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Hiatus hernia remedy - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Digestion and Bowels
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
Doctor :   How can I help you?'
User :   Hello Doctor
User :   I am .... and this query is for my husband who is 33years old
Doctor :   Yes, please proceed with your query.
User :   for past 4years he is taking a medicine , Nexpro for his burning sensation in his food pipe
User :   and docotr identified it as like a hiatus hernia
User :   did a endoscopy 2years back also
User :   now docotr suggesting to go for a laproscopy to tight his food pipe with diaphram and also tight the stomach (this is wat we understood)
Doctor :   Ok
User :   considering his age
User :   he has a family history of cancer..his father and brother also got cancer
User :   since he is taking medicine for past 4 years ,nexpro,docotrs are suggesting this in bangalore
Doctor :   Ok
User :   so i would like to know is this the only solution for this or is thre any side effect for this surgery?
User :   is this a permanenet solution?
User :   kidnly enlighten me
User :   *kindly
Doctor :   Ok
Doctor :   Let me explain to you.
Doctor :   Hiatus hernia is a condition where there is laxity of lower oesophageal splincter leading to reflux of the contents of the stomach.
Doctor :   This is treated either conservatively or surgically.
Doctor :   Surgical treatment, though is the best available corrective surgery, conservative line of treatment is tried initially.
Doctor :   So if the medical drugs such as antacids, proton pump inhibitor along with lifestyle modifications are not preventing the treatment,
Doctor :   surgical treatment is opted for.
User :   ok
Doctor :   The commonest surgery performed is called as Nissen's fundoplication.
Doctor :   In this surgery the herniated stomach is plicated/stitched around the lower end of the oesophagus, thus strengthening it.
User :   ok
Doctor :   As this is a surgical treatment, yes, there are side effects.
Doctor :   The side effects include the following
Doctor :   1. During the surgery - anaesthesia complications, bleeding
Doctor :   2. Immediately after the surgery - chances of infection, pain.
User :   will this be happen in a laproscopy? sorry to interrupt you
Doctor :   The chances of infections, the amount of pain and bleeding are far less in a laproscopic surgery, however
Doctor :   the later complications can occur both in laproscopic surgery as well as an open surgery.
User :   ok
Doctor :   Those side effects include bloating of the stomach.
Doctor :   and in some cases, since this surgery just tightens the lower oesophagus and doesn't correct the lax oesophagus(if it is associated), there are chances of symptoms of indigestion and heart burn returning.
Doctor :   Your doctor who has physically examined you and performed the endoscopy will be able to predict the chances of recurrence better than me.
User :   ok
Doctor :   The chances of recurrence theoretically are about 1-2%.
User :   so you also suggest the surgical correction than taking medicines daily?
Doctor :   I would suggest you to consider surgical correction only if needed.
User :   we were told that the cancer happening could be there if he continue with the medication
Doctor :   I still consider using conservative line of treatment and lifestyle modifications.
User :   conservative line of treatment ? could you please enlighten me here? is there any other method than taking medicine?
Doctor :   The present medication which he is on is a proton pump inhibitor which can lead to achlorhydria.
Doctor :   This can increase the chances of gastric cancer.
User :   ok
Doctor :   But if his symptoms are not hiatus hernia are not severe, then strict lifestyle modifications, use of antacids (as and when required), physical exercises, yoga can be tried
Doctor :   they can be as effective as the medical drugs.
Doctor :   If these measure have been tried already, or if there is severe lax lower oesophageal splincter, then surgical option can be considered.
User :   how will we know the severity?
User :   he is taking the medicine and he has no problem as of now
Doctor :   This can only be predicted by the doctor performing the endoscopy.
Doctor :   The medications reduce acid secretions and thus treat his symptoms
Doctor :   and doesn't correct the hiatus.
User :   he has not tried with physical excersise and all
User :   yes
Doctor :   The lifestyle modifications that I suggest is again preventing the symptoms
Doctor :   and not correcting the condition.
User :   could you suggest a dcotor in bangalore so that we can meet ?
User :   ok i understood
User :   so thru lifestyle modification, we can correct the symptoms without taking medcine, but to correct the condiiton,w e have to undergo the surgery
Doctor :   Yes,
Doctor :   Symptoms can be treated by medications and lifestyle modification.
User :   after taking a endoscopy we can take a descion right?
Doctor :   Life style modification include
Doctor :   regular diet, less spicy diet,
Doctor :   avoiding eating full stomach,
Doctor :   Avoid hitting the bed immediately after a meal
User :   he tool his endoscopy two years back...and docotor suggest for endoscopy and manometer test which s a costly one right?
User :   *took
User :   ok
Doctor :   Sleeping in an inclined position with 2/3 pillow to the head
Doctor :   Restricting caffee, tea and other beverages
Doctor :   Along with physical exercise , yoga and pranayama are few measures that your husband can adopt to treat the symptoms.
User :   ok
Doctor :   Discuss with your gastroenterologist who can suggest how lax the splincter is
Doctor :   alternatively you can opt for a second opinion from a different gastroenterologist.
Doctor :   You can opt for surgical correction if absolutely necessary.
User :   could you please suggest for a one?
Doctor :   May I know your location?
User :   should we meet a surgical gastroentrologist or a conusltant gastroentrologist?
Doctor :   A gastroenterologist will assess the condition, and the endoscopic findings - he may perform a second endoscopy(if necessary) and give an opinion regarding the need for surgery.
Doctor :   The surgery offcourse will be done by a surgical gastroenterologist.
User :   ok
User :   can we take a endoscopy now and meet the docotor? is that be done?
User :   meet the docotr with the findings? or is the docotr himself has to take it?
Doctor :   Since the endoscopy will be best predicted during the endoscopy,
Doctor :   I would suggest you to consult a gastroenterologist directly(if you are opting for a second opinion)
User :   yes
Doctor :   Do you wish to consult a gastroenterologist for a second opinion?
User :   yes
Doctor :   Ok
Doctor :   We have one Dr XXXXXXXX who is an experienced gastroenterologist.
User :   ok
Doctor :   Since you are our corporate customer, we can arrange for an appointment with the same doctor if you wish too.
User :   which hospital?
User :   sure
Doctor :   I shall ask one of my customer support team to call after this chat and discuss regarding the details of the doctor.
Doctor :   If you are interested in meeting the doctor, we shall arrange for a appointment.
Doctor :   Alternatively they shall help you in fixing an appointment with a doctor of your choice too.
Doctor :   The customer support team will call you shortly after this chat.
Doctor :   Do you have any other medical query that you want discuss?
User :   sure, could you please tell me from which hospital
User :   yes, I have one more query regarding mr
Doctor :   Please confirm your phone number?
Doctor :   The doctor is probably practising at ... Hospital, this will be confirmed by the customer support team when the call you.
Doctor :   Hope that is fine.
User :   when i did a abdomen scan as part of my routine check up, found that my uterus is enlarged and a very small fibroid in the wall
User :   thanks docotor
Doctor :   It was my pleasure helping you with your first query.
Doctor :   Please proceed with your next query.
User :   my query was: when i did a abdomen scan as part of my routine check up, found that my uterus is enlarged and a very small fibroid in the wall
User :   reg my that something to be worried about reg the enlargement of uetrus.. am a mother of 4year and had a c-section due to less dilation
Doctor :   Can you confirm your age?
User :   am 32year old
Doctor :   Do you have any symptoms such as abdominal pain, menstrual irregularities?
User :   no
User :   sometimes pain will be there n my lower abdomen and back during my periods time
Doctor :   Ok
Doctor :   Let me explain to you.
Doctor :   Fibroid is a benign condition.
User :   when they did the c-section for my delivery, they also took a large fibroid also
Doctor :   A small fibroid which are asymptomatic do not cause any problems.
Doctor :   You need not concern.
Doctor :   However few of them can progress in size leading to symptoms.
Doctor :   If such growth in size or development of symptoms occur then you will need treatment
Doctor :   either in the form of medical drugs or surgical removal - myomectomy or hysterectomy.
User :   so should i take a scan often to find out
Doctor :   You can get repeat ultrasound scans done once in a year or twice a year.
Doctor :   However, if you develop symptoms such as pain, menstrual irregularites, you will need scans as early as possible.
User :   ok,sure
User :   how about uterus enlargement?
Doctor :   Uterus enlargement could have been due to this fibroid
Doctor :   or due to the action of hormones
Doctor :   which regulate the periods.
Doctor :   You need not worry about the uterus enlargement.
Doctor :   as this can be normal some times( this can happen normally as your part of menstrual cycle)
Doctor :   Watch out for the progress of the fibroid size
Doctor :   watch out for symptoms
Doctor :   If they occur, then you will need the treatment.
User :   ok thanks
Doctor :   Alternatively, you can prophylactically get the surgical treatment once you stop planning for family.
User :   ok
User :   we are planng for our second baby soon,so thats y i am concerned
Doctor :   I mean, you can opt for prophylactic hysterectomy when you feel you and your husband decide against any more children.
User :   yea
Doctor :   Pregnancy can increase the size of fibroids in some cases.
User :   ok
Doctor :   So its is possible that the fibroid can increase in size.
User :   that happened with my first kid's case..
User :   means, my first pregnancy case
Doctor :   Very few of them can cause problems such as miscarriage or fetal compromise.
User :   ok
Doctor :   If such incidents happen, you will need surgical treatment.
Doctor :   The chances of this happening are less though.
Doctor :   So you need not worry.
Doctor :   Have you followed?
Doctor :   Do you have any other query?
User :   Thanks a lot docotor
Doctor :   Do you have any other query?
User :   No, i dont have any more query
Doctor :   Thanks for consulting me.
Doctor :   Take care.
Doctor :   Wish you the best of luck to you and your husband too.
Doctor :   Bye for now.
User :   so please pass my phone number to your cust, so that i can meet Dr. soon
Doctor :   Yes.
User :   Bye,take care
User :   and once again thanks
Doctor :   My team shall call you shortly.
Doctor :   Thanks again.
Doctor :   Bye for now.
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