Hiatal Hernia. What helps?

Posted by betterb4 @betterb4, Feb 13, 2017

I was just diagnosed with a small hiatal hernia but I'm feeling pretty miserable. I was a perfectly healthy person and this all started a couple months ago. It started with a feeling of a "lump" at the bottom of my esophagus (or top of my stomach). Sometimes I had a burning feeling in my esophagus. I mentioned it with my gastroenterologist before a routine colonoscopy; she pretty much dismissed it but immediately put me on Prilosec in the morning and Zantac.It really doesn't help very much. before bed. I had and EGD and she diagnosed and irritated esophagus and stomach and a small hiatal hernia.
I have now given up coffee, wine, chocolate, beef, tomatoes and eating after dinner (everyday the list grows.) We have propped our bed at an angle. I am afraid to eat. She insists that the hernia is not causing this, but it must be. I'm in my 50's, perfect weight and have never even had heartburn. If this doesn't improve soon, I am thinking of going to Mayo for a full evaluation. I can't live this way and I DO NOT want to be on medicine the rest of my life.

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Having been through this, I would get a second opinion from a different GI doctor. Mayo told me to sleep upright, stop eating for the day at least three hours before bedtime, and to avoid certain foods: greasy foods, spicy foods, peppermint, and more.

Your inclination to avoid meds long-term is spot-on! I had a 4 cm hiatal hernia and GERD issues for years, and the sphincter between my stomach and esophagus was failing. My home doctors treated me with Nexium and it's generic equivalents for years. Twelve years later, and getting sicker and sicker, in September 2015 I took myself to Mayo and they figured out that I genetically don't properly metabolize these medications, which is the reason why I was getting sicker and sicker. Thing is, even if you do properly-metabolize these meds, these meds themselves inhibit the enzyme system that metabolizes these medications, which means that people on these meds long-term will slowly develop symptoms to the medication inhibition. (Both Prilosec and Zantac are also inhibitors.) Unfortunately, the majority of doctors don't know about it.

So solve this problem for me, last October Mayo performed a Nissen Fundoplication surgery on me to fix the hernia and GERD issue. No more meds for me!

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Hello @betterb4,

Welcome to Connect. As a healthy individual, it can be very disappointing and frustrating to learn about your diagnosis! You are not alone in those feelings, and we are so glad to have you here.
thank you so much @kdubois, for sharing all the information: there's no better teacher than personal experience,and thanks to @mrsdeecee for the tips, and advice.
Here is an overview about hiatal hernia from Mayo Clinic, which you may find helpful: http://mayocl.in/1Qp9mzL

Allow me to also introduce you to @tlv68, @peck1944, @thawyzard, @cathy615, @mnangelmom, @pinkmk, @SherryD, @ilenen, @cmaso67, @ladysky, @patreats5674, @ladysky, @safetyshield, who have discussed hiatal hernia and may be able to offer some insight.

@betterb4, if you would like to make an appointment at Mayo Clinic in Minnesota, Arizona or Florida, you can call or request an appointment online here: http://mayocl.in/1mtmR63.

Diet seems to play an important role in managing the symptoms, betterb4; what other dietary changes have you made? And, may I ask why your symptoms like the burning feeling were dismissed?

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@kdubois

Having been through this, I would get a second opinion from a different GI doctor. Mayo told me to sleep upright, stop eating for the day at least three hours before bedtime, and to avoid certain foods: greasy foods, spicy foods, peppermint, and more.

Your inclination to avoid meds long-term is spot-on! I had a 4 cm hiatal hernia and GERD issues for years, and the sphincter between my stomach and esophagus was failing. My home doctors treated me with Nexium and it's generic equivalents for years. Twelve years later, and getting sicker and sicker, in September 2015 I took myself to Mayo and they figured out that I genetically don't properly metabolize these medications, which is the reason why I was getting sicker and sicker. Thing is, even if you do properly-metabolize these meds, these meds themselves inhibit the enzyme system that metabolizes these medications, which means that people on these meds long-term will slowly develop symptoms to the medication inhibition. (Both Prilosec and Zantac are also inhibitors.) Unfortunately, the majority of doctors don't know about it.

So solve this problem for me, last October Mayo performed a Nissen Fundoplication surgery on me to fix the hernia and GERD issue. No more meds for me!

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May I ask what age this all started with you?

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I eat small meals. Oatmeal for breakfast, something small like a half of turkey sandwich for lunch. A small afternoon snack and then we try to eat before 7 pm and we are very healthy eaters. My husband is an excellent cook. We usually, and always have, eat chicken & a vegetable or a veggie dish. That is why this is so hard to understand. I don't drink soda. I have one cup of coffee in the morning. I think what brought it on was eating late, as we are empty-nesters and we would have a glass or two of chardonnay. So now, I can't have any of my favorite things. It all came about within 2 months. It started with feeling like I had swallowed a golf ball. No heartburn or anything. Just the feeling like there was something (a lump in my stomach) My GI doctor said this is not the hernia, she doesn't know what that would be. The heartburn, (esophagus burn) just started within the last few weeks. But it is bad enough to make me have a sore throat and be hoarse at times.

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@kdubois

Having been through this, I would get a second opinion from a different GI doctor. Mayo told me to sleep upright, stop eating for the day at least three hours before bedtime, and to avoid certain foods: greasy foods, spicy foods, peppermint, and more.

Your inclination to avoid meds long-term is spot-on! I had a 4 cm hiatal hernia and GERD issues for years, and the sphincter between my stomach and esophagus was failing. My home doctors treated me with Nexium and it's generic equivalents for years. Twelve years later, and getting sicker and sicker, in September 2015 I took myself to Mayo and they figured out that I genetically don't properly metabolize these medications, which is the reason why I was getting sicker and sicker. Thing is, even if you do properly-metabolize these meds, these meds themselves inhibit the enzyme system that metabolizes these medications, which means that people on these meds long-term will slowly develop symptoms to the medication inhibition. (Both Prilosec and Zantac are also inhibitors.) Unfortunately, the majority of doctors don't know about it.

So solve this problem for me, last October Mayo performed a Nissen Fundoplication surgery on me to fix the hernia and GERD issue. No more meds for me!

Jump to this post

Also, thank you for so much information. I think I would turn to Mayo sooner, rather than later, if I don't find relief through diet changes. It sounds like they are more thorough, and I'm glad you finally have relief.

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@kdubois

Having been through this, I would get a second opinion from a different GI doctor. Mayo told me to sleep upright, stop eating for the day at least three hours before bedtime, and to avoid certain foods: greasy foods, spicy foods, peppermint, and more.

Your inclination to avoid meds long-term is spot-on! I had a 4 cm hiatal hernia and GERD issues for years, and the sphincter between my stomach and esophagus was failing. My home doctors treated me with Nexium and it's generic equivalents for years. Twelve years later, and getting sicker and sicker, in September 2015 I took myself to Mayo and they figured out that I genetically don't properly metabolize these medications, which is the reason why I was getting sicker and sicker. Thing is, even if you do properly-metabolize these meds, these meds themselves inhibit the enzyme system that metabolizes these medications, which means that people on these meds long-term will slowly develop symptoms to the medication inhibition. (Both Prilosec and Zantac are also inhibitors.) Unfortunately, the majority of doctors don't know about it.

So solve this problem for me, last October Mayo performed a Nissen Fundoplication surgery on me to fix the hernia and GERD issue. No more meds for me!

Jump to this post

My heartburn issue started in February 2004 when I was 32. My doctor put me on Nexium at that time. Mayo figured out my genetic drug intolerance when I was 44, and they did the surgery later in the year after I had turned 45.

Interestingly, my brother has the same exact issue and has had the same exact surgery to correct the hernia and GERD. My mom has GERD issues, as well.

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@kdubois

Having been through this, I would get a second opinion from a different GI doctor. Mayo told me to sleep upright, stop eating for the day at least three hours before bedtime, and to avoid certain foods: greasy foods, spicy foods, peppermint, and more.

Your inclination to avoid meds long-term is spot-on! I had a 4 cm hiatal hernia and GERD issues for years, and the sphincter between my stomach and esophagus was failing. My home doctors treated me with Nexium and it's generic equivalents for years. Twelve years later, and getting sicker and sicker, in September 2015 I took myself to Mayo and they figured out that I genetically don't properly metabolize these medications, which is the reason why I was getting sicker and sicker. Thing is, even if you do properly-metabolize these meds, these meds themselves inhibit the enzyme system that metabolizes these medications, which means that people on these meds long-term will slowly develop symptoms to the medication inhibition. (Both Prilosec and Zantac are also inhibitors.) Unfortunately, the majority of doctors don't know about it.

So solve this problem for me, last October Mayo performed a Nissen Fundoplication surgery on me to fix the hernia and GERD issue. No more meds for me!

Jump to this post

I truly wish I had gone to Mayo sooner -- at least a decade sooner. They not only figured out this issue, but they figured out a bunch of other issues in other specialties for me as well, including endocrine and sleep.

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@betterb4 I read above that you had a colonoscopy. What imaging exams have been performed on your GI system to view the area? Has your doctor ordered anything to view the area where you feel (lower esophagus/upper stomach)?

In addition to the foods listed above, I would avoid sugary foods, which I love. It would help me to drink some fat-free milk after dinner. Milk is a base and can help reduce the acid. Prior to my surgery, I would eat dinner by 5:00 p.m. Not ideal, but it did help.

From what I've learned, Nexium was actually never intended to be used long-term; the package insert states the time frames. It's also not good to use Tums long-term. With that said, heartburn and esophageal burn can cause other issues long-term.

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I would strongly suggest going to Mayo for an endoscopy. I have been told by my Dr at Mayo that A Hiatial hernia can be corrected thru surgery if there is no Barretts located in the hernia area. I suffered with GERD for many years with a hiatial hernia and I developed Barretts esophagus with high grade dysplasia. Since going to mayo for treatment i no long have dysplasia. Since the dysplasia in where the hernia is, it can't be corrected. By the way, I have been taking Nexium 4 times the recommended dosage for 3 years now under my Mayo Dr. Supervision with no ill effects. The only thing I need to monitor is my calcium uptake since Nexium can lower its absorption. I take 2000 units of D3. Going to Mayo was a God send for me.

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@dandl48

I would strongly suggest going to Mayo for an endoscopy. I have been told by my Dr at Mayo that A Hiatial hernia can be corrected thru surgery if there is no Barretts located in the hernia area. I suffered with GERD for many years with a hiatial hernia and I developed Barretts esophagus with high grade dysplasia. Since going to mayo for treatment i no long have dysplasia. Since the dysplasia in where the hernia is, it can't be corrected. By the way, I have been taking Nexium 4 times the recommended dosage for 3 years now under my Mayo Dr. Supervision with no ill effects. The only thing I need to monitor is my calcium uptake since Nexium can lower its absorption. I take 2000 units of D3. Going to Mayo was a God send for me.

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Thank you and I do take calcium but I think I will increase the dosage, just to make sure.

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