Living with Hiatus hernia and vagus nerve problems for 30 years

Best wishes,

Mick Payton

i have read about your life long problems with hiatus hernia.

i to was injured in the army as a result from a fall i ended up with a hiatus hernia.and had to undergo surgery to repair the hiatus hernia. and had another 3 ops after my first in 1990 to repair reoccurrent hernia's. what that your doc may not have told you is untreated hernias irrespective of type can only get bigger and as the increase in size more of the stomach pushes through into the chest and causes you to experience more symptoms e.g pain under left ribcage,pain pain iand tingling in your left arm shooting through to left shoulder blade, the feeling of fullness after eating very little amount of food. tightness in the chest  fact you have been lifting heavy items of furniture will increase the possibilty of the tear in your diaphragm bieng bigger as it has been 21 years since you were diagnosed.and 11 years since you had a endoscopy done.

Acid reflux is a result of the valve at the top of the stomach not closing properly

and acid flows from the stomach and sometimes partly digested food could end up backing up into your mouth after swallowing.  it would be prudent to speak to your doc and get a mri scan done to find out the true size of your hiatus hernia. e.g 3cm,5cm 10cm. remember 3cm is two and half inches.  a scan will put your mind at rest . didnt say if you had severe heartburn ?you may need an endoscopy to see if you have developed barrets osoephagus which is acid erosion of the lining at the bottom of your osoephagus  which causes chest pain and heartburn,indigestion

if barrets osoephagus is not detected and treated you could end up with cancer?of the osoephagus so if you not been checked get checked? a.s.a.p  you have to  look after yourself.

you need to speak to your gp and let him know how this problem is affecting your quality of life . you may want to discuss with youre gp what  regarding the possibility of

a laproscopic repair of your hernia .which is less invasive than an open op proceedure .

It's  been 19 years since they said you had an hiatus hernia. I don't know if they told you what kind of hiatus hernia you have but I think you need to be reassessed if you have a rolling ( paraesophageal hernia) then it more urgent for treatment. I had that kind and had an operation to put my stomach back in its rightful place. 

Once while I was waiting for surgery I had the Vegas nerve being pressed by my stomach that caused me a terrible headache, nausea and dizziness. I went to emergency that time. It really made me burp continuously , so much so that they couldn't get a temperature by oral method. I didn't have the shoulder pain but used to get a sore chest. Find yourself a new doctor that is willing to send you for another endoscopy. 

Judy

I just want to thanks you all in advance knowledge is power 

Mick

Here is my story:  I have had a sliding hiatal hernia since at least from the mid 1980’s when it was discovered during a comprehensive physical exam while I was in the USAF.

At that time, there was no discomfort from the HH so I shrugged it off especially as the doc didn’t seem to find it significant.  Life was good, with absolutely no GERD symptoms, but gradually some perplexing symptoms began to gradually appear; first palpitations similar to you but mine were more like a second or two of rapid fluttering followed by a short pause, and ending with a strong thump.  Later I began to experience minor chest pains (always in the upper right side), and then occasional throat pains which were always on the right side too.   I went in to the base hospital to have each checked out, and was told the palpitations were normal, and the chest and throat pain were likely due to my strenuous work outs and sports I played.     

Then in 1993 while driving to work, the chest pains were unbearable so I detoured to the ER, and since I presented with severe chest pain, and  pain in my right throat, and  tingly numbness in my right cheek and ear, I received an exhaustive cardiac work up with every conceivable test, which took a few months to complete, but the results categorically ruled out any cardiac involvement, and my records were stamped with Atypical Chest Pain.

I retired from the USAF in 1995, still with the same symptoms but tolerable pain.  On my own, I eventually discovered four things:

1st - The palpitations, chest pain, throat pain, and cheek /ear paresthesia (tingly numbness) were closely associated with sitting down, and if I stood up and walked around a little bit, or lay flat on my back, the symptoms disappeared.  

2nd - The symptoms were intensified when wearing tight belted trousers.

3rd - The symptoms were at their worst when driving while sitting upright and securely seat belted.

4th – When the level of the chest pains were lowest, there was no involvement of throat and cheek/ears.  When the level of the chest pain was moderate the throat pain was present but there was no cheek/ear involvement.  When the level of the chest pain was highest, everything was involved.

I didn’t think much about the cause, but adjusted my life style to become a sloucher when sitting, and wearing looser trousers, and life was good with minimal symptoms.

Eventually with no military fitness standards to meet, and advancing age, I gained almost two stones of weight, and the symptoms aggressively returned and I sought medical help again.  After taking my medical history they agreed there was no cardiac involvement and targeted the hiatal hernia which they said can mimic heart attacks in some patients.  They also said it would correlate with pain while sitting since the abdominal pressure would force the stomach through the hiatus and disgorge stomach acid into the esophagus.  However they were puzzled when I reported no pain while lying flat on my back.

This precipitated an intense series of tests to evaluate heartburn as the cause.  First I was given heart burn medication (PPI’s) and when I reported no effect after 30-days, they doubled the dose, and when I reported no effect from the higher dose the games began.  Leading off was an endoscopy which confirmed the sliding hiatal hernia and measured it a 2 cm, but also indicated a normal esophagus with no evidence of GERD, and no Barrets  Then came a barium swallow, which was negative.  Then  an esophageal manometry test which showed no abnormalities in the supine position, but I sweet-talked the operator into also running the test while I was in a sitting position and the results (to my eyes) were markedly different, but the doc said they were still within norms.  This led to the esophageal 48-hr pH monitoring test, where they harpoon a pH probe to the inside of your esophagus and the probe sends continuous pH readings to a recorder via telemetry.  This test showed no pH excursions throughout the entire monitoring period even though I had experienced multiple chest pain episodes.   

Needless to say the doc was perplexed and as a last ditch decided to investigate if the pain was musculoskeletal  and proceeded to poke and probe my chest and do everything except have an intern jump on it, and ordered a chest X-ray and Cat-scan, and arrived at the diagnosis: Atypical Chest Pain.

I asked about any possible connection with referred pain from the hiatus nerve caused by pressure from the sliding hiatal hernia during sitting, and the higher the abdominal pressure, the higher the pressure on the vagus nerve, which cause higher orders of symptom pain.  Which he dismissed as improbable, but when I persisted, he said since I had a clinically diagnosed hiatal hernia, he could offer to do a hiatal hernia repair but he wouldn’t guarantee that it would do anything to relieve my symptoms. 

I have declined the offer and am continuing my slouching life style and dieting and working out to lose the stones, and searching the web for answers.