Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

198 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Taking nexium for non reducible hiatal hernia and reflux problem. Should I go for surgery?

Answered by
Dr.
Dr. Om Lakhani

Endocrinologist

Practicing since :2004

Answered : 319 Questions

default
Posted on Thu, 14 Feb 2013 in Digestion and Bowels
Question: I have a moderate sized,sliding,non reducible hiatal hernia and have had reflux problems for 7 years, I take nexium and sometimes when I bend forward I have regurg of acid.On a recent upper GI they identified a schatzki ring as well.
Would surgery be indicated in this type of case?
doctor
Answered by Dr. Om Lakhani 2 hours later
Hi XXXXXXX

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) have proposed the following Indications for surgery in GERD:

1) have failed medical management (inadequate symptom control, severe regurgitation not controlled with acid suppression, or medication side effects)

OR

2) opt for surgery despite successful medical management (due to quality of life considerations, lifelong need for medication intake, expense of medications, etc.)

OR

3) have complications of GERD (e.g., Barrett's esophagus, peptic stricture) 18, 19

OR

4) have extra-esophageal manifestations (asthma, hoarseness, cough, chest pain, aspiration)

In your case we can reasonably say that there are some regurgitation symptoms despite medical therapy so you can be considered as a surgical candidate. However practically speaking surgery is generally a personal choice. If you are okay with the symptoms and can deal with the occasional regurgitation, you do not need any surgery, however if you are unhappy with the symptom profile, surgery might help.

Schatzki ring and Hiatus hernia are often seen with GERD and are per-se NOT INDICATIONS FOR SURGERY.

Remember surgery does carry some risk and hence you must discuss with your GI surgeon the risks and benefits of the surgery. As a personal opinion I would advice you against the surgery. What I would advice you apart from your medications is loosing some weight. At 200 lbs loosing a few pounds itself would help you with your GERD.

Hope this answers your question.

Regards
Dr. Om Lakhani, MD


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,   ,   ,  
Drug/Medication
Medical Topics

Recent questions on  Hiatus hernia

doctor1 MD

Hi, I am 56, average weight (57kg), 169cm tall. Lately I had several occasions where after drinking green tea or water I develop belching and severe dull pain in my left kidney area, sometimes lasting for 2 days. Often it is when I twist my torso or do anything just after drinking. It is not indigestion - it is usually on empty stomach. Could it be something with my kidneys or pancreas? I am taking pancreatin for digestive problems. I also have sliding hernia and a host of other problems, but this is a new one.

doctor1 MD

Hi, may I answer your health queries right now ? Please type your query here... i have a small hiatal hernia and i also had my gallbladder removed two months ago i have never had so much acid reflux as i do now no medication seems to be helping me at all i tried them all. i also have naussa and and somtimes a stomach ache and diarrhea four days a week i had mrs cat scans they found nothin wrong with me can i have some other type of infection help what can i do now. sandy

doctor1 MD

Hi. Since ten years now I have been suffering from digestive problems. Doctors said it was Ibs but now they say its all because of hiatal hernia. My prob they say has no solution. Have been asked to take vibact ds, saril, digeplex and lopamide tablet. Is there no remedy to hiatal hernia

doctor1 MD

I had a nissen fundoplication in 1999. Two years ago I began to experience nausea, heartburn, bloating, pain if I don't eat. Pulling sensation with lifting and increasing sob. Chest CT shows moderate hiatal hernia. Did not have hernia before surgery. Does this mean the wrap has failed and I need a redo?

doctor1 MD

I have pain in the center of my chest near the bottom of my ribcage. sometimes it hurts and burns at the same time. I also have several lumps on my chest and in my left breast. they usually don't bother me but when I get cold they hurt until I...

doctor1 MD

Persistent queasiness, espohogeal regurgitation present for over a month plus diarrhea for the as two days. Also, a taste of acid in my mouth 2to 4 hrs after eating. I take 45 mg nexium daily and have no acid reflux . the regurgitation is not acidic.

doctor1 MD

Can this be esophagus cancer or something else? Worried it might be esophagus cancer. Symptoms: 23 year old male, about 1.6 (1 year and 6 months ago), upper endoscopy was done with no esophagitis , normal biopsy of esophagus. Hiatus hernia was...