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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffering with hiatus hernia, have swelling in esophagus causing gastritis, heart burns. Treatment advise?

i am suffering from hietus hernia i have a swelling in my oesophagus causing high gastric problems specially empty stomach i am having nexpro rd 40 since 3 yrs from now and when i stop intake of my medicines for 1 day i have problems such as heart burns and severe gastric problems what should i do what medicines will cure me or do i have to operate it
Mon, 29 Oct 2012
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Gastroenterologist 's  Response
Hello, viveksinghdeo333,
You tell us that you have had the problem for over three years
and you have been diagnosed to have hiatus hernia. You have
also been on the treatment to control acid.
Hiatus hernia, by itself does not cause problems unless it is very
large. The main problem is the weakness of the sphincter muscle
at the junction of the esophagus and stomach. Because of this
acid and stomach contents back up into the esophagus resulting
in damage to the lining. If this goes on untreated, ulcers can
develop and scarring with narrowing of the opening. This can
cause difficulty with swallowing. The most seroius complication
is called "Barrettt's Esophagus " where the type of cells change
to a pre-cancerous type of cells (In the lining) and can result in
cancer of the esophagus.
I hope you have had an endoscopic evaluation by a specialist
to get a good look inside and also perform a biopsy to determine
the degree of damage.
As for therapy, majority of cases do not require surgery. Drugs
should be continued as long as you have symptom relief and ther
is improvement endoscopically. This ,combined with strict dietary
measures will help. Avoid alcohol, excess caffeine, tobacco, citrus
products and drugs like aspirin and ibuprofen that can add to the
damage.
If all of this fails and your life style is affected , then consider
surgery. Now the surgery called "Fundoplication" can be safely
performed either laparoscopically or through endoscope.
Make sure that the surgeon is very well experienced in this type
of surgery.
Wish you well.
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Suffering with hiatus hernia, have swelling in esophagus causing gastritis, heart burns. Treatment advise?

Hello, viveksinghdeo333, You tell us that you have had the problem for over three years and you have been diagnosed to have hiatus hernia. You have also been on the treatment to control acid. Hiatus hernia, by itself does not cause problems unless it is very large. The main problem is the weakness of the sphincter muscle at the junction of the esophagus and stomach. Because of this acid and stomach contents back up into the esophagus resulting in damage to the lining. If this goes on untreated, ulcers can develop and scarring with narrowing of the opening. This can cause difficulty with swallowing. The most seroius complication is called Barrettt s Esophagus where the type of cells change to a pre-cancerous type of cells (In the lining) and can result in cancer of the esophagus. I hope you have had an endoscopic evaluation by a specialist to get a good look inside and also perform a biopsy to determine the degree of damage. As for therapy, majority of cases do not require surgery. Drugs should be continued as long as you have symptom relief and ther is improvement endoscopically. This ,combined with strict dietary measures will help. Avoid alcohol, excess caffeine, tobacco, citrus products and drugs like aspirin and ibuprofen that can add to the damage. If all of this fails and your life style is affected , then consider surgery. Now the surgery called Fundoplication can be safely performed either laparoscopically or through endoscope. Make sure that the surgeon is very well experienced in this type of surgery. Wish you well.