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Laparoscopy for hiatus hernia. Palpitation, sweating, heaviness in the throat, constipation. What should be done next?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
I had an successful Laparoscopic surgery for Hiatus Hernia on October, 2011at Medica Super sepeciality Hospital, Kolkata under Dr. Sanjoy Mandal, GI Surgen. After 02 months i went for follow up and as such there was no complication. Recently I had severe palpitation with sweating. I rush to a nearest doctor and gone through ECG whose findings were normal. At present I am feeling somesysmpotms from quite few days:1. Uneasiness or heaviness below my throat (esophagus), 2. frequent blenching, 3. constipation. Now I want to ask that could there be possibility of further recurrence of hiatus hernia after successful surgery. Or is it some thing else? . In this regard I also talked to Dr. Mandal over phone, he also denied about further recurrence of hernia and I will XXXXXXX him on May. I read in internet about failure rate of Laproscopic surgery. So, if this hernia recur, what should I do next. At the moment I am very much tensed & confused. Pl suggest.
Posted Wed, 23 May 2012 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 14 hours later

From your description it appears that you are suffering from a condition called “Gas Bloat”syndrome. This is a known complication after hiatus hernia surgery, irrespective of the approach whether open or laparoscopic. This condition will take time to settle. You will require altering your food habits as well as requiring some medications.

The chances of recurrence in a well done surgery are quite low.

I hope this answers your query.

With regards
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Follow-up: Laparoscopy for hiatus hernia. Palpitation, sweating, heaviness in the throat, constipation. What should be done next? 3 hours later
Sir, i want to know: 1- whether GAS BLOAT SYNDROME could be appear after five months of surgery. As i done my surgery on October-2011 & above complications started in this month i.e. April-2012. 2- What kind of food habit & medications i should pursue?
Answered by Dr. Ketan Vagholkar 7 hours later

Thanks for following up.

The symptoms which you have described could be attributed to any of the following:

1. Gas bloat syndrome as you have symptoms of belching and chest uneasiness.
2. Dumping syndrome as you have symptoms of palpitations and sweating (autonomic symptoms)
3. Mechanical factors such as stricture of the esophagus or technical failure of the surgery itself.

The line of treatment should first be conservative comprising of avoidance of aerated beverages or flatulence creating food items, multiple soft feeds, antacids and propped up position while sleeping.

Avoid prokinetic drugs like metachlopromide; Perform blood sugar levels for assessment of dumping syndrome.

If all the above are normal or the above treatment fails to give relief then surgical complications in the form of stricture or technical failure need to be considered. In such case, ether an endoscopy / contrast study to rule out stricture or a CT scan needs to be considered.

I hope my explanation serves as a road map for resolving your problems.
If you do not have any further queries, please close this discussion.

With regards
Above answer was peer-reviewed by
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