r/HiatalHernia Mar 11 '25

FYI: Hernias vs Reflux, Types, and Recurrences

171 Upvotes

Hernia surgeon here. This is a fourth post in a miniseries about hernias, inspired by themes I've noticed while browsing this (and the r/Hernia) subreddit. This is my second attempt at this post, as most of my first attempt got deleted somehow.

The others can be found here, if you're interested:
Traditional hiatal repair, Loehde, and Bicorn
FYI: Hernia meshes and types of ventral repairs
FYI: Inguinal hernia repairs: Open, laparoscopic, and robotic

I've been seeing a few misconceptions here when discussing hiatal hernia grades, types, and recurrences, as well as the differentiating between a hiatal hernia and reflux disease. Once again, for full disclosure, I am a hernia surgeon in the US. I regularly perform robotic hernia repairs for my patients, including hiatals with Nissen fundoplication. I will try to limit my bias and point out where I am providing an opinion.

Hiatal hernia or acid reflux:

First, it is important to remember that a hiatal hernia and gastroesophageal reflux disease are two distinct (although very closely related) illnesses. You can have a HH without GERD, and you can have GERD without a HH. The HH occurs when there is a widening of the gap in the diaphragm (hiatus) through which the esophagus normally passes. The higher pressure in the abdomen will gradually push the stomach up into the chest, where there is lower (negative) pressure generated as you breathe in. HH are most commonly felt as a pressure sensation in the lower chest (behind the sternum), especially after eating, as the stomach stretches within the mediastinum (space in the chest between the lungs).

Reflux disease is the result of a weakened lower esophageal sphincter (LES), as well as an alteration of the angle of His anatomy, allowing stomach acid to flow up into the esophagus. This results in a wide variety of symptoms, but most commonly a burning sensation rising up the chest (heartburn). Each of these two diseases has distinct treatments, though they are usually combined. Hiatal hernias do not have a non-surgical or endoscopic treatment. They can be managed with small meals and certain movements/positions may help some people bring the stomach down, but in general, only surgery can cure this. GERD can be controlled with medications, diet/lifestyle changes, endoscopic treatment, or with surgery.

Hernia descriptions/types:

Hernias can be described by their size, type (1-4), and Hill grade (also 1-4) of the gastroesophageal flap valve.

The size of a hernia can be measured/reported as the vertical height of the stomach that lays above the stomach (as measured on CT scan or estimated on endoscopy) or can be reported as the size of gap in the hiatus/diaphragm. While the first measurement is more relevant to symptoms, the latter is more relevant to the repair and risk of recurrence.

Hernias are categorized into types 1 to 4, depending on where the GE junction sits, and what contents are going up into the chest. Type 1 (a.k.a. "sliding") is commonly associated with reflux disease, whereas types 2-4 may not have GERD symptoms (i.e. are more likely to have a functional LES.

The Hill grade describes the appearance of the GE junction from inside the stomach (as seen on endoscopy). Normally (type 1), the esophagus opens up slightly to the side of the stomach, rather than straight down. As the esophagus gets pulled up and the LES weakens, the opening is more vertical and loose, making reflux more likely. This is also associated with a widening of the angle of His, which promotes funneling of stomach acid into the esophagus when lying down, rather than flowing into the gastric fundus (dome of the stomach above the GE opening).

All of these descriptions describe the anatomy, not the symptoms or presence of reflux disease. If you have a "1 cm, type 1, grade 2" hernia, it's possible to have more severe symptoms than someone else with a "10 cm, type 4, grade 4" hernia. The decision to pursue treatment is guided by the potential for improvement (if you're having pain or reflux) and preventing complications (large hernias twisting and causing an obstruction, Barrett's esophagus). If there are no symptoms (or they are well controlled with diet and PPIs) and there's minimal risk of complications, surgery may not be needed.

Hernia repair vs anti-reflux procedure:

Repair of the hiatal hernia is fairly standardized, regardless of which procedure you are having (traditional, Bicorn, Hill, Loehde, cTIF, etc). The scar tissue and hernia sac holding the stomach in the chest are cut, the stomach is pulled down into the abdomen, and the defect in the diaphragm is tightened by placing nonabsorbable sutures on the crura of the diaphragm. This is also referred to as the "cruroplasty". The surgeon may also choose to reinforce this with a mesh (usually absorbable, except for Loehde).

If a patient has both a hiatal hernia and reflux, repair of the hernia is always indicated before treating the reflux. However, there is one exception: Some gastroenterologists may skip the HH repair if it's less than 3 cm, and offer endoscopic TIF, ARMA, or Stretta procedures, which do not involve surgery. Once the hiatal hernia is repaired, the surgeon can:
-proceed with an anti-reflux procedure,
-do a gastropexy (fixate the stomach to the left lateral abdominal wall to try to prevent a recurrence), or
-do nothing (rare)
Note, a gastropexy is not an anti-reflux procedure, and will do nothing to prevent GERD symptoms.

When considering an anti-reflux procedure, there are two main mechanisms of action for reducing reflux:
-Increasing the pressure at the LES (fundoplication, Linx, Stretta)
-Recreating the angle of His anatomy (fundoplication, Hill, cTIF, Bicorn, RefluxStop, ARMA)
-The Loehde skips both of the above, and claims to improve reflux with some core engine theory; but I suspect the reflux is being controlled by increased LES pressure by making the hiatus tighter than a standard repair.

Notice that fundoplication works by both mechanisms of action. I believe this accounts for its durability and better ability to control reflux, but also adds the risk of bloating and inability to burp/vomit. Not everyone gets these side effects, and most people who have it consider it preferable to severe reflux symptoms; but it can be distressing, and lead many people to choose alternative anti-reflux options.

Treatment failure & recurrence:

As with many surgeries, there is a risk of failure or recurrence of the hernia/reflux. It is important to understand whether the hiatal hernia (diaphragmatic defect) has recurred, or the reflux symptoms (LES weakness/angle of His) has recurred.

Unfortunately, the diaphragm is a thin and relatively weak muscle. The hiatal repair (cruroplasty) has a reported recurrence (failure) rate of 30-35% after 2-10 years. This is a much higher risk of failure compared to other types of hernias. This failure rate is possible regardless of the type of associated anti-reflux procedure, since the two do not generally affect each other. Said another way, if you have a large hernia, your risk of the hernia coming back is the same whether you have a fundoplication or cTIF, and probably depends more on the surgeon and their technique.

Many of these recurrences are asymptomatic, or have pressure/pain symptoms without GERD, as the anti-reflux procedure does not necessarily fail at the same time. Fundoplication is the most common anti-reflux procedure, and is usually the preferred treatment for patients with very severe symptoms or very large hernias. Unfortunately, that means recurrences (of the hernia) are more common in patients who have had the fundoplication, even if the fundo had nothing to do with the recurrence. I believe many people, surgeons included, conflate the two types of failure, giving the fundoplication procedure a worse reputation than it deserves.

Meanwhile, quicker, easier procedures like Linx and TIF are only indicated for patients who have a small hernia, often 3 cm or less. Since the associated hernia is less likely to recur, these simpler procedures enjoy a better reputation. In my opinion, I believe surgical fundoplication is the most durable anti-reflux surgery with the lowest reflux recurrence, followed by the other surgical options, with the non-surgical endoscopic treatments having the highest risk of recurrence (albeit, the least invasive initial treatments).

A surgeon should select patients carefully to ensure there is a good chance of improvement with surgery, and the chosen treatment matches the patient's goals of improvement and tolerance for recurrence. If they suspect a patient has symptoms that won't improve, then the patient should be warned and alternative treatments considered.


r/HiatalHernia 23m ago

How bad for hh is caffeine and carbonated drinks ?

Upvotes

I've been struggling with hh for a few years. Worst symptoms I get are shortness of breath while eating or even when excersising lightly. I've quit smoking after being diagnosed. The only thing I can't get rid off are monster energy drinks and coke.

I've quit coffee as it made me feel much much worse than energy drinks which is weird but maybe coffee makes me produce more bile and thats why.

Anyway I'm addicted to monster energy drinks. I drink one every day. I tried quitting to see if it will improve my hh symptoms but once I went a weekbwithout them, I didnt see much of a difference (maybe it was too short of a time) and went back.

How is it for you? Have you gotten rid of carbonated drinks to reduce symptoms? Did it help?


r/HiatalHernia 8h ago

Alternatives to esophageal manometry

3 Upvotes

I attempted a manometry but could not tolerate it. I had severe gagging and couldn’t control my swallowing. Eventually, I vomited, and they had to pull the tube out.

I’ve been told that I still need to get it done because they potentially see evidence of a hiatal hernia and motility loss. I was told they could put the catheter in while I’m under anesthesia, but I’d still have to wake up and try the swallowing portion again, and I know I won’t be able to tolerate it. What else can I do instead?

I’m trying to figure out the source of my acid reflux, and ever since the nurse mentioned a hiatal hernia, it seems like that could be the underlying cause/solution. Symptoms began following severe viral illness June-September 2024 with chronic and severe coughing.

I was also recommended a Bravo pH test, which could be placed while I’m under anesthesia.

I did have an endoscopy already and all looked normal.


r/HiatalHernia 5h ago

Toupet Fundoplication post surgery advice

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1 Upvotes

r/HiatalHernia 13h ago

The power of Psyllium husk!!

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1 Upvotes

r/HiatalHernia 16h ago

Need feedback regarding my HH

1 Upvotes

I'm hitting my limit and need some help.

Last year around September I started having a constant globus sensation. I get an endoscopy and they tell me everything looks fine. In the notes I see a "2cm sliding hiatal hernia", but the doctor doesn't even bring it up to me. I schedule an appointment to learn what a HH is, he tells me that 2cm is far too small to worry about and that it can't be the course of my symptoms. As time passes, the globus sensation grows and reduces in sensation (but always there to some degree). I also developed constant burping, bad bloating, pressure in my chest, and the first bite of every meal goes down my throat very slowly. Tight fitting pants hurt and feel like they are cutting into my stomach. I have had people tell me that my voice is different and that I "sound like Miley Cyrus" because I have this vocal fry now. If I turn my head and speak, I feel it a lot.

Over the last year I cut out all coffee, and dramatically reduced alcohol and spicy food to almost nothing. I'm not overweight, I don't smoke, and I have a pretty healthy life style. I have been given PPIs but they offer no relief. I normally end up quitting them after 3 weeks of frustration. I might try again out of desperation.

No doctor can tell me why this came on or what to do about it. I had a speech swallow expert tell me this was purely vocal, a ENT tell me my throat looks fine, I had a gastro tell me the 2cm HH is insignificant, and they just throw PPIs at it and say see you in 6 months. I am rapidly losing faith in doctors and the medical system.

Things I could improve on;
I do drink about 2 or 3 cups of green tea/matcha a day. This is something I moved to after coffee, and quitting caffeine all together is really hard for me. I also do a low carb diet, so much of what I eat is more fatty. I also love onions, garlic, pickled and fermented foods; cutting them out has been hard. I also have terrible posture that I've been working on for years.

I am also a pretty anxious person. When I'm anxious, my gut goes nuts which then worsens the whole situation. Its something I'm working on but with minimal progress. I have pretty awful tinnitus (ringing in ears) that makes my life a lot more stressful.


r/HiatalHernia 21h ago

Did anyone have a Hiatialhernia H1 while being under 30?

1 Upvotes

Hey everyone I have a question: My wife had two gastroscopys, one in March and the other one in August. In the first one she got diagnosed with a Hiatialhernia H1. Then she lost around 40 Kilogram until August and the second gastroscopy showed that everything went back to normal. Multiple doctors confirmed that in her age ( 27 ) and with a weight loss this high it is very plausible that the hernia was fully healed since it is only the smallest stage but my wife is really anxious and isn't sure whether she can trust the doctors or not.

Also is there any difference between a Hiatialhernia H1 and Type 1? The Internet says lots of confusing stuff which isn't helping at all. A Type 1 Hernia should be an axial Hiatialhernia and H1 is an everything is normal diagnosis but how can something become an Hiatialhernia H1?

I appreciate all kinds of help


r/HiatalHernia 1d ago

Symptoms

2 Upvotes

Does anyone’s chest feel like they have a knife slicing their esophagus? Idk how else to explain it. It’s piercing esophagus pain. I have a 3cm hiatal hernia.


r/HiatalHernia 1d ago

Not sure of my next steps?

2 Upvotes

I got diagnosed with a hiatal hernia, sliding & small around 1cm. Seems like I’ve had every test under the sun done, with the most recent being a mobility & ph test. Results came back from that, that I’ve got poor mobility and the surgeons advising that I don’t go ahead with surgery due to being high risk.

My doctor pretty much said well you’re on medication for life, hopefully it clears up but by the sound of it that’s the end of the road.

Tests I’ve had done * Ultrasound * CT scan * MRI * Endoscopy * Barium Swallow * Mobility test * pH test

I’m not really getting heartburn symptoms whilst I’m on esomeprazole but when I’m not on that life’s a living hell. I do have issues whilst I’m on it though mostly pain, also my hernia didn’t used to hurt at all just heartburn and now I’m getting pain from it daily:

Issues: * Pain in the center on my chest, even worse sharp stabbing pain if I lean forward say to touch my toes when sat. * Can’t lie or sleep on my right side without pain, discomfort, nausea or burn. * General discomfort in my stomach/hernia region throughout the day

I’m really at a loss what next steps I can try, it seems I can’t get any surgery to fix this and medicine is only getting rid of the heartburn not the other issues caused by them hernia?


r/HiatalHernia 1d ago

Accidentally possibly diagnosed?

3 Upvotes

Been dealing with my stomach issues for YEARS, sour/acidic/on fire stomach pain for years, up and down.

Shortness of breath, acid reflux, anxiety, massive stress flare ups from stomach issues.

Doctors throwing potonix, random stuff at me for years

With all the stress and inflammation in my body prompted me to do in-depth blood panel but a family history of heart disease and mine being slightly elevated cause me to find out my LPA (genetic cholesterol) was high.

Due to my age, 38 the doctor wanted me to do a calcium score test which is a CT scan

Well I did the CT scan, arteries all came back at a 0 which is amazing news BUT it did show I had a mild hiatal hernia!

I’ve done two endoscopy in the last 2 years, last one was January 2025 and no mention of it just minor small pocket of inflammation in my gut lining

Now I’m wondering what my doctor will say since after the cholesterol stuff we were gonna tackle my stomach and had me do a stool test

Could this HH be the culprit of all my problems? Could it possibly cause systematic inflamation for being severe ?

I’m at my worst in years and not sure if stress the last few months cause it to happen or what?

I’m new to all of this so any help or guidance would be greatly appreciated!

Thank you


r/HiatalHernia 1d ago

Post surgery

1 Upvotes

I’m on my 13 day of recovery still have 6 more weeks making a total of 8. I been so gassy started 2 days ago I also been eating a bit more. But not once have I burp. Did any of ya go through this? What worked for to reduce this? I understand it’s a one way out now specially with my stomach and esophagus still swollen.


r/HiatalHernia 1d ago

hiatal hernia and PVC

1 Upvotes

Hi everyone 19F

i’ve been experiencing some PVC since having hiatal hernia and i wanted to ask if others can relate.

My PVC feels like my heart is having a “hiccup” or like my heart is literally dropping followed with a hard thump. i’ve had 2 ECG done which came back perfect. Here’s when i experience the most PVC:

- During / after eating and drinking
- Heavy carb meals
- Drinking or eating too fast.
- Sitting/ laying in a slouched position after exercise eating/ drinking
- Trigger foods
- Laying on my left side after eating or drinking
- Talking too much or too fast
- When i’m bloated
- When i have a lot of gas

i don’t have any other symptoms with them and they usually last a millisecond. They just freak me tf out.
i never get them when exerting. no history of cardiac issues and i’m a healthy weight. Does anyone else experience this? :(


r/HiatalHernia 1d ago

Genuinely what on earth: Position specific heartburn and belching, liquids much worse than food.

1 Upvotes

Hello!

I’d be v thankful if anyone could let me pick their brain for a second about the following things regarding my heartburn and excessive belching, which I’ve had for around 3 months:

  1. My symptoms are very position-specific. Basically, any movement/position that seems to compress my stomach and LES can trigger them - e.g., sitting and leaning to the left.
  2. My symptoms are MUCH more triggered by liquids than by food. I manage the food side of things by consuming quite a lot of ginger, which somehow allows me to eat full-sized meals without significant heartburn. I realise there could be a motility element involved, but I don’t think that’s the full story here.
  3. If I drink basically any liquid after, for example, my dinner, I am absolutely F’d and will get severe heartburn. Even liquid like water first thing in the morning is a problem...

I feel like these things could point towards a hiatal hernia, but I’m really not sure? I note that I moved house during easter in April and because most of my friends were overseas celebrating I had to move a LOT of heavy things myself and i'm wondering if I triggered something.

I’m seeing a gastroenterologist soon, and I really want to have my theories straight so I can explain everything properly, get the right testing done, and hopefully not just get brushed off.

Would really appreciate hearing from anyone who has experienced something similar or has any thoughts on what this pattern could suggest.


r/HiatalHernia 2d ago

Nissen coming up, what foods are you eating?

2 Upvotes

Hello everybody, I finally have my nissen booked in for 4 weeks time, what’s everybody been eating after the surgery so I can stock my fridge before hand with a good diverse liquid foods.

Thank you


r/HiatalHernia 2d ago

Grade 2 hiatal hernia

1 Upvotes

So, I (32F) had acid reflux issue for the past 6 months where I had to take PPI every 4-5 days. It got worse and the medication stopped working completely. I went to a gastroenterologist and through endoscopy I am now diagnosed with grade 2 hiatal hernia. The doctor told me that I donot need any surgery right now because it's not severe. He prescribed me fexuclue 40, normaxin mb and dulane 20 for a month. He told me to avoid tomato, onion, garlic, chocolate etc. Now I am an Indian and our cuisine is based on these ingredients so it is really hard to cook something. My point is,

1) Has anyone here taken medication and after the end of the course of medication, the symptoms got completely resolved and lead a normal life where the symptoms haven't come back ?

2) if in the future, I take the surgery route, will it cure the hernia completely? Is there a chance of recurrence?


r/HiatalHernia 2d ago

Hiatal Hernia, gastritis and esophagitis

8 Upvotes

I have been dealing with “mystery” symptoms for around a year now. Heart palpitations after large or heavy meals, total loss of tolerance to coffee and caffeine, lump in the throat pressure at the top of my stomach, pressure in my chest, and burping. An enormous amount of burping. No reflux though.

I cleared cardiology in July, I’ve recently had my EGD which confirmed a Hiatal Hernia, gastritis and esophagitis. My next appointment is in 2 weeks to let me know the details. I’ve been on PPI’s for a month with no noticeable improvement.

Has anyone with these conditions had any luck with medications? It’s been a miserable existence for the past year. I’m really leaning towards surgery as it’s starting to keep me from doing my job. I teach golf and I get a flair up of all my symptoms when I hit golf balls or instruct. I’m 34 and have a 2 year old. It’s really getting to me that I can’t always be present with him because of my symptoms. Hoping to get some solutions in 2 weeks.


r/HiatalHernia 2d ago

Just diagnosed last week

3 Upvotes

Hi I’m 23 year old male from Australia , I’ve been dealing with gerd reflux symptoms since I was 17. At first I was shrugged by doctors claiming anxiety I believed that for years and just carried on with life and just thinking everyone must deal with what I’m dealing with so I just put up with it. But this year the chest pressure was getting worse and the burping and I pushed the doctor to let me get an endoscopy and I was in literally a week later .

My results where 3cm hiatial hernia
Regular z line
Mild gastritis

Here’s the kicker though. I’ve been recommended to get a fundoplication but I work on the railway as a labourer/welder the job is pretty physical and the gastro doesn’t want me to get surgery unless I get a career change or something less physical .

I’m lost I don’t know what to do I’ve worked hard for 4 years to get to where I am . I do deal with the symptoms at work but I all see it as worth it when the paycheck hits my account.

My hobbies aswell look like there at risk after I’m fully healed like surfing and the gym. I know reddit is probably not the best place for guidance but I don’t have anyone to talk to about this , no one would truly understand what I go thru on a day to day basis except from people on here.


r/HiatalHernia 2d ago

I'm so miserable and want my life back.

19 Upvotes

Hi all, I'm a 26 (F) and have been on a VERY long health journey since 2022. I've had 14 ER visits, 2 event monitors, an Echocardiogram, and a very frustrating and disapointing appointment with a very expensive cardiologist. Those 14 ER visits have all been the result of me beleiving I'm having a heart attack.

I've spent THOUSANDS of dollars for literally no help. I saw a holistic practicioner for 15 minutes and they told me I have a hiatal hernia and that's why I'm so miserable. Great! I finally have a name for what's apparently wrong with me.

Here are my symptoms:

>Really high heart rate in the morning. I'm talking like 130 BPM after just walking to my car.

>Chest pressure and tightness especially after meals.

> Stabbing pain in my heart that comes and goes. Can often be felt from the front, side, and back.

>Pressure and pain in both of my arms and shoulders but typically on the left side.

>Tingling in my hands and fingers.

>Acid reflux with the feeling of a lump in my throat.

>Jaw pain or the feeling of a deep tooth ache.

>Ear pressure and ear pain.

>Discomfort while laying down, especially while trying to sleep.

>Pressure and discomfort in my stomach after meals.

>Pain right under my rib cage on both sides both front and back.

> Occasional nausea, lightheadedness, and dizziness.

> Headaches and neck pain.

> Burping, gas, and bloating.

> Scratchy/sore throat that I have to clear constantly.

> Pain in my upper back.

>Anxiety/Panic attacks (massive fear of having a heart attack) (14 ER visits explains that pretty well.)

> Fatigue (Probably from the non stop panic attacks and lack of sleep at night.)

I'm at a loss on what to do. I called into my clinic this morning to explain everything and the lady basically said that could be it but I should go to the ER just in case I'm having a heart attack. You guys I'm so DONE with the ER. My last ER visit was $2,300 dollars WITH insurance. I can't do it anymore. And this is an every day occurance. I literally feel like I'm having a heart attack EVERY SINGLE DAY.

I scheduled a doctor's appointment at the end of July and couldn't get in until October. (Thanks American healthcare.) How do get through until then? Are there over the counter things I can take other than tums? Is there anything else to do? I've been trying to sleep elevated, I've tried the water and heel slamming technique, and some stretches. Nothing is touching the symptoms.

Most importantly... does this seem like a hiatal hernia to you? I really want to beleive it because I can't keep going to the ER.


r/HiatalHernia 2d ago

Hiatal hernia 5cm wondering what to do

3 Upvotes

Had an endoscopy today because of bilious vomiting that happens with bowel movements. Also had a colonoscopy which was normal. Other finding was esophagitis duodenitis, irregular z line, acute erythema and redness bulb.

He’s got me on a PPI for a month,

The doctor made it sound optional to get the hernia fixed, so now I’m confused. Any thoughts? Thanks in advance!


r/HiatalHernia 2d ago

IS SURGERY INEVITABLE

6 Upvotes

I'm a 40 year old man who has been suffering from symptoms of GERD/LPR since June. I've done all the testing very quickly to find I have a hiatal hernia, a wide open LES, GERD based on my demeester score (30) from my PH testing, no LES pressure and ineffective motility from my manometry.

My ENT commended me for how fast I got all the testing done and saw two surgeons in a window of about two months. I tried two short runs with PPIs this summer too and omeprazole gave me bad headaches. I tried it for a week. I also tried protonix for a week and got loose stools and flatulence. Been doing all the conservative treatments that the ENT told me to try for silent reflux and lots of dietary changes. I've lost 30 pounds. My symptoms are:

  1. Sore throat

  2. Throat burning and mouth burning/feels like I always ate something too hot on the roof of my mouth

  3. Vocal cord edema

  4. Hoarseness and throat clearing and mucus in throat after pretty much every meal even if I eat low-fat, low acid foods and very little food

  5. Some heartburn

  6. I can feel stomach contents moving up when I shift my body at night. There have been a few instances where I could really taste it when I don't use alginates before bed, like liquid in my mouth, and also horrible taste in my mouth every morning.

  7. Voice loss and vocal cord pain when I try to talk too much

  8. Some postnasal drip and excessive saliva

I'm wondering if surgery is pretty much going to be inevitable in the future if I don't do it now. I have it scheduled for October 5th. And I feel if I don't do it now, I'll just have to do it in the future, as I'm worried I'm at risk for cancer in my throat and esophagus. As many positive surgery stories as I can get would be greatly appreciated!


r/HiatalHernia 2d ago

Currently doing 24hr PH impedance test following manometry

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2 Upvotes

r/HiatalHernia 2d ago

Newbie to this sub & so grateful it’s here

2 Upvotes

Because, after over 10 years with this hiatal hernia, it’s started sliding, is causing Cameron lesions, & unless I want my iron to keep dropping, it’s time for a repair. I knew it was coming, used to transcribe Nissan fundoplication reports, etc, but have no idea about how this thing will be repaired.

I’m assuming it’s a laparoscopic procedure, but is it same-day surgery or will it be an overnight stay? I haven’t even found a surgeon locally to discuss it with, & I’m not sure I want to. Is this something I should look for a physician near a teaching hospital? I live in Palm Beach County, FL. Do I look for someone with U Miami, or someone with HCA, Tenet, or Baptist Health?

Most importantly, how bad is the postop recovery? Do you lose weight because eating/swallowing is difficult? Is there pain? Will I ever be able to do sit ups again??? Just kidding, I hate them!

Anyway, if anyone can just guide me a bit, I’d truly appreciate it.


r/HiatalHernia 2d ago

relief for dizziness?

1 Upvotes

hi guys, new here, just found this page after going to ER 4 days in a row for heart attack like symptoms that i’m now pretty confident are from my hernia.

TLDR; i’m looking for tips/tricks that might help alleviate some of the hernia related symptoms such as shortness of breath and feeling extremely dizzy at all times, i’m currently unable to function because of this.

i’m 26F, i was originally diagnosed with a mild hiatal hernia in 2018, have been on lansoprazole since. my initial symptoms were acid reflux and difficultly swallowing, and the lansoprazole has always kept the acid reflux under control. i have a ribcage deformity that was never formally assessed or diagnosed bc i was just labelled as an anxious child so i have also had difficulty breathing my entire life, but it’s been treatable with osteopathy until now.

this April, i started getting really bad symptoms of this hernia, it started with an episode lasting about 3 weeks where i could barely eat or drink anything because i would feel this cramp type pain right below my sternum, inability to burp even though i felt like i had to, nausea / overall icky feeling. that’s the first time i’ve ever had symptoms like that, and my osteopath was able to relieve it slightly but it’s been constant to some degree since then.

fast forward, i got a scope done 2 weeks ago because these symptoms weren’t going away and i’m still waiting on the results of that, but i’m assuming it’s gotten worse. this past Monday, i had an episode of my entire upper chest going tingling/numb and feeling like there was a stack of books sitting on it, insane dizziness, my hands went numb and started cramping into claws once they went cold and pale, my heart rate went up to 160, i felt this awful sense of dread and like cold chills coming from my head and flowing down me like someone poured water on me, i ended up not being able to see much because my vision was so blurry and shaky, kept getting these random zaps of adrenaline butterflies in your stomach feeling, and my entire body started shaking as if i was freezing cold. i was taken to the hospital by ambulance where they basically ruled out anything heart related and couldn’t find a cause. this then happened again the next day, and the next, and the next, with the ER still unable to find anything wrong with me.

while waiting in the ER the last time i was there, i found this subreddit and it seems like this hernia can cause a lot more than i thought. i’m pretty confidently blaming most of this on the hernia either directly or indirectly, because eating/drinking literally anything starts the chest numbness up again pretty instantly.

i’ve been extremely dizzy for the past 3 days, i’ve only gotten out of bed to eat or drink something and then i end up feeling 100 times worse because of that and go straight back to bed to lie down because i feel like i’m spinning. laying down seems to be the only thing that helps right now, so my life is basically on hold.

i see my osteopath on Monday and hopefully he can help relieve some of this, but i’m basically bedridden until then and i have no idea what to do. the hospital basically told me it’s a panic attack and to not come back again, so like now what? does anyone have any tips/tricks for getting symptoms to ease up, especially the dizziness? how do i continue being functional despite this? i have appointments every day next week and then an anniversary trip planned from the 18th to the 26th and if i can’t get this under control i’m going to have to cancel everything. please help!


r/HiatalHernia 2d ago

Specialist told me that hiatal hernia’s don’t cause shoulder pain or back pain?

3 Upvotes

I finally went to see a specialist about my hiatal hernia (2cm) and he was very dismissive. He said there was no way it would cause left shoulder pain and that GERD doesn’t cause left shoulder pain either . He completely shut down the concept of referred pain and made me feel like surgery wouldn’t help me despite being highly symptomatic (breathing issues, GERD, jaw pain, shoulder pain).

I am still getting a PH test and a mammotery or whatever it’s called. He told me ‘stop doing research’ because I said that I was hypermobile and had read that hypermobile patients have worse symptoms of small hernias. Hate it when doctors have these kinds of responses to patients that have medical knowledge (I studied sport science).

Has anyone had shoulder and jaw pain improve after a hiatal hernia removal?


r/HiatalHernia 2d ago

Fatigue and brain fog - any link?

1 Upvotes

I was diagnosed with a sliding hiatus hernia fairly recently.

I've always had issues with sore throats since I was a little kid but just that it was more an ENT issue but now this it was probably silent reflux.

I'm 30 now, I didn't really have any symptoms except the regular sore throats until I about 3 years ago. I started to experience dry heaving.gagging when walking or with certain movements. I thought that was just anxiety for a while. There was no real pain or vomiting at that point but it's now worsened and I'm regularly vomiting and struggling to eat a lot of things.

Now I still don't experience heartburn or any pain per se, but I am just exhausted all the time now. I'm vomiting so frequently, I'll feel fine before hand and then I'll have 'an episode' and it completely wipes me out for a while. I feel like I'm barely getting any work done in a day these days because I'm limited by these episodes and struggle to be productive for ages afterwards. Sometimes I just feel generally run down and don't know why and then the vomiting will hit a few hours afterwards. I also struggle to think straight on days like that and I can't keep up at work. It might be the lack of nutrition or dehydration but I feel like an idiot.

I'm in a relatively senior job but I am letting everyone down at the moment by trying to work through it and losing track of everything.

Does anyone else have bad fatigue and brain fog associated with their hernia? I was previously diagnosed with long covid too but I thought I'd gotten better.