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What causes GERD and hiatal hernia?

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Posted on Tue, 28 Apr 2015
Question: I have GERD w/ hiatal hernia and resultant frequent aspiration during sleep even when being well elevated. I also snore very loudly w/ reported pauses in breathing. I have eaten as much as 7 hours prior to sleep and still have the aspiration. I am on Nexium 40mg q d. have taken motillium with no apparent change in symptomatology. I am a 61 year old married white male weighing 220 lbs, and stand 6' tall. I have been scoped in the past 3 years both throat and colon w/ some diverticulum and precancerous polyps which were removed. I have borderline GFR numbers >60 w/ high normal creatine leading to a possible stage 2 CKD diagnosis. I also have slightly high alt/SGOT at times and an enlarged aortic base (43mm and stable for at least 5 years confirmed by echo cardiograms each year) and I have a bicuspid aortic valve w/ no reflux or subluxation noted. I have mild hypertension controlled by Toprol XL 50mg q d and Cozaar 25mg q d. I have BPH and have had holmium laser ablation of the prostate for that about 7 years ago which seem to be holding up very well. My PSA numbers are normal (>3) I have constant sinus and nasal congestion with a suspected continuous sinus infection which varies somewhat in severity but has not totally resolved in over at least 15 years. I suspect emesis from the reflux as a major contributing factor.
The frequent aspirations and possible sleep apnea seem to be leading to decreased lung productivity. I carry a pulse oximeter and have found my normal reading to be about 95% with pulse rate about 90-100 resting. I cannot take stairs without becoming quite winded and cough incessantly to try to clear the emesis I have aspirated. Also as a result of this, I believe I suffer from circadian rhythm desynchronizes, sleep deprivation, and resultant daytime sleepiness/ general fatigue.
I have GERD w/ hiatal hernia and resultant frequent aspiration during sleep even when being well elevated. I also snore very loudly w/ reported pauses in breathing. I have eaten as much as 7 hours prior to sleep and still have the aspiration. I am on Nexium 40mg q d. have taken motillium with no apparent change in symptomatology. I am a 61 year old married white male weighing 220 lbs, and stand 6' tall. I have been scoped in the past 3 years both throat and colon w/ some diverticulum and precancerous polyps which were removed. I have borderline GFR numbers >60 w/ high normal creatine leading to a possible stage 2 CKD diagnosis. I also have slightly high alt/SGOT at times and an enlarged aortic base (43mm and stable for at least 5 years confirmed by echo cardiograms each year) and I have a bicuspid aortic valve w/ no reflux or subluxation noted. I have mild hypertension controlled by Toprol XL 50mg q d and Cozaar 25mg q d. I have BPH and have had holmium laser ablation of the prostate for that about 7 years ago which seem to be holding up very well. My PSA numbers are normal (>3) I have constant sinus and nasal congestion with a suspected continuous sinus infection which varies somewhat in severity but has not totally resolved in over at least 15 years. I suspect emesis from the reflux as a major contributing factor.
The frequent aspirations and possible sleep apnea seem to be leading to decreased lung productivity. I carry a pulse oximeter and have found my normal reading to be about 95% with pulse rate about 90-100 resting. I cannot take stairs without becoming quite winded and cough incessantly to try to clear the emesis I have aspirated. Also as a result of this, I believe I suffer from circadian rhythm desynchronizes, sleep deprivation, and resultant daytime sleepiness/ general fatigue.
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Answered by Dr. Heera Lal Poonia (2 hours later)
Brief Answer:
do basic tests and meet a surgeon for hernia surgery

Detailed Answer:
Dear XXXX, welcome to hcm and thanks for choosing us.

I understand your concerns. You should have mentioned about the surgical expert's opinion on surgery for hiatus hernia because this hernia is behind your current symptoms like sinusitis, decreased lung capacity, snoring

Surgery is an ideal and definitive treatment for hiatus hernia, but you need to discuss an expert anaesthetist as you have several health related issues, which complicate the anaesthesia process. I think if you under go the surgery you will be fine .

Meanwhile do your basic laboratory tests like blood work up, ecg, urine test to rule out some common problems like anaemia, urine infections, heart rhythm disturbances as these conditions also present in similar way as you have been facing. Multiple organ diseases affect all these basics.

Meanwhile keep taking good food with more fruits and green vegetables along with fluids, which will help in recovery and improving general health.

I wish you good health. Please write to hcm or me for follow up queries. Thank you
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Heera Lal Poonia

General & Family Physician

Practicing since :2008

Answered : 506 Questions

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What causes GERD and hiatal hernia?

Brief Answer: do basic tests and meet a surgeon for hernia surgery Detailed Answer: Dear XXXX, welcome to hcm and thanks for choosing us. I understand your concerns. You should have mentioned about the surgical expert's opinion on surgery for hiatus hernia because this hernia is behind your current symptoms like sinusitis, decreased lung capacity, snoring Surgery is an ideal and definitive treatment for hiatus hernia, but you need to discuss an expert anaesthetist as you have several health related issues, which complicate the anaesthesia process. I think if you under go the surgery you will be fine . Meanwhile do your basic laboratory tests like blood work up, ecg, urine test to rule out some common problems like anaemia, urine infections, heart rhythm disturbances as these conditions also present in similar way as you have been facing. Multiple organ diseases affect all these basics. Meanwhile keep taking good food with more fruits and green vegetables along with fluids, which will help in recovery and improving general health. I wish you good health. Please write to hcm or me for follow up queries. Thank you