What should be done incase of hiatus hernia and grade 3 esophagitis?

Posted on Mon, 3 Mar 2014

Question: Near 60 yr old male with limited ability to understand, hoarding tendencies and smokes recently diagnosed with "hiatus hernia & grade 2 near grade 3 esophagitis. Diagnosed via ct scan, x ray and ultrasound. Meeting with surgeon who diagnosed him today and preparing a list of questions. Im requesting your medical standpoint on what questions need to be asked to help treat further progression and/or cancer, treatment options, visual indicators that emergency medical intervention is required and to help gain a full understanding of what to expect. My job strictly binds me to confidentiality and i am not attending this appointment, a coworker is. I realize this condition could turn into cancer if treatment isnt started immediatly and even treatment isnt a guarantee, so I need to ask the right questions as it is the difference between life and death! Im moderatly informed on condition so im asking for more complex questions from you, stuff i may not know or wouldnt consider without knowing more about condition. Whatever your opinion please share in question form for my coworker to ask at appointment. Thank you so much!

Answered by Dr. Amit Jain (4 hours later)

Brief Answer: Please see the details Detailed Answer: Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM). First of all I will advise him to get an endoscopy examination for correct diagnosis, like size of the hiatus hernia, grade of oesophagitis and biopsy to see for any dysplastic changes (Premalignant changes). So accordingly question asked to treating doctor should include: 1. Will you like to do an endoscopy and biopsy from oesophagus 2. Chances of dysplastic changes and accordinly risk of malignancy 3. Can medicine be used for this and what are the success and failure rate of that. And for what period those medicines is to be taken. What are the side effects of those medicines 4. Any lifestyle modification will be helpful 5. Diet to be taken or avoided 6.Is any surgical management is feasible, if yes what are the success and failure rate. What will be the expenses, complications and duration of stay in hospital and when can routine work be done I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

Above answer was peer-reviewed by : Dr. Vaishalee Punj