Rolling hiatus hernia and gastric volvulus
Posted , 14 users are following.
First of all, thanks to others for sharing your experiences on this forum, now it's my turn!
I've been having problems eating a normal size meal for about 18 months now (gastric pain / reflux/vomiting after eating). I first went to my GP after about 3 months and was given Omeprazole first, then Lansoprazole, neither of which worked. I had an ultrasound to check for gallstones (negative) and about a year ago went on the waiting list for an endoscopy. After about 4 months of waiting my GP managed to get me bumped up the waiting list as \"urgent\" because the medication wasn't working. (At the time we were going on the guess that it might be an ulcer). I eventually had an endoscopy in late January (without sedation, just throat spray - bad decision, it was really miserable and I retched solidly for about 20 minutes during the procedure), and they decided that I had an intrathoracic pylorus (basically my stomach was all twisted and partly in my chest cavity) so sent me for a barium swallow a few weeks later which showed a large hiatus hernia.
Fast forward to July when I eventually had an appointment with the consultant endoscopist to tell me all this officially, and refer me on to the surgical team. After the hernia diagnosis my GP had put me onto Metoclopramide but it hasn't honestly made much of a difference.
I saw the surgeon in mid August and they described the condition as gastric volvulus with hiatus hernia and that they will do a laparoscopic fundoplication with an anterior wrap (hopefully has fewer side-effects than a full wrap) and put me on the urgent list as the symptoms aren't managed by drugs.
So I had a phone call last Thursday evening saying that they'd had a cancellation and would I like to come in for my operation on Tuesday (tomorrow!) so after a quick (15 mins) pre-op assessment on Friday, I'm now in the final stages of waiting for the big day. I have a bit of a cold unfortunately so there is the chance that tomorrow they'll decide I'm not fit. Hopefully not, as I've spent the last 4 days doing a massive handover of all my projects to my colleagues - it would be a bit of a let down to walk back into the office on Wednesday saying \"I'm back!\" but ultimately it's about what's safe and best for my recovery.
I'm rather apprehensive about the general anaesthetic (never had one before), the post-op pain/discomfort and the whole \"soft diet\" challenge coming up over the coming weeks, but if it puts an end (eventually) to the misery of not being able to eat a normal meal without cramping and vomiting, it'll be worth it in the end.
Wish me luck!
3 likes, 37 replies
Taura
Posted
I was whisked through all the administration on the day (meeting surgeons, nurses, anaesthetist) and was in theatre by 8.15 - the op was about 2.5 - 3 hours and they found that most of my stomach was in my chest cavity, so they pulled it out, covered the hole in my diaphragm with mesh and stitches, did a partial fundoplication and generally sorted things out. I have 5 small holes with soluble stitches (remarkably invisible) which are healing well.
I came round, rather groggy obviously for an hour or so, and with a horrendously dry mouth, then was transferred back to the day surgery ward where I sipped water and felt sorry for myself for the rest of the day. They gave me liquid paracetamol and liquid dihydrocodeine which, together with the leftover morphine in my system from the op, made it bearable. I had shouldertip pain (something to do with the gas that they blow up the abdomen with and transferred pain) which was almost the most uncomfortable bit for a while. I find it hard to breathe deeply (or cough etc) because of the discomfort in the diaphragm. The good news is that I can still burp
(although that hurts because of the diaphragm, oh well)
I wasn't allowed to eat anything on the day of the op, although I got my partner to bring some Ribena in to add to the dull water to liven it up. The surgeons said that I could try some breakfast the following morning, so the nurse gave me a weetabix swimming in milk, however even though it was very mushy it hurt to eat so I gave up after about 5 teaspoons. I tried a yoghurt later in the evening (I was discharged at lunchtime) with the same result, so just drank fluids all day.
On Day 3 I had a whole yoghurt for breakfast and made some apple puree, ate some ice cream and had a pureed soup for supper. All of which were tolerated well. Last night I had unpureed soup (still mushy) and that was fine too. This morning I had weetabix and had no problems.
The pain has reduced significantly since I was discharged - I've not had any painkillers for about 24 hours now and feel fine - a bit sore but nothing worth numbing. I can lie on my back, front and sides and sit without discomfort. I walked to the GP surgery and supermarket yesterday and carried a small amount of shopping home.
Merryl
Posted
Just read about the problems you had with a Hiatus Hernia. I have been going through similar symptoms for a long time and taking Lansoprazole. Although, they stop the heartburn, I am still suffering from other symptoms. I suffer from palpitations, and a heavy feeling/pain in chest, back/shoulder blade pain. Also, when I swallow, I have what I describe as a fullness in my throat. I have not been sick but retching at times with nothing coming up and a lot of burping. Did you have any of these symptoms?
I was referred to the hospital for a Barium Meal but when I received the letter it was for an Endoscopy. I refused to have it done because I have read how awful it can be. I know I should go through with it because I am losing weight and can't eat much when I get the symptoms.
Hope you are feeling a lot better after your operation!
judy54212 Merryl
Posted
I had the endoscopy under conscious sedation and don't remember a thing. No pain afterwards. If you have a large hernia you need to find out. A CT scan or a chest X-ray will find it too. Please keep up the medical testing. Your symptoms suggest you need help.
JudyJudy
Merryl judy54212
Posted
Thank you for your reply. I had the endoscopy just over a year ago. I went private and was put out before the camera went down and I did'nt feel a thing. I was out for 40 minutes. The Dr also sprayed my throat and injected me with pain killers. I was feeling sleepy nearly all day but I can put up with that.
I was told that my hernia is mild so I take it that means small. But I am getting worse chest pain now for the last 4 /5 months. It is severe pain and a heavy feeling in my chest. It seems to be worse in the morning after eating breakfast but can last all day on and off. When I had the endoscopy it showed I had h-pylori and was put on antibiotics but don't know if it was cleared or not. I had a test 2 weeks ago for that and waiting for the results.
Also 6 weeks ago I had a barium swallow (nhs) and it showed a dismotility problem and was told it is not too bad. I am beginning to think they have missed something. There is so much going on that I don't know what's causing the dreadful pain. Strange thing is my Hernia was never mentioned. when I had the barium swallow. I have lost a lot of weight due to the dismotility problem and some day's can't eat much and other days I can eat but only soft mushy foods. I am at the end of my tether now. I was also taken into hospital 3 months ago with ectopic beats and was in for 10 days and now on meds for that. I was told my heart is sound apart from the palpitations so I don't think the chest pain is from my heart. I read that the barium swallow can show a small or large hiatus hernia so I am confused that mine was not even mentioned. Sorry this is so long.
Merryl
judy54212 Merryl
Posted
i had to go and look up dismotility as I wasn't familiar with that word. I live in Canada so I am not familiar with your health care system but I know I have had lots of wait time for tests , results ,etc.
You obviously are not well and they need to find some way to help you digest your food.
Twenty years ago I was diagnosed as having irritable bowel syndrome . They did a colonoscopy for that and a barium swallow. I had trouble , usually in the evening with vomiting and diarrhea. Now I have been diagnosed with a large para esophageal hernia. I have met with a thoracic surgeon and am waiting for a surgery date. I am eating small amounts at a time and watching that I don't eat anything spicy or fatty. I burp all the time, have pains in my rib cage . Sometimes I have trouble swallowing food and have even thrown up sometimes when it seems to get stuck. I don't like going very far in the car because I am soon burping and uncomfortable. I can not do physical work for very long ( 1/2 an hour) because my abdomen gets sore and I have back pain and burping. I am retired so I can rest when I need to. I spent a lot of my time walking or lying down but not sitting as it is more uncomfortable.
I really hope you get some answers soon. Try to eat small bits more often and drink fluids with your food. Maybe it will help a bit. It is awful to be so uncomfortable. I have lost 15 pounds with my situation.
Judy
Merryl judy54212
Posted
Sorry to hear about your problem but glad that you will have an operation soon. I have started to get pain in my rib cage, in fact I was woken up this morning at 4 oclock with the pain and had it last week as well. Mine is more in my upper side than in in the front. Do you have pain in the chest at all? I also burp a lot and when I get the chest pain I lean forward give a loud burp then the pain goes away. I was told the dismotility disorder can cause spasms in the chest and that causes the pain. But I can't understand why I am having all these problems when my Dr told me the hiatus hernia and the dismotility disorder are both mild, so I don't know what to do next. If I go back to the Dr he will say you have had the tests and they are not too bad.
Did you have an endoscopy for you hernia or did it show up on the barium swallow? I had those 2 scans done so 2 of them can't be wrong. I am also retired so don't need to worry about going to work. I don't go far either because of the chest pain. I lost 2 stone in 2 months. I don't want to lose anymore but feel stuck not knowing what to do. Good luck with your operation.
Merryl
judy54212 Merryl
Posted
i had an endoscopy, a CT scan and an x-ray that all showed a large para esophageal hernia. Para means beside and my stomach has pushed up beside my esophagus. More than 3/4 of my stomach has pushed up. The barium swallow was twenty years ago so it didn't show then but it sure would now. My hernia is still a hiatus hernia but a rare kind of this type of hernia. Mine is more of a concern than the sliding hiatus hernia. Maybe you can go to a different doctor . If not tell him your symptoms and write them down before you go. I would think getting a food diary and what happens after might help you and your doctor solve your problem. He might not be aware of how much it is bothering you.
Judy
Merryl judy54212
Posted
I think I will have to make an appoinment with my Dr and I will ask him if I can have a CT scan to see what that shows, it might show something different. He might not agree but I will ask anyway. I also had the barium swallow over 20 years ago and that confirmed my hiatus hernia but according to my recent b / swallow it is only mild. I find my hernia or the motility problem plays up worse first thing in the morning.
I phoned my local surgery yesterday to find out if the test I had done 2 weeks ago for h-pylori has come back but he said they have not had the results yet.
Merryl
Posted
Forgot to ask, have you had a manometry test done?
judy54212 Merryl
Posted
I didn't have a monoentry test. When I first got the pains I could press on the bottom outer edges of my ribs and it hurt so my doctor sent me for a bone scan and that came back negative. What started my investigation is tha I went to just get a routine check up that I hadn't had in five years and I was very anemic. Then after taking iron supplements my ferritin levels were not coming up very much at all and then started to drop again. That meant I was loosing blood somewhere. My problems are worse in the evening. I tend to eat a little more in the evening . I am taking a pill called domperidone to relax the muscles at the GE junction and that is helping a bit. The GE junction is where the esophagus meets the stomach.
Im surprised your results aren't back yet. Hopefully they will be back soon.
Judy
Merryl judy54212
Posted
I have read that a manometry test is usually done along with the endoscopy and barium swallow. Perhaps for some reason they can't do it because of the type of hernia you have.Just wondered because I have not been told I need it done. From what I know it is a very uncomfortable test and you cant be sedated for it either.
I had mince for my evening meal big mistake. I could feel it stuck in my chest which caused a heavy feeling and my upper abdomen felt very bloated. I am running out of things to eat. When I was in hospital I had mince there but it was very fine and soft and had no trouble eating it. I put on 2 lbs in weight while I was there by eating 2 cooked meals a day. But don't think I can eat that much now. Do you eat anything that makes yout hernia worse?
judy54212 Merryl
Posted
I stay away from fatty foods and have for years, I avoid soda pop or anything I think would give me gas, no spicy foods.. I find I have trouble swallowing bread. I mostly eat small meals and more often. Lots of fruit and vegetables are on my list. I didn't have a barium swallow this time as the CT scan showed the hernia. Can you drink milkshakes? I am craving them at present.
I hope your doctor can pursue your case soon and you get an answer.
Judy
Merryl judy54212
Posted
I can drink milk shakes, drinking is'nt a problem. I have a glass of milk in the evening to try and keep my calories up because my weight comes off easy but never used to.
Hope you hear from the hospital soon.
Merryl
samantha39955 Merryl
Posted
I know your post is so old but i found myself researching as I too am at the end of my tether. I was diagnosed with a dismotility problem 3 weeks after having my gall bladder removed. Honestly the gall bladder op was a walk in the park but three weeks later I was readmitted with a pulmonary embolism and after having scopes and angiograms they referred me to have a barium swallow and they found out that I had an apparent esophageal spasm that was not allowing the food to pass down the esophagus. On the 22 March it will be a year ago. I have lost so much weight because of me struggling to eat, i lived on soup for a long time and then sofy food. Depending on what I eat it feels like my food is stuck in my chest and is not digesting. I went to a GI for a second opinion and he has been treating me with medication but so far none of them are helping. I have my good days and then I have my bad ones, while I am typing this I can still feel the food stuck in my chest from Friday. They have picked up that I have a sliding hiatus hernia as well. I just dont feel like eating and feel bloated all the time and very uncomfortable. I just dont know which way to turn. Do you have any suggestions for me
Taura
Posted
What I learnt from my whole experience was that a lot of similar symptoms have all sorts of possible diagnoses. I had an ultrasound in case it was gallstones, drugs in case it was an ulcer, etc. The endoscopy found that I had a very twisted up stomach and the barium swallow spotted that my stomach had gone through the hiatus into my chest. I didn't enjoy the endoscopy (not sure anyone would!) but it was a bit longer than normal because my stomach was so twisted the Registrar couldn't find her way throughand had to call the Consultant. If I had to have another I'd ask for sedation but last time I had to be on a plane the next day so it wasn't an option for me. My suggestion would be to speak to your doctor about your concerns and see if they can either arrange for the X-ray or allay your concerns over the endoscopy.
I should point out that my type of hernia was a) the rarer type and b) larger than normal. I had retching as well as being sick, a feeling that I couldn't swallow properly and general bloating.
4 months post-op I'm off the surgeon's review list (ie I'm \"fine\"
. I had a period when I felt I couldn't swallow stodgy stuff eg bread and it would get stuck above my lower oesophageal sphincter (confirmed by another barium swallow that they'd done the wrap a bit tight) but that's not a problem anymore. I get a bit of acid reflux but nothing I'd bother a doctor about.
I had 3 weeks off work, and took it easy for my first week back. After that I was back cycling again (9 miles a day commuting) and diet got back to just-about normal over about 6 weeks. I then proceeded to put back on the weight I'd lost in postoperative diet! Ah well. New Year, new diet...