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Suggest Treatment For Symptoms Of GERD While Having Hiatus Hernia

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Posted on Sat, 7 Jan 2017
Question: I'm April 2015 I had my first episode consisting of extreme chest pain and pain that if I drank something it was hurt as it moved down my oesophagus to my stomach. Following this night I began getting sick every 3/4 days almost like clock work. these attacks now come as one week I get a few symptoms and the following week a major attack. On the 'good' week my symptoms are - feeling if lump in throat, the need to burp but only doing throat burps, tiredness and feeling cold. On the bad week my episode begins with lump in throat and burps, continuing to excess salivation and then following through on the burps and bringing up blobs of clear mucus. I get chest pain that increases until I throw up this mucus, then I get brief relief until the pain increases and I have throw up again. sometimes I need to stick my fingers down my throat to help bring up the mucus. During this time I can't eat or drink anything.
I get extremely cold on what cold be a 40C day. I become exhausted also. I continue like this for 12 -24 hours. At the worst part I am in excruciating pain that I almost become suicidal, everything hurts, my jaw, throat, chest, everything- even walking and especially talking can worsen the pain. Finally I begin to throw up bile a few times in concentrated form, meaning there is no fluids left to help it out and this burns very badly. After that I can sometimes sleep a little and begin to recover. It takes a about a day to recover from the pain but can take 2 days to recover from the pain on my insides, oesophagus etc. Then I'm back to normally completely until the next week.
I've seen doctors and naturopath and taken all different medicines, I've had blood tests and ct scans and biopsies taken from my stomach and oesophagus. I tried eliminaton diets and kept months worth of food diaries. My GP has admitted defeat and the specialist I saw was said it was oesophageal spasms but it isn't.. I'm at my wits end. Please help. I have 5 young children I'm trying to look after while dealing with this. and it's not stress as my doctor ruled that out after my house burned down this last august and I still didn't get sick until I was 'due' to... Just wanted to add I was actually at my healthiest when this started I had lost 10kg and was running 5k most days on my treadmill and doing weights. We had just had a week away camping where quite a bit of alcohol was consumed and the episode was in the week after this.
doctor
Answered by Dr. Dr. Happykumar Kagathara (4 hours later)
Brief Answer:
Hiatus hernia related severe GERD

Detailed Answer:
Hello,
I can understand your worry on prolonged symptoms.
1) Your symptoms are suggestive of GERD of severe variety in which stomach acid (bile) reflux back into esophagus (upto mouth). This is due to weak sphincter mechanism at lower end of esophagus and hiatus hernia is most common cause for this.
2) In esophageal spasms you experience difficulty in swallowing but reflux could not occur in spasm episodes.
3) Hiatus hernia is condition in which small portion of stomach move up into chest through opening in diaphragm from which esophagus enter into abdomen. This condition require CT scan in specific position to confirm the diagnosis and sometimes large hiatus hernia can be diagnosed in endoscopy also.
4) Medical treatment is required to relieve from symptoms but surgery is only treatment option for cure. As a prevention, you should avoid eating/drinking 2-3 hours before going to bed at night. Prokinetic + anti-emetic group of medication is also useful to relieve symptoms.

Hope I answered your query. If you have any further question, I would be happy to help you.
Have a good day!
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Happykumar Kagathara (41 minutes later)
I've had a Gastroscopy and a CT scan, they ruled out a hernia (as that was my doctors inital thoughts). I am basically being treated for GERD morning and night with Esomeprazole and Nizac but they have not helped. I also take Claratyne twice daily as I developed Ulticaria at the same time. Also if it was GERD how can I be fine and then sick for up to 24hrs and then absolutely fine again?
I feel like I'm going round in circles with doctors .... am i just going to be put in the too hard basket again.
doctor
Answered by Dr. Dr. Happykumar Kagathara (6 minutes later)
Brief Answer:
Cyclic symptoms due to continous production of acid in stomach

Detailed Answer:
Hello,
Symptoms of GERD develops generally at night or in empty stomach because when you eat all stomach acid will be utilised to digest food and it move ahead into small intestine along with digested food.
But stomach secrete small amount of juices in empty stomach (without food) also and this reflux back. Therefore you are experiencing cyclic symptoms rather than persistent symptoms.
Both of your medications (Esomoprazole and Nizac) are to reduce acid production in stomach. You might require stomach-motility group of medication also (Lesuride) which help in reducing reflux.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy
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Answered by
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Dr. Dr. Happykumar Kagathara

General Surgeon

Practicing since :2006

Answered : 444 Questions

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Suggest Treatment For Symptoms Of GERD While Having Hiatus Hernia

Brief Answer: Hiatus hernia related severe GERD Detailed Answer: Hello, I can understand your worry on prolonged symptoms. 1) Your symptoms are suggestive of GERD of severe variety in which stomach acid (bile) reflux back into esophagus (upto mouth). This is due to weak sphincter mechanism at lower end of esophagus and hiatus hernia is most common cause for this. 2) In esophageal spasms you experience difficulty in swallowing but reflux could not occur in spasm episodes. 3) Hiatus hernia is condition in which small portion of stomach move up into chest through opening in diaphragm from which esophagus enter into abdomen. This condition require CT scan in specific position to confirm the diagnosis and sometimes large hiatus hernia can be diagnosed in endoscopy also. 4) Medical treatment is required to relieve from symptoms but surgery is only treatment option for cure. As a prevention, you should avoid eating/drinking 2-3 hours before going to bed at night. Prokinetic + anti-emetic group of medication is also useful to relieve symptoms. Hope I answered your query. If you have any further question, I would be happy to help you. Have a good day!