Hiatal Hernia.. WTF?

[Kman34]

I went to the ER in Dec because of Diverticulitis and had a CT scan and one of the things that was on the scan was a Hiatal Hernia.. I went to my Doc for a follow up after and he didn’t think it was a big deal if I wasn’t having any Acid reflux.

Went and had an X-ray today for a shoulder issue and they called and said my Hiatal Hernia was quite large and showed up on the X-ray..
This seems concerning to me and I’m going to make an appointment with a Gastroenterologist...

Do any of you guys have any experience with this condition? I’m currently on a diet but still feel bloated sometimes after eating which is a symptom of this.

[Skyy God]

You should stop taking it up the ass.

https://www.google.com/amp/s/www.ste...use-hernia.amp

[SupDock]

Originally Posted by Monticore

Any internal infection can lead to sepsis death etc , I had patient who had diverticulitis where the inflammation was eroding through the bladder wall.

Urine a shitty situation at that point.

['Hamas' Jenkins]

Originally Posted by SupDock

That's true, but neither is uncontrolled gastroesophageal reflux. It would be preferable to be on an h2 blocker as opposed to a PPI

Those have their own issues--namely tachyphylaxis. Rarer side effects can include thrombocytopenia.

PPIs can cause electrolyte deficiencies, B12 malabsorption, and increased pneumonia risk. Neither class should really be taken indefinitely. Lifestyle changes and antacids are generally the best bet, w/ two week courses of these drugs if at all possible unless you have a hypersecretory disorder like Zollinger Ellison

[Kman34]

Originally Posted by Cave Johnson

You should stop taking it up the ass.

https://www.google.com/amp/s/www.ste...use-hernia.amp

That’s what I told your Mom...

[Eureka]

Originally Posted by scho63

Ive had a hiatal hernia for years. Just medium sized. If I eat too fast it holds some of the food longer making me feel like a softball under my sternum
Acid reflux from time to time.
Just keep an eye out if they also diagnosed you with Barret's Esophagus. That can lead to cancer.
I have an endoscopy check up end of this month.
Not a big deal for 95% of people with one.

Does water fasting do anything for this condition?

[Rasputin]

I had an umbilical hernia a few years ago wasn't a terrible thing but just kinda weird. The doctor had me have surgery just so it wouldn't rupture he said that would be bad. What I remember most was laying on the gurney strapped down with my arms out to the side like a cross. When they gave me a shot and put the mask on me to put me to sleep they told me to count down from 100 but instead i kept repeating to myself "At least I'm not at work, at least I'm not at work, at least I'm not at work" then I zonked out but I remember thinking I'd rather have my gut cut open for surgery than be at work that day lol.

[SupDock]

Originally Posted by 'Hamas' Jenkins

Those have their own issues--namely tachyphylaxis. Rarer side effects can include thrombocytopenia.

PPIs can cause electrolyte deficiencies, B12 malabsorption, and increased pneumonia risk. Neither class should really be taken indefinitely. Lifestyle changes and antacids are generally the best bet, w/ two week courses of these drugs if at all possible unless you have a hypersecretory disorder like Zollinger Ellison

And for the patients that continue to have uncontrolled symptoms?

This is a consensus statement on treatment from Uptodate

********

In patients with frequent (two or more episodes per week), severe symptoms that impair quality of life or Barrett’s esophagus, we suggest initial therapy with standard-dose PPI once daily (Grade 2B). (See*'Overall approach'*above and*'Proton pump inhibitors'*above.)

In patients with recurrent symptoms within three months of discontinuing acid suppression, we continue long-term maintenance therapy with a PPI. However, if symptoms occur after three or more months, we use repeated eight week courses of previously effective acid suppressive therapy (algorithm 1) (see*'Recurrent symptoms'*above).

********

All patients with gastroesophageal reflux should perform lifestyle changes, it's just not reasonable to tell them you can't take an h2 blocker or a PPI, just take Tums.

In addition to people with ZE, anyone with Barrett's esophagus or significant esophagitis on endoscopy should be on PPI therapy pretty much indefinitely

['Hamas' Jenkins]

Originally Posted by SupDock

And for the patients that continue to have uncontrolled symptoms?

This is a consensus statement on treatment from Uptodate

********

In patients with frequent (two or more episodes per week), severe symptoms that impair quality of life or Barrett’s esophagus, we suggest initial therapy with standard-dose PPI once daily (Grade 2B). (See*'Overall approach'*above and*'Proton pump inhibitors'*above.)

In patients with recurrent symptoms within three months of discontinuing acid suppression, we continue long-term maintenance therapy with a PPI. However, if symptoms occur after three or more months, we use repeated eight week courses of previously effective acid suppressive therapy (algorithm 1) (see*'Recurrent symptoms'*above).

********

All patients with gastroesophageal reflux should perform lifestyle changes, it's just not reasonable to tell them you can't take an h2 blocker or a PPI, just take Tums.

In addition to people with ZE, anyone with Barrett's esophagus or significant esophagitis on endoscopy should be on PPI therapy pretty much indefinitely

Then you treat more aggressively. We're in agreement, but PPIs and H2RAs are both over used.

[JD10367]

Originally Posted by Monticore

I think in general it is always best to avoid surgery when possible whether minor or major there is always risk involved and potential long term issues , unless it's affecting your quality of life ie reflux/pain/discomfort/shortness of breath/vomiting , but the specialist will have a better idea .

I have an inguinal that I'm having surgery done on this coming Monday for. My actual conversation with the doctor a few weeks ago.

Doc: "It's not life threatening."
Me: "Cool."
Doc: "People live with them for a long time and sometimes never get them done."
Me: "Sweet."
Doc: "It's mostly a pain and comfort issue."
Me: "Gotcha."
Doc: "But it'll keep getting bigger, and I've seen them get huge... and eventually it'll move down into your testicle."
Me: "Stop right there, pal. Book that surgery."

[Pablo]

Originally Posted by JD10367

I have an inguinal that I'm having surgery done on this coming Monday for. My actual conversation with the doctor a few weeks ago.

Doc: "It's not life threatening."
Me: "Cool."
Doc: "People live with them for a long time and sometimes never get them done."
Me: "Sweet."
Doc: "It's mostly a pain and comfort issue."
Me: "Gotcha."
Doc: "But it'll keep getting bigger, and I've seen them get huge... and eventually it'll move down into your testicle."
Me: "Stop right there, pal. Book that surgery."

Yeah, there's barely room in a smart car for xxsmall testes, don't want to crowd the limited space you've got.

[Captain Obvious]

Originally Posted by 'Hamas' Jenkins

Those have their own issues--namely tachyphylaxis. Rarer side effects can include thrombocytopenia.

PPIs can cause electrolyte deficiencies, B12 malabsorption, and increased pneumonia risk. Neither class should really be taken indefinitely. Lifestyle changes and antacids are generally the best bet, w/ two week courses of these drugs if at all possible unless you have a hypersecretory disorder like Zollinger Ellison

ZE diagnosis last year. Sucks.

[kjwood75nro]

I had stabbing pain in my left midsection for about 2 months. It got unbearable, so I got a CT scan which showed a hiatal hernia. Got a colonoscopy which showed all clear. Normal kidney/liver function.

The pain was so bad that it caused appetite loss, which took me from 215 down to 198. And...I think that fixed it.

The only real trigger is overeating. I don't drink beer anymore because of gout and possibly the hernia. Whiskey doesn't seem to affect either.

I take PPI daily. They want me to do an upper endoscopy, but I don't think I'll do it. Just don't eat like a pig, keep the weight down, and it should be okay.

Mom said I spit up more than usual, so it's possible that I was born with it. Dad has similar issues.

[Monticore]

Originally Posted by JD10367

I have an inguinal that I'm having surgery done on this coming Monday for. My actual conversation with the doctor a few weeks ago.

Doc: "It's not life threatening."
Me: "Cool."
Doc: "People live with them for a long time and sometimes never get them done."
Me: "Sweet."
Doc: "It's mostly a pain and comfort issue."
Me: "Gotcha."
Doc: "But it'll keep getting bigger, and I've seen them get huge... and eventually it'll move down into your testicle."
Me: "Stop right there, pal. Book that surgery."

Speaking of testicles I had a guy post motorcycle accident(fractured pelvis) ended up with his right testi in his upper inner thigh , initially they thought he had just ruptured it but few months later when the hematoma in scrotal sac resolved the sac was empty ( no residual testi tissue) which seemed odd to me , then The guy mentions that he has tender lump in his thigh that he thinks is his testi and sure enough it was there intact still with good blood flow. When the patient had mentioned it to his urologist the Doc told him he was crazy and left the room even I had a hard time convincing him that it was his testi.

And good luck with surgery

[htismaqe]

Originally Posted by Monticore

Any internal infection can lead to sepsis death etc , I had patient who had diverticulitis where the inflammation was eroding through the bladder wall.

Dayum.

The last time my MiL had a flare up, she was in the hospital on IV antibiotics for 3 days.

[htismaqe]

Originally Posted by 'Hamas' Jenkins

Those have their own issues--namely tachyphylaxis. Rarer side effects can include thrombocytopenia.

PPIs can cause electrolyte deficiencies, B12 malabsorption, and increased pneumonia risk. Neither class should really be taken indefinitely. Lifestyle changes and antacids are generally the best bet, w/ two week courses of these drugs if at all possible unless you have a hypersecretory disorder like Zollinger Ellison

Exactly what my surgeon tells all of his patients.