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Suffering from anxiety and panic-attack. Prescribed anti-depressants. Diagnosed with hiatal hernia. What to do?

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hello :)

I have a very interesting question and weird too :..

I have been suffering from anxiety and panic-attack for 4 years; sometimes it's very good; and sometimes I feel bad for a long time.
My first doctor gave me anti-deppression pills; which actually helped me.
I stopped taking them after 1 year and 6 monts.
I started to be bad again; but never as bad as it was before.
1 year after, I was diagnosed with a hiatal hernia;; so I really but my believing in that the hernia was the actually problem I felt when I was having a panic attack and feeling bad; because my stomach push up agains my heart and lungs. But 2 weeks ago; everything I was believing in was shut to sunshine; after my doctor told me; that I had a very small hiatus hernia; after seeing me through gastroscopy; and that it was impossible that the stomach did this kind o problems for me; and this hernia didn't needed to be taken care of with surgery or anything. I have never had much reflux; so that isn't a problem; but I have pills for that also; so it kinda helps very well: when I get it.
But after the doctor told me I didn't have a hiatal hernia and I didn't needed to worry about; I felt good and everything turn to normal after 3 hours.. kinda weird..
7 days after; when I started working again; and I had many plans in my head; everything went wrong Iagain..
So I took 2.5mg diazepam; which my mom did have; because she's afraid of flying.
2 hours after; everything was back to normal. and now 48 hours later; it still is.
I can eat everything without my stomach push up and; without raising my puls; and giving my a hard time.
But as soon as I feel bad and panic; I can't eat anything without my stomach get pissed of and give me a hard time; and really feels like a heart attack.
I had my heart check; and there was nothing wrong with it.

I think; my body act the way I think; when I thought I had a hiatal hernia which was large; I had very very bad problems; and I felt like the stomach was in the chest the whole time;; when my doctor told me it was small and the stomach didn't was in the chest; and never had been.; the problem did stop.

this is really hard; hard to keep my body on an even keel.

What can I do ? ..
I really don't want to start again with anti-depression; because I am a really positive person; but my stomach and heart really get pissed of sometimes; when I start thinking to much and get angry or mad or something. and

is there anything I can do ?
Posted Mon, 29 Jul 2013 in Digestion and Bowels
Answered by Dr. Amit Jain 8 hours later

I understand your concern. A very small hiatus hernia most of the time is asymptomatic. Feeling of stomach push up and pressing on heart and lung may be due to postprandial fullness. As a small hiatus hernia is reported, I suggest the following measures:
1. Avoid fatty meals
2. Don't lie down soon after meals for at least half hour
3. Take small and frequent meals, instead of full meals at a time
4. Wear loose clothoings
5. If you are overweight or obese do weight reduction with dieting and exercise
6. Avoid straining while defecation, lifting heavy weight, coughing, sneezing and smoking (if any)

Along with it some medications can be tried for better results. I suggest 3 drugs to my patients with similar post prandial fullness and hiatus hernia:
1. Domperidone - it don't simply act as a prokinetic agent but it also increase the tone of lower esophageal sphincter
2. Baclofen - which helps in increasing tone of lower esophageal sphincter
3. May be proton pump inhibitor like rabeprazole
Discuss with your treating doctor about these drugs.

I understand you do not want to use antidepressants further, however panic and anxiety attacks can be best controlled with medications. You may discuss with your doctor about changing doses if there are any side effects. One can add anti-anxiety agent instead of antidepressants like combination of propranolol and alprazolam. This combination will relieve your anxiety and apprehension.

In brief, small hiatus hernia usually don't cause any problem even if it persist for whole life.

I hope I have answered your query and this will help you. Remain in touch and get-well soon.
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