you live a normal life with a hiatus hernia?

Digestive health
1

Hi everyone, I am a 36 year old woman, I weigh about 11 stone and I am a stay at home mum to 3 children. I have suffered with excess acid for about 10 years now. The doctor put me on lansoprazole which I have been taking everyday. Everything was going fine until I was put under a lot of stress due to some family issues. I started to get very bad acid reflux which I don't normally suffer from, only have acid in stomach. I also have a really bad pain in between my shoulder blades. Gp referred me to gastroentologist who performed an endoscopy. She confirmed a sliding hiatus hernia, 4 cms. She said it has been there a while, it is not new. I don't know how she knows that. Any way I am in so much pain that all I can think of is to have the surgery which is what she has recommended. What is stopping me is that, if I have had the HH for a while, I have lived a normal life. I know I am lansoprazole but I could eat what I wanted apart from spices. I could eat how much I wanted, when I wanted.  I don't drink or smoke but I love my food. At the moment everything gives me heartburn but I am hoping that it will slowly repair itself or is this wishful thinking. If I have the surgery there still may be a chance that I won't be able to enjoy my food. I would love to hear your different opinions.

thanks Nancy

2

Two of my lady neighbours cured their reflux with a strict diet and weight loss. I don't think that they also had an HH.

I've had an HH for over 30 years and last time I had a barium X-Ray it was much smaller. Usually it looked big on the screen but last yime it looked much smaller. The doctor doing it said that they can vary in size.

3

Do you follow a strict diet as well. Do you suffer with flare ups?

4

No, I eat carefully but not a strict diet, Yes, it flares up and a lot recently. I don't know why but Spring is usually the worst time of year. I;ve tried all the PPI's and Nexium suits me best. I also chew a few Bisodols when needed. I don't find Gaviscon much of a help.

Years ago I went to a homeopathic GP who helped it for a long time. I later went to another one who was not a GP and she was useless.

5

Hiatus hernia is very common in the population. Although most people manage to live with it, for some the reflux that it permits causes symptoms (including those you describe) they cannot control.

Whereas dietary changes may affect acidity, they rarely help reflux which is a mechanical action.

Drugs like nicotine and, for some people, caffeine and alcohol, may weaken the muscles that constitute the lower oesophageal sphincter but for those with a hiatus hernia, those muscles are already compromised.

Lifestyle changes are recommended which may or may not be sufficient:

lose weight if necessary, avoid tight clothing, avoid overfilling the stomach by eating little and often, wait at least 3 hours between last meal and going to bed, raise the head of the bed 6 to 8 inches on blocks etc...

If you are unable to manage the reflux by these measures, reflux reduction surgery may be the answer and Laparoscopic Nissen Fundoplication is the gold standard. The keyhole surgery repairs the hiatus hernia and fixes the lower oesophageal sphincter.

I had te operation 8 years ago and it gave me my life back, removing all the symptoms I had suffered with all my life - some of which I hadn't previously considered were due to reflux.

Following LNF, it takes a few weeks before you are able to eat as you did before but recent research following over 100 patients who had LNF over 20 years ago, found 95% were glad they ahd it.

Find the relevant section on Reflux in the www DownWithAcid org uk book/website - especially the chapter on fundoplication.

You may also read the blog of when I had the operation on my personal website www chrisrob co uk by clicking on the Barretts tab.

6

Hi Nancy, yes of course you can. I'm a sixty year old woman, weigh 8st 8lbs and have a HH. If you go to that well known internet video channel (can't mention it otherwise it gets intercepted) there are loads of smoothie vids on there specifically for HH and reflux. I've followed lots of those and am now completely off of omeprazole and without reflux. I had a gastroscopy last Tuesday to check my stomach, all very healthy but just a small HH. I gave up smoking a year ago too and that helps immensely. Have a look at those vids and WHY we get reflux, it'll surprise you because we are actually LACKING enough natural stomach acids which in turn allows bacteria to feed off carbs and create reflux. I hope you get the results I got - good luck. wink

7

Thanks the useful information. Can you eat what ever you want now that you have had surgery? Do you still have to eat little and often?

8

I will certainly have a look at some of the videos. I am just finding it hard cooking for my family knowing that I can't eat the same and it smells so nice and looks delicious. I have to refuse invitations to restaurants because I won't be able to eat anything. Just hoping the flare up will end soon

9

I was able to eat full meals within 6 weeks - and anything. And no more meds.

10

A doctor told me  that after the operation you cannot belch or be sick.

11

Thats excellent. That's what I am hoping for as well. 

12

I have heard this in the forums aswell but I have also heard people say they can be sick and belch. I suppose it's different with everyone. I have also heard some people are sick a lot. 

13

Did you experience food getting stuck after you had surgery?

14

There is a newer LINX procedure that has been discussed here.

https://patient.info/forums/discuss/linx-procedure-455013

 

15

The Linx procedure does not repair the hiatus hernia.

16

Some patients may experience difficulty burping or vomiting while the internal scaring heals - or if the surgeon does the wrap too tight.

In my case, I burped before I left hospital the next day.

The procedure is quite standard and most surgeons who do it are quite good at their job. If, however, the wrap is too tight, it is usually possible to loose it with dilation.

17

I also have a hiatus hernia so they say. But they've put me on Dexilant and Sucralfate 1GM daily. Ask your Gastroentiologist about them. The Sucralfate coats your stomach  preventing the acid from coming back up. While the Deilant helps the stomach reduce the acid it produces. These have been the only things that have worked for me. I realize everyone is different though. I've tried Nexium and others that didn't seem to help, Good luck to you. 

Mack.

18

The LINX Reflux Management System is used for treating GERD when medication no longer provides adequate symptom control. The LINX System is another option to the standard surgery for GERD, such as Nissen fundoplication. The LINX System is: Less invasive.

19

Procedures from the NHS web site.

http://www.nhs.uk/Conditions/Gastroesophageal-reflux-disease/Pages/Treatment.aspx#surgery

20

But Linx doesn't repair a hiatus hernia. A hiatus hernia is when some of the stomach has herniated, or pushed up, through the diaphragmatic hiatus (the hole in the diaphragm through which the oesophagus passes).

In so doing it misaligns the diaphragmatic and phreno-oesophageal muscles which compose the lower oesophageal sphincter meaning the sphincter doesn't work as it should.

With a fundoplication, the herniated stomach is carefully withdrawn from the thorax to its proper position and the gastric fundus wrapped around the part of the oesophagus protruding into the abdominal cavity. This prevents reherniation, realigns the sphincter muscles and enhances their efficacy.

With Linx, insertion of the device is not considered if there is anything other than a very small hiatus hernia. A skilled surgeon may retrieve that at the time of implantation of the Linx device but the magnetic bracelet does not hold it and reherniation may occur.

Linx may be marginally less invasive but still requires 4 or 5 incisions and manipulation within the abdominal cavity with laparoscopic instruments. The patient knows no difference being under sedation for the operation.

Afterwards, with fundoplication, because of internal scar tissue that needs to heal (which has the effect of over tightening the lower oesophageal sphincter, scar tissue being less elastic) soft foods are required initially and some patients find difficulty burping.

After a Linx implantation, patients are required to eat denser foods and have sufficient peristaltic pressure for them to push open the magnet ring.

Read about Linx and other reflux reduction devices and techniques that are, or have been, available in the appropriate section of the www DownWithAcid org uk book/webste.