Hiatal hernia (HH)

Mila, thank you! I've read it. This is food for thought!

The hernia was discovered two days ago during an X-ray examination, which also showed a shortened oesophagus and a bunch of other things, like altered mucosal relief in the oesophagus and duodenum. Today I had a gastroscopy: the oesophagus isn't shortened, there's no pathology of the mucosal relief anywhere, signs of GERD, and indeed cardia insufficiency, the hernia was confirmed. A breath test for H. pylori came back at 9mm. So we'll start with that, the doctor said it could be the cause of the insufficiency, as could opisthorchiasis. Symptoms include belching and occasional dysphagia, but that's more likely neurosis now, and tingling in the back under the shoulder blade, which means I should get my back checked. What bothered me most was veeery severe heartburn during pregnancy (I gave birth to my second child 8.5 months ago, and similarly with my first 7 years ago), the large foetuses were pressing against my poor diaphragm, but I managed to give birth naturally, just didn't know about the hernia, and thank God I didn't. I've never really been treated conservatively, antacids don't count, didn't follow any diets, lay down after meals, I really love beer, work and life are constant stress, even a healthy person would start having problems here. Now I'm going to undergo a course of treatment with the best gastroenterologist in Tomsk, my city. I'm confident I'll solve the cardia issue, which means the esophagitis problem will be resolved too. And if 100% of people were sent for a proper X-ray check for a hernia, I'm sure 60-70% would be diagnosed; people just live with it, treat the heartburn and don't bother. Heartburn tablets are the best-selling in the world.

Hello Yulia! I'm facing similar issues and I'm not rushing into surgery just yet, after reading up on it here... I'd really like to chat with you, please drop me an email at: rodin_1977.inbox.ru. I'd be absolutely delighted!

Julia, you are at the very start of a long, difficult, and sometimes unsuccessful treatment journey. So your optimism at this stage is quite justified. Although, if you've had cardia insufficiency for 14 years, it's naive to think that this muscle can start functioning normally again. Gastroenterologists, the best and not so much, all treat it the same way. They all follow the same protocol: diet, proton pump inhibitors, prokinetics, and even a psychotherapist if you bother the doctor too much. I live in a fairly developed city, but in three years, I haven't solved the issue with my cardia. And it's precisely this that's the culprit behind our poor health. And this is despite a strict diet, a huge amount of medication, physical exercises, acupuncture, and so on. "You'll be ill for the rest of your life" - that's the doctors' verdict. With a hernia, the cardia will never close on its own; it can only be corrected through surgery. I don't want to go under the knife either, but when you're 28 and nothing helps, yet you still want to live, everything else becomes irrelevant.

We'll give it a try; the main thing is not to stress about it. When they found my hiatal hernia two days ago, I didn't know what to do with myself. I read all sorts of things online, but people who live with a hiatal hernia without symptoms don't visit such sites and don't leave comments. I didn't know about hiatal hernias either, and it didn't interest me before. Maybe I've had it for 10 years or more, and so do other people who know nothing about their stomachs. I'm planning to undergo a course of reflexology because I suspect that's the cause. When I was 20, I went on a weight loss course that lasted three days and involved acupuncture, supposedly to reduce stomach volume and so on. I think that's what harmed me, plus I lost weight abruptly. So, we'll fight fire with fire. Do you have such strong symptoms, or is it just a fixation?

By the way, it was the following year that I first went to see a doctor.

Yulia, what's the deal? I'm just fed up with this miserable life. I can't bend over, I can't swim, I can't do fitness, I've forgotten when I last ate fresh vegetables and fruit. Although my hernia is small, they've diagnosed it as first degree. It seems to be up to 3 centimetres. During the gastroscopy with massive magnification on the screen, the endoscopists couldn't see it, but it shows up on the digital X-ray. In these three years, I haven't felt good for a single day. Either it's heartburn, or acid flooding my oesophagus, a constant sensation of acid in my mouth all day, burning tongue, frequent sore throat, and a nagging cough in the mornings. You know, Yulia, my father is in the military, and we live in a military town in St. Petersburg. The population of our town is over 1,000 people, and almost everyone knows each other. The town is closed. I don't know a single person who has the same condition as me. And you write 60-70%. That means every sixth person I know should have a hernia? That's unbelievable! Where does this statistic come from? I've tried reflexology. It was a waste of time. By the way, one has to be very careful with PPIs. It's hard to get off them. There's a rebound effect where the symptoms become much worse. And another question, Yulia, if nothing particularly bothered you, why did you have an X-ray? A gastroscopy?

Rita, you need to have the operation in St. Petersburg. Remember the woman from St. Petersburg wrote that her friend (though with a large hernia) had a successful surgery. It seems there's a good surgeon in St. Petersburg, Kostiuk, or the other one, Puchkov? I hope not.

Mila, do you have a hernia diagnosed? If so, how do you live with it? Or have you made friends with it? How did we all fall for this Puchkov? On all the websites, people only dreamed of having surgery with him, and it turned out to be a "nightmare." And I was even praising him to Ilya. Yesterday, I wrote some very harsh comments about this "super-surgeon." They weren't approved. So be careful in the comments.

The gastroenterologist referred me based on my symptoms, said we'll see. Even if there is one, it's likely small. On the X-ray, they said it's not large, but not exactly small either; no grade was assigned. Mainly, I'm bothered by sensations in my back, crawling feelings, tingling, but that's probably the spine. And I had very severe heartburn during pregnancy; now I just avoid harmful foods. Who told you that you can't swim, eat fruits and vegetables? That way, you'll completely clog your body, there'll be even more bile, you're going in circles. Have you been treated for H. pylori? Have you had your gallbladder checked?

Well, for example, and there's plenty of such information on the internet.

"Hiatus hernia is a very common condition. It occurs in 5% of the entire adult population, and in 50% of patients, it presents no clinical symptoms and, consequently, goes undiagnosed."

Here's another,

"In approximately 50% of cases, hiatal hernia can be asymptomatic with very minimal clinical signs and simply be discovered incidentally during X-ray or endoscopic examination of the oesophagus and stomach. Quite often (in 30-35% of patients), the clinical picture is dominated by heart rhythm disturbances (extrasystole, paroxysmal tachycardia) or chest pain (non-coronary cardialgia), which leads to diagnostic errors and unsuccessful treatment by cardiologists."

So there are plenty of people with this diagnosis; they just don't know about it, like I didn't two days ago.

Julia, fortunately, I don't have that harmful bacterium. Everything else has been thoroughly checked, multiple times. My main diagnoses are: first-degree axial sliding hernia, catarrhal reflux esophagitis, and cardia insufficiency. I've loved swimming since childhood and was quite good at it. Now, when I swim, acid immediately rises to my throat, along with belching and even regurgitation. The doctor said that intra-abdominal pressure increases, and I can only swim on my back. As for raw vegetables and fruits, they start to make my esophagus hurt and often cause heartburn. That's the situation.

Julia, thank you for the link. I probably didn't make it into that lucky 50%. This hiatal hernia is really making my life miserable.

And are there any sensations in your back?

And are there any sensations in your back?

Yes, Yulia. I often have pain between the shoulder blades that radiates to the shoulders... I think it might be from the oesophagus because the pain worsens after eating. Or could it be a hernia causing this pain? What do you think?

Pain or crawling sensations, tingling, stinging? It subsides when I lie down but worsens when sitting or walking.

No, I specifically have pain that starts behind the breastbone and radiates to the spine.

Rita, everything you're describing, especially the pain and discomfort in the oesophagus, I experience too, but these aren't symptoms of a hernia; they're classic reflux symptoms, though I always think it's a hernia. I was also diagnosed with a grade 1 hernia. You were quite categorical and curt in your responses before the truth about Puchkov came to light: it all seemed like, "write, write, but I know what to do..." That's just the point—IT'S NOT ALL THAT SIMPLE! The issue is that there are still no entirely satisfactory methods to correct this anatomical defect. Instead, there's a risk of falling for a charlatan. Everyone clung to the "uniqueness of Puchkov's method!" Now they're at a loss... As a Russian, you can go either to St. Petersburg or to the Vishnevsky Institute—what's there to ponder over so much?

I swallowed a light bulb, suspecting it's a Gopd. Tomorrow I'll be looking for an X-ray. I'm in shock!

We are all in shock here. Alexei, which city are you from? What are your symptoms?

Also, the X-ray must be digital; a simple one doesn't detect anything, except in cases of large hernias.

NO MORE PAIN. THERE ARE MINOR CUTS. I TOOK OMEPRAZOLE AND OTHER MEDICATIONS PRESCRIBED BY THE DOCTORS FOR 2 MONTHS. AFTER THAT, HEARTBURN STARTED. I SWALLOWED THE ENDOSCOPE AGAIN AND... SIGNS OF GASTROESOPHAGEAL REFLUX DISEASE. REFLUX ESOPHAGITIS GRADE 2. INCOMPETENT CARDIA. ESOPHAGUS WITH EROSIONS ON ALL WALLS.

Reflux oesophagitis doesn't seem to be getting better, I think. GERD.

Hello Mila! I also have a diagnosis with this peculiar illness! Of all the symptoms, only the belching and the sensation in my throat, as if food is stuck there, bother me! The surgeon said that a hernia could cause such symptoms! Tablets aren't helping! I'm deciding to have the operation! Here in Tomsk, we have an Institute of Gastroenterology, and it has good reviews... but the operation is performed using the Nissen technique. I already haven't been able to swallow properly for 8 months (I only eat purées), and if dysphagia occurs as a complication after the surgery, I won't be able to endure that! I saw information about Puchkov and decided to have the operation there... although it's very expensive. Could you possibly write to me privately about what you found out. Please!!!!

I can, but where is the private message address?

For the second year now, I've been experiencing the same symptoms as you, Olga, and I still haven't mustered the courage for surgery. Initially, like many on the forum, I had hopes for Puchkov, but recently we received reliable information about his dismissive attitude towards patients and a failure rate just as high as most surgeons in this type of operation. Unfortunately, dysphagia is a quite common postoperative complication with the Nissen method, and that's only half the trouble. If the vagus nerve is slightly over-compressed, it can lead to constant vomiting; the cuff might also collapse (rendering the surgery pointless), and the most unpleasant part is the recurrence of the disease, the return of reflux esophagitis, and the reappearance of the hernia. But that's not all: all the operated patients we know of lose the ability for physiological belching (which I think will result in frequent stomach heaviness, though that might be bearable) (carbonated drinks are then off-limits for life), and they lose the ability to vomit naturally, meaning in case of poisoning, one must call an ambulance immediately and get an IV... That's why we're sitting here, pondering and enduring! I too was all packed and ready to go to this Puchkov, but now I'm sure—he won't help, he might only make things worse.

I recall my mindset a year ago when I found out about the hernia... straight to surgery! Only that will help! I'll have it done and live like everyone else! I came home from the X-ray and went online. For two months, I knew nothing about these forums and studied medical articles... I read about complications, realised that surgery not only doesn't guarantee freedom from GERD and the hernia but could worsen an already poor condition... I read questions to online gastroenterologists and surgeons on various sites, then made my way to forums where I didn't participate but just observed the opinions of those affected. There were posts from those who had unsuccessful operations..., writing: "And what do we do now?"... so that's how we're living.

Thank you for responding! Here's the private message address! ounzhakova@mail.ru

Olga, I have written to you.

Meaning, I wrote it )))

Ilya, do you ever experience rumbling in your chest? Do you have an agent, MSN, or email? How can I get in touch with you?

Good afternoon, Maka! Do you have a hernia as well? Which city do you live in? Ilya hasn't been on the forum for a very long time. Probably, he's recovered. Ilyusha, please respond!!!

Hi Rita! I'm still with you too... haven't made up my mind about the surgery yet. Have you found out anything new? Made any decisions?

Hello, Mila! On Friday, I'm going for an X-ray, hopefully the last one. The gastroenterologist said during my last visit to get it done and then come to her for a referral to a surgeon. I've come to realize myself that it can't be cured. How about you? Has anything improved? I'm so tired, Mila, that I don't care anymore: surgery, no surgery...

No, Ritochka, it hasn't improved... I'll be preparing for surgery too... and where will you have yours? In St. Petersburg? Maybe at Kostiuk's?

Rita, shall we switch to using the informal 'you'? Do you mind?

Absolutely no objection, only in favour. Mila, I had a consultation with Kostiuk. He's a good specialist. The only thing that bothers me is that he operates in the suburbs. It's a bit far to get there. I'd prefer it to be in the city. With family nearby, it feels somehow calmer. Mila, how do you know him, did you write to him? And why did you suddenly decide on the surgery, you seemed to have mixed feelings about it. You know, I still haven't found anyone who's had this operation, and Ilya has disappeared. Do you have any acquaintances who've had this surgery?

Rita, I just read about Kostyuk online; he's just as hyped up as Puchkov, only in St. Petersburg. I didn't write to him; my correspondence with Puchkov, who promised to work miracles, was enough for me. I've decided that once I'm fully mentally prepared, I'll go to the Shalimov Institute in Kyiv. It's the best clinic in Ukraine for digestive system issues. They perform highly complex surgeries like digestive organ transplants, and of course, our type of operation too. My local professors have connections with the top surgeons in Ukraine, so I won't need to rely on online acquaintances. I'll go when they call me. I made this decision because nothing else is helping, though I still understand that even with surgery, there are no guarantees... I don't know anyone who's had the operation... they're like mythical creatures: elusive... invisible...

Mila, have you been in touch with Olga from this forum? Has she decided to go ahead with the surgery or not? I think she's from Tomsk.

Rita, we all understand there are no guarantees, yet everyone hopes their case will be the fortunate one.
Because there's no other way out, and we all want to live. And the fact that you have such brilliant connections among the professors—that's fantastic! What do they say about the surgery? Will it help us? Have you asked? After all, acquaintances won't mislead you.

Of course, Milá

Rita, Olga and I have been in touch; she hasn't decided on the surgery yet. She found a letter online from someone who had an unsuccessful operation and sent it to me – we both got scared together..(( I can post that letter here for you (it's not a secret).. My professors say surgery should only be considered as a last resort, as the outcomes are mostly negative.. There are many recurrences, and some consequences become irreversible after the intervention.. My professor tells me this: "Right now you're suffering, but at least PPIs help with the heartburn, you cry and beg for surgery, but what if the operation goes wrong? – for some reason, the pills stop working then.. and it can't be fixed.. What would you (we) be asking for then?"... He's trying to help me in a friendly, familiar way all the time; we discuss it together but don't draw any conclusions.

Mila, if you could, please send that letter here. Perhaps I too would prefer enduring the discomfort over having surgery. It's just that trouble seems to be lurking not far away... The thing is, during my last visit to the gastroenterologist, she frightened me by saying that long-standing sliding hernias can eventually fuse with the surrounding tissues and become fixed, which might lead to the stomach being trapped. That's why she's sending me for another X-ray; I had the previous one done last year. So that's how it is, Mila.

Рита,вот письмо: Добрый вечер! В сентябре сделали операцию на грыжу пищеводного отверстия по Ниссену. Какие могут быть побочные эффекты после операции? Слышала, что после такой операции нельзя рвать, иначе придется снова делать операцию. Как быть при токсикозе? Можно ли забеременеть? И неужели всю жизнь нельзя рвать? Мне 7 лет не могли установить диагноз у меня была бес пристанная отрыжка, громкая (можно подумать что квакала как лягушка), слабость, рвота. В этом году сделали рентгенографию и показало что есть грыжа. Я была так рада, что нашли причину, что с удовольствием согласилась на операцию. Сейчас, прошло 4 месяца, приступы все также повтаряются, отрыжка стала еще чаще, аппетита нет, тошнота, слабость. Прошла МРТ, УЗИ брюшной полости. Ничего страшного там нет, показывает, что есть загиб желчного пузыря. Гастроэнтеролог говорит, он у многих есть и не должен давать таких приступов. Как мне быть, помогите, пожалуйста? Можно ли переделать операцию и будет ли от этого польза. Насколько опасна рвота после Ниссена и возможно ли это? Мучаюсь уже с 2004 года. Теперь жалею, что сделал операцию, раньше хоть вырвет и легче, а сейчас страх перед едой. А вес всего 40 кг. в 26 лет. Альбина Казань

Рита,если разбираться со скользящими грыжами,то даже если она переходит в фиксированную,речь идёт о 10 годах существования..и то,если она изменяется,то вначале меняются её размеры: из пищеводной она может перейти в кардиальную,потом в фундальную,потом в тотально-фундальную.Так вот при увеличении грыжи до фундального состояния об операции уже не спрашивают,а делают.Поэтому угрозой будет не переход в фиксированную,а рост скользящей грыжи.А ущемляются только параэзофагеальные...но не суть..Держу за тебя кулаки-делай в пятницу рентген,а там и видно будет.

Рита,ты ,пожалуйста,не пропадай,будь в диалоге.Нам надо держаться вместе.А у тебя грыжа пищеводная или кардиальная? ты что-то о её размерах знаешь?

Привет всем. Я Сергей, я из Украины.У меня походу такая же проблема. Месяц назад начало болеть под лопатками,пошол к врачу,сказал гастрит,прокололи-безтолку. Потом глотнул зонд,сказали рефлюкс-эзофагит,три недели пропил таблетки- не помогло.Сейчас думаю делать ренген. Очень боюсь если обнаруэат грыжу...Как дальше жить...Еще все это время сильно болит в груди и изжога.

Сергей,что значит: Как дальше жить? На крайний случай надо делать операцию,но раньше времени не паникуй! Сначала сделай рентген. Сколько тебе лет и из какого ты города? Сразу на ты,а то начинаем на Вы,потом:А не против на ты? так что сразу на ты