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bigtone 11-16-2004 06:46 AM

Hiatal Hernia???
Approximately 6 months ago I had a chronic violent cough that would not go away. After this, I had chronic heartburn and having food stuck in my throat. I requested an endoscopy and the doctor said a ihad 2nd degree esophagitis but no hiatal hernia. Is it possible he missed it? Would a barium swallow test be better? I have pain in my lower back and front left rib after I eat and am constantly having heartburn. I am taking pantoloc for the heartburn is there a better drug for an hiatal hernia? Please help!!

bigtone 11-17-2004 11:43 AM

Re: Hiatal Hernia???
Anyone out there?

Streetcar 11-17-2004 12:19 PM

Re: Hiatal Hernia???
Hey Bigtone!

I jsut had a EGD on Monday and the dr showed me the photo of my Hiatal Hernia. Can't add anything else at this point since my follow-up visit isn't until 12/6. The GI dr that performed the EGD wasn't my regular GI dr (he was on vacation) and they suspect that I have a esophigeal spasams and achalasia. Anyway, there is someone out here after all. LOL

bigtone 11-17-2004 06:23 PM

Re: Hiatal Hernia???
Good to hear from you. what is an egd?

Streetcar 11-18-2004 10:09 AM

Re: Hiatal Hernia???
I know that sometimes it seems like there's nobody out there when you don't get any response to your posts, but I think that usually it's that those that are out there just don't know what to say.

EGD is the abbv. that the drs use for the endoscopy of the esophagus, the tech. med term is two mouthfuls and unpronounceable by normal people. I had similar symptoms to your's. It was so bad that I could barely swallow and I lost 12 lbs. in 10 days. After the EGD the dr dialated my esophagus and I am finally able to swallow again but I still have a little difficulty sometimes. Hopefully I'll find out more in Dec.

bigtone 11-18-2004 07:36 PM

Re: Hiatal Hernia???
thanks for your reply. I had a "scope" done on September 2nd and the doctor said he found that I had esophagitis. Could it be that he missed me having an Hiatal hernia?

TJN 11-20-2004 10:13 AM

Re: Hiatal Hernia???
You don't need a hiatal hernia to have GERD . And not all hiatal hernias cause symptoms. Many people are walking around totally healthy and unaware they even have a hiatal hernia. A hiatal hernia itself doesn't cause symptoms -- it contributes to GERD by compromising the LES thus causing abnormal acid exposure to the esophagus.

But there are many contributing factors to GERD besides a hernia.

Your question as to if a SCOPE can miss a hiatal hernia . Yes it can. Mine was missed on an endoscopy and on 2 upper Gi s .Sometimes they do some stomach manipulation during the upper GI to be able to see the hernia. That's what was done to me -- and a hernia was seen on my 2ond upper GI . My 3rd upper GI didn't show it again, so they can be tricky little things to find.

Pantaloc didn't work very well for me, but everyone reacts differently to meds depending on the person. Nexium i found worked best .

Streetcar -- you need a manometry to properly diagnose your motility problem.

bigtone 11-22-2004 05:55 AM

Re: Hiatal Hernia???
Thank you for your kindness. You have been so helpful! How do I get the test you mentioned done? What is it and what does it entail and for what problem does it detect?

Streetcar 11-22-2004 01:10 PM

Re: Hiatal Hernia???
Hello TJN,

When I go see my GI dr on 12/9 that is one of things we will be going over. I don't know what manometery is but the dr that performed the EGD (an assoc of my dr) said I needed it. What can you tell me about it? Is it aprocedure that requires any prep, are they done in office or what?

Thanks for any and all info you can provide.

LynneJW 11-22-2004 01:13 PM

Re: Hiatal Hernia???
Ken, may I ask, do you have symptoms of esophageal spasms? If yes, what are they? I've been told I have this, and it's excruciating, but only happens every couple of weeks or so.

Streetcar 11-22-2004 03:00 PM

Re: Hiatal Hernia???
Hi Lynne,
That's really hard for me to answer. Acouple of weeks ago I developed hiccups really bad everytime I tried to eat. After a couple bites, the hiccups started (excuriating to say the least) and I couldn't swallow. I called my GI dr who setup an esophagram for me that showed that I had "some stricture" of my esophagus. Last Monday they did an EGD and dialated my esophagus. The notes at the bottom of my copy of the procedure report said: "probable esophagial spasms" and "achalasia". Since the EGD, swallowing has been a lot better although a couple of times I could feel my esphagus close before the swallow was completed and the food came right back up (Yuck!). I've only had a couple of hiccups since then though. They didn't occur while trying to eat nor did they cause the excuriating pain that they had done before so I just kinda ignored them. Symptoms of esophagial spasms would be the feeling of the esopgagus closing prior to the completion of the swallow, I guess but I don't know for sure. I'm supposed to see my GI dr on 12/9 for a follow up visit and boy do I have some questions for him? Hope the info helps.


bonnieb730 11-22-2004 05:05 PM

Re: Hiatal Hernia???
I had surgery 15 years ago on a hiatal hernia. They put a plastic ring around my esophagus that was called an angel chik. My problem now is I feel worse now then I did before and I asked my doctor about it. He never even heard of an angel chik and alot of the surgeons he contacted hasn't either. He said according to the x-rays I need it removed. Any info that anybody has on this would be greatly appreciated. They did take this off the market the same year they put mine in.

hrtofluv 12-09-2004 03:37 PM

Re: Hiatal Hernia???
The doctors found my hiatal hernia duirng the endoscopy last July and put me on Mexium 40 mg for the esophaghitis. But I also have the esophageal spasms (which twice sent me to the ER with such sever chest pains). The hernia though is totally different and kinda funny. I could have sworn that I was 4 months pg cause something inside was kicking me (just like when my I was pg with both my kids or when they would get hiccups while I was carrying them). It I guess was this hiccup that everyone talks about, but mine is right under my left rib - so it was the stangest thing. You could feel this hiccup externally as well as see it visually.
Anyway - not sure if it might help someone out. The hernia is more a fun thing for me - the GERD not so fun (especially sleeping), but much much better with the Nexium.

Ron 12-12-2004 07:57 PM

Re: Hiatal Hernia???
Hi All,

This may be off-topic, but I think you may find it does apply to those with reflux.

Hi Thanatos,

I notice that this Bad Breath string is getting too hard to navigate because it is getting
so long again.

I was tempted to post in a shorter string and may still do so, even though it would be off topic.

I have read the first 70 posts and seen some people with a few good hints as
to the causes of bad breath. There are quite a few and it has become a business selling remedies to those who are suffering from the problem

One must first determine where the bad smell is originating.

Here are a few tests to try..

Have a trusted person give you some feedback...

1/ Breathe out through your mouth and see if that smells so bad to the person

2/ Close your mouth and breath out only through your nose.

3/ If there is no difference, the smell is originating in the lungs.

4/ If the smell is worse when breathing through your mouth, then one would think that it is coming from the mouth. Maybe NOT.

5/ Try to burp and have that person tell you if the smell is the same as the breath or not. If it is the same or worse then the esophagus or stomach might well be to blame.

6/ If it is different or less offensive, then the stomach and esophagus are
probably not the source.

7/ If the smelll is only bad when breathing through your nose, then you must rule out a sinus infection. A nasal swab would be a good thing to culture.
(Many people carry a Staph Aureus bacteria in their noses/sinuses and if acne is also a problem on the face, this may be the cause as well.)

If you do not have a trusted person to smell your breath, then you can get some information from a pet dog especially if they revolt from both your mouth and nose breath.

If you have a spouse or mate, they may also have the same bad breath and not notice yours very much. You may also not be offended by theirs.

Ask yourself if you have had an improvement in breath when taking antibiotics.
If so, then maybe you did not take them long enough to clear up a difficult infection. Your doctor may be willing to prescribe longer, but some are not so understanding.

If you are sexually active, you may have picked up a hard to diagnose infection from your partner... Bacteria such as Mycoplasma, Ureaplasma and Chlamydia will not culture on the usual petri dish media. If your doctor is a thinker, he will say... ""We can't find anything obvious to treat, but something
must be causing the offensive smell, so lets try a week of Zithromax which will
treat the hidden bacteria as well."" If it works, that must have been the problem. Of course, your mate may need to be treated at the same time or reinfection can easily occur .

If the smell is coming from the stomach, poor digestion, a weak or open sphincter, or a gastric infection with Helicobacter Pylori should be ruled out.
A blood test for Helicobacter Pylori or a breath test for Urea would be a big help. (The Urea smell may be the source of the bad breath.)
If that was positive, then a week of two antibiotics and an ulcer med
like prilosec or omeprazole would be the first thing to try.. This is called the
"Triple Therapy" and has been accepted treatment for at least 8 years.
Symptoms may include, belching, burping and burning in the stomach which gets better after eating for an hour or so... a white coated tongue, bad breath, and a sour taste in the mouth. If you have this... Get tested.
If your doctor will not test for HP, then you need another doctor.

If the test is negative, (which is possible) taking the triple therapy may still
be helpful because not all Helicobacter strains are detectable.

If you have hurt your esophagus in a car accident where whiplash was involved, or have injured yourself in the mid chest area while doing too many
ab-crunches, it is possible that an important sphincter called the "Lower Esophageal Sphincer" and the "Phrenoesophageal Ligament"
were damaged leaving you with a problem called acid reflux (gerd) that could be allowing stomach acid to burn the delicate esophageal tissue and cause the smell of rotting meat that is offending others. Surgery may be needed if this is the case. Sinus problems that resemble an infection can be due to
breathing these acid fumes through delicate nasal membranes.

If you need more info on such problems, do a search on "heartburn" or any of the other
words in brackets.


Ron 12-12-2004 08:06 PM

Re: Hiatal Hernia???
[QUOTE=bigtone]Approximately 6 months ago I had a chronic violent cough that would not go away. After this, I had chronic heartburn and having food stuck in my throat. I requested an endoscopy and the doctor said a ihad 2nd degree esophagitis but no hiatal hernia. Is it possible he missed it? Would a barium swallow test be better? I have pain in my lower back and front left rib after I eat and am constantly having heartburn. I am taking pantoloc for the heartburn is there a better drug for an hiatal hernia? Please help!![/QUOTE]

Hi Bigtone,

The violent coughting may well have injured your diphragm where it connects to the esophagus. there is an important ligament called the "Phrenoesophageal Ligament" which prevents reflux. If you stretched this,
you may regain function in time, but if you tore it completely, a hiatal hernia
is the result. A sliding hiatal hernia is a smaller one and can be missed. Your stomach may slide partially up into your chest from time to time and cause you pain, and pressure as well as swallowing difficulties and reflux.
Abdominal exertion must be avoided at all costs. Even constipation can
force the stomach where it does not belong when you push.


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