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Diagnosed with hiatal hernia. Having severe abdominal and chest pain. Why?

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Practicing since : 1996
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My mother has been diagnosed with a hiatal hernia. I am a nurse and have never seen or heard of such severe abdominal /chest pain that she has on intermittent basis. Mostly several hours after eating (and sometime even without food) she experiences severe "chest pain" with Shortness of breath. She is raced to hospital and with pain meds they subside. I have seen her in these episode and she sweats profusely, is SOB, has BP drop. Once pain eases, she runs a temp for a day. The doctors have ruled out cardiac of any kind (with stress test, cardiac enzymes, and cath). She now has food fear and hasn't eaten anything in a week except a little applesauce and boost. She can't sustain life. Suggestions or thoughts? Worried daughter. oh - when she had the first episode the staff called in the code team. The doctors thought she was having a dissecting aortic aneurysm with the symptoms. Emergency test ruled this out. During that hospital stay, she was found to have a blood infection gram negative and was given IV antibiotics via PIC line for 10 days. All other test per the local MDs have proven to be negative. Her GP gave her a GI cocktail order this past week and it did help to relieve pain and prevented an ER trip this week (and yes she had pain even with Boost and applesauce). I have wondered about Hpyloric bacteria, intermittent hernia strangulation that may be caused by spasms or tightening of muscle around hernia when she gets so anxious/scared with the pain OR mesenteric ischemia (but she doesn't have all the symptoms of this)... Thanks
Posted Mon, 4 Nov 2013 in Digestion and Bowels
Answered by Dr. Ratnakar Kini 54 minutes later
Brief Answer:
Mesentric ischemia is a possibility.

Detailed Answer:
Thanks for posting your query.
I am Dr.Ratnakar Kini and I am pleased to assist you. As you are from medical field, I choose to use medical terms and give my opinion about your mother's condition.

Sitophobia is very typical of mesentric ischemia. I would definitely consider this a likely possibility.

If I were to be her treating doctor, I would order for duplex ultrasonography or MR angiography. If these tests show abnormal findings, then a splanchnic angiography may be done.

The tests will provide some information about mesentric blood vessel and about possible ischemia. Our treatment can accordingly be planned.

You can discuss with her doctor about these tests.

Let me know if I can assist you further.
Dr.Ratnakar Kini
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