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Dr. Andrew Rynne

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Suggest treatment for hiatal hernia and acid reflux

Answered by
Dr. Ramesh Kumar


Practicing since :1986

Answered : 1996 Questions

Posted on Fri, 3 Mar 2017 in Liver and Gall Bladder
Question: I have a heatial hernia and acid reflux. My only real complaint is that I throw up and gag a lot but its becoming less so and I think its related to anxiety. They did a catscan and everything was normal except the hernia and the acid reflux.How necessary/potentially life saving is an endosconspy? My only main complaint is that I easily gag and/or dry heaves if I don't rush to the bathroom the second that I feel the urge to go.

Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Yes it should be done.

Detailed Answer:
Hi as per your query,
Role of endoscopy in a case of hiatal hernia with gastritis is,
It allows visual assessment of the mucosa of the esophagus, stomach and duodenum. The presence of erosive esophagitis or Barrett’s esophagus can be determined.Barrett's esophagus is a serious complication of GERD, which stands for gastroesophageal reflux disease. In Barrett's esophagus, normal tissue lining esophagus changes to tissue that resembles the lining of the intestine. About 10% of people with chronic symptoms of GERD and Hiatal hernia develops Barrett's esophagus. Further, the size and type of hernia can be determined. Inability or difficulty reaching the duodenum in the presence of a large hiatal hernia is diagnostic of a volvulized paraesophageal hernia.Therefore in a diagnosed case of hiatal hernia endoscopy is should be done and is necessary to rule out further complications arising out of hernia.
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Ramesh Kumar 36 minutes later
Well they did tell me that it was a small hernia. What possible treatments exist that can only be given as a result of getting the endoscopy and that can't be treated without getting the endoscopy? What other alternatives are there? Is blood work a good starting point? What other options do I have? What If I keep putting this endoscopy off?
Answered by Dr. Ramesh Kumar 9 hours later
Brief Answer:
Follow up answer.

Detailed Answer:
Hi again
Possible treatment (can be given without endoscopy)
-over-the-counter antacids to neutralize stomach acid.
-over-the-counter or prescription proton pump inhibitors to prevent acid production, giving your esophagus time to heal.
-Surgery(depends on endoscopy)
-rebuilding weak esophageal muscles.
-putting your stomach back in place and making your hiatus smaller.

Alternatives are-
Barium X-ray-you drink a liquid with barium in it before taking an X-ray. This X-ray provides a clear silhouette of your upper digestive tract.
Lifestyle changes-Acid reflux causes most hiatal hernia symptoms. Changing your diet can reduce your symptoms. here are also certain foods that may increase your risk of heartburn. Consider avoiding spicy foods,chocolate,foods made with tomatoes,caffeine,citrus fruits stopping smoking and alcohol.

losing excess weight'not straining during bowel movements, getting help when lifting heavy objects and avoiding tight belts and certain abdominal exercises.

No blood work will not help.
Try to go for life style modificaton changes and medication for 21 days.If not relieved go for endoscopy.

Above answer was peer-reviewed by : Dr. Nagamani Ng

The User accepted the expert's answer

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