Living with Hiatus hernia and vagus nerve problems for 30 years

Digestive health
1

In 1985 I gave myself a hiatus hernia this was caused while lifting weights but was not actually diagnosed until 1994. In 1985 when I injured myself I was in the Royal Air Force up until this point I considered myself to be quite fit, the first symptom I started experiencing was palpitations especially after over exerting myself from exercise. I went to see the RAF doctor at the time and after experiencing extremely bad chest pain was referred to a military medical specialist this was in 1986 in between I kept on getting the palpitations which was starting to worry me. After my appointment with the specialist he said that I was suffering from a chest virus which was more common in older people. He said it would clear up by itself and advised me to carry on training. So I carried on with my running cycling and I carried on with weight training but used lighter weights as well as sit ups skipping and football. The palpitations carried on I stared to experience other things I had pain in my neck shoulder ache headaches and chest pains.

 

I left the RAF in 1897 but this symptoms carried on I got a job as a furniture lorry driver which meant lifting and carrying a lot, looking back on it I sometimes wonder how I managed and I cycled back and to work for many years but always had an uncomfortable feeling in my stomach especially under the ribcage I was also suffering from acid indigestion and regurgitation. I was now seeing a German Doctor as the chest pains were more frequent he carried out many tests and sent me to a heart specialist I had a barium test but nothing showed up. Then in 1993 we moved to a new area and the problems I was having were not getting any better I was getting more and more neck pain shoulder pain and pain between my shoulder blades. But my stomach was always very acidy so my house doctor sent me to an internist who gave me my first examination with an endoscope and found that I had a small hiatus hernia this was in 1994. This was the first time that I was put on omeprazol 40mg and have been taking this medication since then. 

 

The past couple of years my back pain has got a lot worse underneath my shoulder blades my neck my left shoulder sometimes my arm goes numb and now my left breast aches like hell and I now have a lot of pain in my left arm pit. I am in continuous pain right between my shoulder blades and now seem to have an itch that I can’t scratch also in the shoulder blade region.

 

I have been on an internet form which I have recently come across which discusses the vagus nerve and hiatus hernia this forum seems to cover all the symtoms that I have been experiencing over the past 30 years. I have recently had a medical I am now 52 years old and still refuse to stop doing exercise even though I am now at the end of my tether. The doctor told me that I am still keep myself quite fit, but I am finding this quite hard to keep up. I can’t cycle anymore and running and jogging is out of the question, I walk quite often but it’s more of a march than a walk I do not enjoy it I suppose it’s just self disiplin that makes me do it but for how much longer I don’t know. This forum that I came across seems to have answered the question that I have been asking doctors for many years now. The vagus nerve could be the culprit and is it true that the hiatus hernia presses against this nerve and could therefore be causing most of my symptoms, like I said I am now finding this condition very hard to live with, I am looking for help on how to deal with this medical condition as the doctors I have visited won’t listen to me.

Thank You for your time

Richard Jones

2

Hi Richard, there is a very informative post on this site here if you haven't seen it https://patient.info/forums/discuss/hiatus-hernia-and-palpitations-18051?page=0#1404081

Best wishes,

Mick Payton

3

Hi welshexport

i have read about your life long problems with hiatus hernia.

i to was injured in the army as a result from a fall i ended up with a hiatus hernia.and had to undergo surgery to repair the hiatus hernia. and had another 3 ops after my first in 1990 to repair reoccurrent hernia's. what that your doc may not have told you is untreated hernias irrespective of type can only get bigger and as the increase in size more of the stomach pushes through into the chest and causes you to experience more symptoms e.g pain under left ribcage,pain pain iand tingling in your left arm shooting through to left shoulder blade, the feeling of fullness after eating very little amount of food. tightness in the chest  fact you have been lifting heavy items of furniture will increase the possibilty of the tear in your diaphragm bieng bigger as it has been 21 years since you were diagnosed.and 11 years since you had a endoscopy done.

Acid reflux is a result of the valve at the top of the stomach not closing properly

and acid flows from the stomach and sometimes partly digested food could end up backing up into your mouth after swallowing.  it would be prudent to speak to your doc and get a mri scan done to find out the true size of your hiatus hernia. e.g 3cm,5cm 10cm. remember 3cm is two and half inches.  a scan will put your mind at rest . didnt say if you had severe heartburn ?you may need an endoscopy to see if you have developed barrets osoephagus which is acid erosion of the lining at the bottom of your osoephagus  which causes chest pain and heartburn,indigestion

if barrets osoephagus is not detected and treated you could end up with cancer?of the osoephagus so if you not been checked get checked? a.s.a.p  you have to  look after yourself.

you need to speak to your gp and let him know how this problem is affecting your quality of life . you may want to discuss with youre gp what  regarding the possibility of

a laproscopic repair of your hernia .which is less invasive than an open op proceedure .

4

Richard,

It's  been 19 years since they said you had an hiatus hernia. I don't know if they told you what kind of hiatus hernia you have but I think you need to be reassessed if you have a rolling ( paraesophageal hernia) then it more urgent for treatment. I had that kind and had an operation to put my stomach back in its rightful place. 

Once while I was waiting for surgery I had the Vegas nerve being pressed by my stomach that caused me a terrible headache, nausea and dizziness. I went to emergency that time. It really made me burp continuously , so much so that they couldn't get a temperature by oral method. I didn't have the shoulder pain but used to get a sore chest. Find yourself a new doctor that is willing to send you for another endoscopy. 

Judy

5

I had laparoscopic fundoplication surgery two months ago because I had a giant Hiatus Hernia ie my stomach was totally encased in my thorax. I had many trips to the hospital because I thought I was having a Heart Attack. Pain which was in my jaw and teeth and running down my arm and pain in my chest and palpitations and eventually I found it difficult to breathe. My GP sent me to have a multitude of tests for heart lung and I did loads of research until I found that it could be the hernia! IT WAS AND NOW I CAN BREATHE AGAIN! I am soooooo pleased I had this surgery although I have had the expected side effects of the op but happily I am on the mend and have had no palpitations since! Find a good Specialist who deals with Hiatus Hernias and tell your GP to think outside the square!

6

I fully understand what you are talking about. I as a baby my parents were told that they probably would not rear me. I always had sore throats and what the Dr termed tolsilitis and colds. I wad a good athlete and ran like the wind but was sick after. Always had giddy attacks and could not even have a ride on a swing because of the dizziness. As I grew older and married, each time I became pregnant had a bad time. Could not breathe etc. My 2nd son had the same and everytime they had a sports carnival and he did tug of war etc he was vomiting and the Dr always said that he had food poinoning from eating hot dogs for lunch. he suffers badly with back problems and pains under the shoulder blades, as do I. One specialist said that I had a large liver but another one I went to said that it was not my small sliding hiatud hernia at all that it was the bloating from the bowel gas causing my stomach to push up under my rib cage, hence the constant pain. It is a very diversive subject. i do know several people who have been diagnosed with food intolerance. latest relative of mine was told she had fibromalgia but it was in actual fact all pain caused from food intolerance. it is a matter of finding the right Dr that will listen to you and not just give you a hand full of pills and hope you get better. I do have heart palpitatios and break out in hot sweats as soon as I eat something that I cannot tolerate. I could go on and on but hope what I have said here may help you get the right diagnosis. Irritable from food intolerances can actually cause stroke or heart attacks and I have been told that if you don't keep the bowel regulat that it cn actually cause ruptured bowel. Woukd like feed bck from you after you see someone.

7

Well I must say I hope this to be the most informative post on Hiatal Hernai and Barrett's esophagus. I have had both for 9 years all or most of the same pains and issue as all of you I will be very curious what info comes out of it 

I just want to thanks you all in advance knowledge is power 

 

8

I'm going for second opion dr soon. You might need a Mri. Very expensive. Test. Would show nerves with damage good luck

9

You have probably read my posting. i have not hadany mentionof vegus nerve damageor such, will be worth asking my dr next week when i go formy next procedure.

10

Hi Richard,I fell Ill Oct 2012 and was diagnosed with HH and duerdenal ulcer the following March,was already on 20 mgs omeprozole so they uped it to 40 mgs and over the next 2 years I was on anything between 20 and 80 mgs a day,Chest always felf tender, breathless most of the time and always felt nausius.March this year had second endoscopy and they said I still had my HH but I had ulcers all over and I now had a Schatzki ring and that even had an ulcer on it,they put me on 40 mgs of esomeprozole( which is stronger)FOR A MONTH BUT STILL FELT THE SAME.So after 2/12 years of feeling rotten every day decided things needed to change,so went to Drs and told him what i felt like.He decided to take me off the omeprozole and put me on Ranitidine which is one of the older antacid drugs,I also did 3 things my self.(1)Istarted taking magnesium supplement after finding out people who have been on antacids over 6 months can be come magnesium deficient which causes nausia,(2)I have gone tea total,and (3) i dont eat anything after my evening meal around 6pm,The change has been astounding.Nausia gone 95%,breathlessness almost gone,chest no longer tender,I also used to get a lot of neck pain but that has gone.dont no if it,s a combination of everything or the pills or what but after nearly 3 years of feeling cr**p I now feel almost normal.Changing the pills might not work for every one but the Dr did say the new PPI,s(omeprozole)etcdidn,t work for every one,so i,m glad i gave the old pills a try.

11

You will also find that if you take anti-acids you will not absorb vitamin B12 - lack of can cause palpitations, fatigue etc., the ONLY way you can supplement your B12 is by injection or under the tongue spray.

Mick

12

Firstly I would like to thank everybody for their input it is very helpful reading all your messages. This problem has been driving me bonkers 30 years is a long time I have had 5 endoscopy's over the years and have been advised to have one every 3 years so due another this year. I have found that over the last 18 months or so that the pain issues in my neck shoulder blades left shoulder and armpit have got worse and are with me most of the time. Walking is painful but I grit my teeth and march on with it. I was on 40mg Omep since 1995 and about a year ago changed to 20mg and am at the moment trying hard to wean myself off this drug completely I did this because of the side effects in the end OMEP was just making things a lot worse, I now take milk of magnesia and eat burnt toast an old remedy for acid indigestion.  I have just started taking magnesium I have always slept with my bed at least 6 inches higher than the foot end I stopped eating most dairy products years ago I find that artificial sweeteners make my palpitations worse. I have to control what sort of exercise I do for years I wondered why I felt so ill after cycling to work my job was HGV driver this also caused problems. About 18 months ago I lost my job which I had been doing for 33 years I have been stressed out looking for work and this does not help. Sport should relieve stress but that aggravates the Vagus nerve problem. 30 years of aggravation, forgot to say I have also suffered from psoriasis since I was 18 and psoriatic arthritis since I was 28. Like I said it is good to discuss my situation with people who know what I am talking about many doctors are not too happy to be told about information that I have found on the internet plus they just have not got the time. I am booking my next endoscopy with the doctor who diagnosed me in 1994, I live in Germany and find that German doctors have less patience that most but I will be asking him about the Vagus Nerve and the connection with the hiatus hernia hopefully I will get some positive feedback. Once again thank you for listening and I will post an update as soon as I get my appointment.

13

Good luck with your next medical appointments. One point I note is that you say about cycling - I myself can't walk too far, or talk too much (to the relief of my partner) but I do find cycling actually helps me, I wonder if this is due to a different position that we each sit on our cycles? I do need a specific position both upright and distance from the handlebars, being able to cycle keeps me fit and I don't feel so useless when we go out on our cycles for a couple of hours. I ride a hybrid style cycle - there's now way I could ride a racer type with low handlebars. Do you read my post on exercises that help relieve the symptoms?

14

Thanks for your post.  We have much in common.  And I was wondering if you have noticed any physical positions or triggers that exacerbate your symptoms.  I have found that my symptoms are almost exclusively related to being in an upright sitting position. 

Here is my story:  I have had a sliding hiatal hernia since at least from the mid 1980’s when it was discovered during a comprehensive physical exam while I was in the USAF.

At that time, there was no discomfort from the HH so I shrugged it off especially as the doc didn’t seem to find it significant.  Life was good, with absolutely no GERD symptoms, but gradually some perplexing symptoms began to gradually appear; first palpitations similar to you but mine were more like a second or two of rapid fluttering followed by a short pause, and ending with a strong thump.  Later I began to experience minor chest pains (always in the upper right side), and then occasional throat pains which were always on the right side too.   I went in to the base hospital to have each checked out, and was told the palpitations were normal, and the chest and throat pain were likely due to my strenuous work outs and sports I played.     

Then in 1993 while driving to work, the chest pains were unbearable so I detoured to the ER, and since I presented with severe chest pain, and  pain in my right throat, and  tingly numbness in my right cheek and ear, I received an exhaustive cardiac work up with every conceivable test, which took a few months to complete, but the results categorically ruled out any cardiac involvement, and my records were stamped with Atypical Chest Pain.

I retired from the USAF in 1995, still with the same symptoms but tolerable pain.  On my own, I eventually discovered four things:

1st - The palpitations, chest pain, throat pain, and cheek /ear paresthesia (tingly numbness) were closely associated with sitting down, and if I stood up and walked around a little bit, or lay flat on my back, the symptoms disappeared.  

2nd - The symptoms were intensified when wearing tight belted trousers.

3rd - The symptoms were at their worst when driving while sitting upright and securely seat belted.

4th – When the level of the chest pains were lowest, there was no involvement of throat and cheek/ears.  When the level of the chest pain was moderate the throat pain was present but there was no cheek/ear involvement.  When the level of the chest pain was highest, everything was involved.

I didn’t think much about the cause, but adjusted my life style to become a sloucher when sitting, and wearing looser trousers, and life was good with minimal symptoms.

Eventually with no military fitness standards to meet, and advancing age, I gained almost two stones of weight, and the symptoms aggressively returned and I sought medical help again.  After taking my medical history they agreed there was no cardiac involvement and targeted the hiatal hernia which they said can mimic heart attacks in some patients.  They also said it would correlate with pain while sitting since the abdominal pressure would force the stomach through the hiatus and disgorge stomach acid into the esophagus.  However they were puzzled when I reported no pain while lying flat on my back.

This precipitated an intense series of tests to evaluate heartburn as the cause.  First I was given heart burn medication (PPI’s) and when I reported no effect after 30-days, they doubled the dose, and when I reported no effect from the higher dose the games began.  Leading off was an endoscopy which confirmed the sliding hiatal hernia and measured it a 2 cm, but also indicated a normal esophagus with no evidence of GERD, and no Barrets  Then came a barium swallow, which was negative.  Then  an esophageal manometry test which showed no abnormalities in the supine position, but I sweet-talked the operator into also running the test while I was in a sitting position and the results (to my eyes) were markedly different, but the doc said they were still within norms.  This led to the esophageal 48-hr pH monitoring test, where they harpoon a pH probe to the inside of your esophagus and the probe sends continuous pH readings to a recorder via telemetry.  This test showed no pH excursions throughout the entire monitoring period even though I had experienced multiple chest pain episodes.   

Needless to say the doc was perplexed and as a last ditch decided to investigate if the pain was musculoskeletal  and proceeded to poke and probe my chest and do everything except have an intern jump on it, and ordered a chest X-ray and Cat-scan, and arrived at the diagnosis: Atypical Chest Pain.

I asked about any possible connection with referred pain from the hiatus nerve caused by pressure from the sliding hiatal hernia during sitting, and the higher the abdominal pressure, the higher the pressure on the vagus nerve, which cause higher orders of symptom pain.  Which he dismissed as improbable, but when I persisted, he said since I had a clinically diagnosed hiatal hernia, he could offer to do a hiatal hernia repair but he wouldn’t guarantee that it would do anything to relieve my symptoms. 

I have declined the offer and am continuing my slouching life style and dieting and working out to lose the stones, and searching the web for answers.

15

Sorry to hear about your problems, I am still living with HH but have given up the OMEP and restricted many foods and alcohol try and eat only when hungry but small amounts. Last year I suffered terrible neck shoulder and upper back pain and muscle loss in left arm and tingling and numbness. Was diagnosed with cervical stenosis as well as Psoriatic Psoriasis of the spine. My HH is better but like you I find sitting too upright for any periods makes it worse English tea seems to set it off but coffee is fine, I can't eat tomatoes or pizzas most dairy products are off limits I always sleep with my bed raised by six inches and only take normal antiacids if I have to. I have been given a special back brace for my lower back but can't wear it as it pushes my HH up.  Operations on HH are hit and miss I have lived with it for so long now I will just carry on. I don't know about you but I find if I gain weight around the middle it aggrivates the HH and laying down on the sofa if far more comfortable that sitting. Even though I have a lot of back problems I walk whenever I can and do as much stretching as possible but last year had to go nearly six months without any exercise because of the stenosis. The hernia seems to be under control most of the time I found that PPI meds like OMEP made the matter worse but I had been taking them for over 15 years they were confusing the stomachs natural acid production. When I over indulge I know I will suffer when you eat a bigger than normal meal your acid production increases and causes bloating and irritates the HH it has taken me years to come to terms with it but my psoriasis and psoriatic arthritis combined with the stenosis have become my priority. Try and do as much exercise and stretching as possible avoid sitting and eatting too much do what you can when you can, HH is a bloody nuisance the palpitions are worse after large meals or long periods of sitting then exertion or during some of my long walks but I don't pay them much attention now at the beginning they used to worry me but not anymore. Hope you learn to cope with the HH life style has a lot to do with it good luck

16

As sad as I am to hear this entire story and read it all it is all-too-familiar for myself as well although not in the military I have had almost exactly all the test that you have had possibly over a shorter course of time of four years I am in my mid 40s and I'm having the same type of issues that both of you speak of on here I guess for me it is always just interesting to hear that other people have the same issues that I have I have been offered the operational route but have declined it due to the low success rate especially for the work that I do it is I have been offered the operational route but have the client it due to the low success rate specially for the work that I do it is very physical and strenuous and was told it would likely just undo itself thank you all for sharing your experiences and suggestions on this site is very informative and much appreciated

17

Someone else mentioned B12 deficiency from being on the antacid, omeprazole. Please please look into this it can cause serious nerve damage if it progresses too long. Your B12 should be in the upper half of normal, at least 500 or you may be becoming deficient. B12 deficiency causes a wide range of symptoms and many doctors are not aware that antacids can cause it.

18

Just catching up with these posts but just wanted to know Welshexport how you got on re the Vegas Nerve?   Did you find out any more about it and how did you fix any problems with this nerve?  I have a sliding HH but do notice that about a couple or three times a year I will be suddenly wanting to vomit - doesn't seem to be food related as such and wondered if the Vegas Nerve does this sometimes?

19

Hello,

I would like to thank everyone for their replies to this discussion, it's a big help just to know that this a real problem so many doctors don't appreciate the stress that you are under with this condition. I am at the moment waiting for another gastroscopy it’s been 3 years since my last. I have been under a lot of stress since I have been unemployed and my hernia has been playing me up as well as my psoriatic arthritis. I was given a 40% disability in 2008 but I live in Germany and you don't receive any financial help until you are 60% disabled am trying to get the right to work on a part time basis because of my health but not having much luck... I have been quite depressed and having a lot of ridiculous thoughts trying to keep up a sense of humor not that easy though finding it hard to carry on with any exercise at the moment. I hope all you people who suffer with these long term illnesses are coping in one way or another. I have put myself on a strict diet which involves next to nothing and only eat when I am really hungry. I have to take one Omep 20mg in the mornings can't manage without it. I checked my records and have been on these meds for over 20 years now. I think my nerves have been damaged in some sort of way by these meds. Doctors just don't seem to have any idea will post results of latest  gastroscopy due next month...Good Luck to all of you with HH

20

Hi welshexport, I also have a hiatus hernia. I treat it as follows with some degree of success. I eat smaller meals. If I get acid reflux I mix a quarter teaspoon of bicarbonate of soda in about a third of a glass of water and drink it straight down. Don't let it sit too long as it starts to taste a bit fishy. This will neutralise the pepsin that gets embedded in the osophagus and causes the burning sensation. It also stops the gas forming. (Although you will get gas immediately after drinking the bicarbonate but this quickly passes. When I get gas I'm convinced the expanded stomach presses on the Vagas nerve and makes me feel really queer and I'll. I also have a small exercise trampoline. When my hernia is playing up. I drink a pint of water and immediately bounce up and down on it for a few minutes. The idea being that the weight of water pulls the stomach back bellow the diaphragm where it should be. During a hospital stay for a different hernia op I was in recovery and fitted with a gastric bag. For three days the contents from my stomach showed Amber coloured normal stomach acid and I felt ok. Then on the third morning it turned green and I got the gas and became quite ill. I have since discovered that caffeine relaxes the valve from your stomach to the intestines. This allows bile reflux that mixes with stomach acid and creates gas. Since I stopped all caffeine even decaf I've been a lot better. I found ant-acids to cause worsening of acid reflux in fact I didn't get acid reflux befor I was prescribed omoprozol. Best remedy I found is bicarbonate of soda. Works fast to relieve symptoms. 

Hope this is some help.