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Shortness of breath, heartburn, raspy voice, sleep onset apnea. EKG normal. Is it hiatal hernia?

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I am 52 year old male. Life-long history of excellent health and an extremely high fitness level (probably 99+ percentile for my age). Was training (mountain biking, running, strength training) 15 hours / week. Suddenly (at end of July), began to struggle with shortness of breath, sensation of heartburn and/or irritation in center of chest just at bottom of rib cage, plus developed raspy voice. Conditions seems to worsen with meals. Also experienced some type of sleep onset apnea (probably due to fear as this symptom has now subsided) when this problem began. Lung doc (via chest x-ray and pulmonary function tests) and cardiologist (via echo cardiogram and stress test EKG) have since confirmed that lungs and heart are healthy. From internet research I would say I have a hiatal hernia (also note that when I feel my abdomen pushing particularly uncomfortably up to my chest, I can push my fingers in just below my sternum, sweep them downward, and get immediate relief in terms of fuller breaths from my abdomen. Does a hiatal hernia diagnosis seem accurate? If so, is further exercise exacerbating my problem? I do not have the same level of energy as before, but I do not want to give up running, biking, swimming, and lifting weights if I do not have to. Is surgery a likely solution or something to avoid?
Posted Thu, 20 Sep 2012 in Digestion and Bowels
Answered by Dr. Om Lakhani 6 hours later

Thanks for writing in.

If the cardiologist and pulmonologist have given you a clear the the symptoms of hiatal hernia seems accurate. However I would say it is Gastroesophageal reflux disease, hiatal hernia is a cause of GERD. A hiatal hernia with GERD just makes a little bit difficult to treat.

Either way the initial treat of hiatal hernia/GERD is proton pump inhibitors. You must take them from atleast 3 months before we consider any other treatment options including surgery. Surgery is the last option and done only if you donot have relief from all other medical options.

You don't to give up excersicing but avoid weight if possible. You need to take care not to bend too during excersicing. Bending forward would make the symptoms worse. Apart from that you can continue with rest of your routine. Also avoid taking heavy meals at bedtime and try sleeping with your head elevated with an extra pilllow at bed time. If meals are causing problem you can have small frequent meals instead of 2-3 large meals in a day and avoid excerscing 1-2 hrs after eating.

Hope this answers your question

Dr. Om Lakhani
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