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Have hiatus hernia, vomiting, regurgitation, choking, distended abdomen, weight loss, urine incontinence. Worried

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Practicing since : 2008
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I am awaiting surgery as I have a hiatus hernia which is causing lotsvof symptoms ie; vomiting after eating certain foods ind igestion regurgitating sometimes when I am sleeping ive almost choked a fwe times I have had a fewvupper respiratory infections recently I have niticed my abdomen can be very distended even though I have been swimming 3 times a week for 6mths and lost weight my stomach remajns very bloated I have also startd to be incontinent of urine it just happens no warnings and then in work (I am a staff nurse I work 12hr shifts)the other day I had an awfull tight feeling across my upper abdomen likevid been punched it lasted for hrs and scared me what can all these symptoms be I am not a moaner I just get on with things but its all starting to worry me , working in oncology dont help
Posted Sun, 25 Aug 2013 in Digestion and Bowels
Answered by Dr. Anjana Rao Kavoor 4 hours later
Thanks for writing in to us.

Hiatus hernia is a condition when the stomach elevates itself partially from the abdominal cavity into the chest cavity. There are 2 types, the sliding type and paraesophageal type.

Unfortunately there is no definitive treatment by taking medications and surgery is the treatment of choice for symptomatic cure.

Your symptoms are explainable:
Vomiting after eating certain foods indigestion, regurgitating sometimes when sleeping with choking a few times. Also had a few upper respiratory infections recently.

The hiatal hernia, acting as a fluid trap for gastric reflux and increasing the acid contact time in the esophagus. In addition, with a hiatal hernia, episodes of transient relaxation of the Lower Esophageal Sphincter are more frequent and the length of the high-pressure zone is reduced. The main symptoms of a sliding hiatal hernia are those associated with reflux and its complications. Upper respiratory infections and choking might be due to very small amount of stomach fluid getting aspirated into airway.

I suppose a CT scan of your abdomen has been done as a part of workup for your problem. In hiatus hernia imaging, the chest and upper abdomen are included to see for exact structural and functional problems.

The medical treatment of hiatus hernia includes,
Modifying lifestyle factors
Neutralizing acid or inhibiting acid production
Enhancing esophageal and gastric motility

Larger hernia however must be treated with surgery. Please do not worry, every thing will start subsiding once you are through the surgery. Surgical procedures offer relief of symptoms in 80-90% of patients. Good long-term results have been reported for antireflux surgery, with adequate control of reflux in the range of 80% at 10 years.

Hope your query is answered.
Should there be any further query to be discussed in detail, please feel free to ask.

Dr A Rao Kavoor
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