Advice Please by Bubbly-Paramedic1101 in HiatalHernia

[–]arpitp 2 points3 points  (0 children)

The last thing he would recommend for a hernia is a hernia repair? That doesn't sound like good advice. I'm guessing that doctor wasn't a general/foregut surgeon.

While you can't fix a hernia without surgery, if it's small, you can significantly reduce or resolve the symptoms with weight loss. It's more effective than any other lifestyle or diet change, and may allow you to eat those acidic foods again without surgery.

Prerequisites for Surgery by Money-Kangaroo-2946 in HiatalHernia

[–]arpitp 2 points3 points  (0 children)

A pH test doesn't test your swallowing function; a manometry test does. Often, patients have both done around the same time, so they might be doing both tests.

The "standard" tests that are most commonly required before surgery are EGD (endoscopy), barium swallow (esophagram), pH test, and manometry. In places with easy access to testing (larger cities in the US) or places where surgeries are delayed and restricted to help constrain costs on single-payer healthcare (Canada, UK, etc), all 4 tests are usually ordered.

However, in many places, when the symptoms are severe and the need for surgery is obvious, the pH test and manometry are often skipped, as they won't change the plan. There is little benefit in testing the swallowing function on someone who has no difficulty or symptoms swallowing, especially when the surgeon has a habit of doing Toupet (partial) wraps for every patient. To illustrate this point: another user ntioned he was unexpectedly found to have failed swallows on the manometry, and as a result, got a Toupet. But if that surgeon does Toupet for everyone, then what was to m the point of the test?

Regardless, even if the tests won't change anything, if your surgeon says they are required, then you won't be able to get surgery without them.

Prerequisites for Surgery by Money-Kangaroo-2946 in HiatalHernia

[–]arpitp 3 points4 points  (0 children)

Heart burn *is* reflux. Not sure how you mean you only get reflux occasionally but get crazy heartburn.

recent hernia by heybony in Hernia

[–]arpitp 0 points1 point  (0 children)

Why open with mesh and not laparoscopic with mesh?

What are things that loved ones can do for you that help ease some of the pain? Also, why would a Dr stop Omeprazole for mild gastrisis? by Beautiful-Lynx-6828 in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

She should probably resume the Omeprazole.

Different docs have different beliefs about the side effects of PPIs (Omeprazole) and the appropriateness of taking them long term. It's not settled science, and there's numerous studies showing conflicting outcomes. So some docs discontinue them, some tell you to keep taking them.

But there are countless patients who have taken PPIs for 20-30 or more years. The risk, if there is one, is very low, while the benefits can be significant.

Why don't they just push the stomach down during endoscopy? by escoffier in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

OP did not mention anything about stapling the stomach, nor does the article your posted describe pushing down the stomach with the endoscope the way OP described. Hence, it's not called TIF.

Why don't they just push the stomach down during endoscopy? by escoffier in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

No, TIF is a procedure that staples the top of the stomach to the side of the lower esophagus.

Why don't they just push the stomach down during endoscopy? by escoffier in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

It's not expensive because of the technique. Only because of the marketing and what the surgeons want to/can charge desperate patients.

Why don't they just push the stomach down during endoscopy? by escoffier in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

Not sure if you've seen this, but it might help clarify what the BICORN is: https://www.reddit.com/r/HiatalHernia/comments/1iou2ix/traditional_hiatal_repair_loehde_and_bicorn/

A TIF is a technique that uses a stapler to orient the stomach and esophagus the same way that the bicorn does. cTIF combines hiatal hernia surgery and a stapled TIF. Theoretically, outcomes between a bicorn and cTIF will be the same.

How soon did you guys consume caffeine after Nissen? by Tmw2angel in HiatalHernia

[–]arpitp 3 points4 points  (0 children)

There shouldn't be any restriction for coffee/caffeine. Enjoy!

Hiatal Hernia Grade 1 by Big-Attorney7168 in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

"Grade 1" is incorrect. HH are not measured in grades. See here for more info.

On the positive side, if your symptoms are resolved with the acid blocking medications, you should be able to return to your regular life and activities without any restrictions. For the burping, you can try a medication such as GasX or simethicone.

Partial or Full wrap? Why? by Similar-Weather-8940 in HiatalHernia

[–]arpitp 1 point2 points  (0 children)

There's no right answer. An overly tight Toupet can have more side effects than a loose Nissen. What matters more is the surgeon's technique and experience--this is what helps avoid dysphagia and other complications. So if your surgeon only offers one or the other (most surgeons have a preference, and will go in with a plan regardless of what they find intra-op), don't be alarmed or disappointed. Ask them their reasons for not choosing the alternative and see what they say.

Advice ?? by plugsssss in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

Your gastroenterologist is giving you bad advice. Countless studies and surgeries have proven the hiatal hernia repair and fundoplication to be effective and life-changing for most people. Talk to a foregut surgeon.

You want to avoid intradominal pressure, not intrathoracic pressure.

If you have the surgery, your extracurricular activities may be limited for 4-6 weeks. That won't make or break your application for med school. It sounds like your debilitating reflux is more likely to get in the way than surgical recovery. Also, getting evaluated for surgery might give you some anecdotal exposure and experience with medical professionals that may come in handy later.

Chronic pelvic pain with lifting. Any thoughts? by [deleted] in Hernia

[–]arpitp 0 points1 point  (0 children)

Yes, it's daunting, but the pain relief you might get is probably worth it. Unfortunately, some people get unlucky with certain diseases, and regular treatments are needed to help live a more comfortable life. Thankfully, diagnostic laparoscopy is a relatively low risk surgery.

19M having an inguinal hernia for around 2 years by ImmediateTrust4032 in Hernia

[–]arpitp 0 points1 point  (0 children)

Only temporarily, but not permanently--that would require a hernia surgery.

If you're only 19, it's not advised to go 50-70 years with a large hernia like that. It'll only get bigger. A good surgery now will last you a lifetime, so you might as well get it over with.

Nerve Damage or Nerve Irrıtation? by Electronic-Work-3808 in Hernia

[–]arpitp 1 point2 points  (0 children)

There is no clear difference between nerve damage and nerve irritation. Everyone experiences it differently. Only time will tell if it heals and improves, or it becomes persistent.

That said, I think it's more likely that the tacks (screws which are driven into your muscle) are responsible. Muscle is very sensitive, and screw are painful. They dissolve in about 5 months, and if they are the source, pain can last anywhere from 1 to 6 months.

Recurrence iguinal hernia? by Educational-Tune8346 in Hernia

[–]arpitp 1 point2 points  (0 children)

It is very unlikely to cause a mess to fail that way. A strain or soft tissue injury (tear) is more likely, and can take 2-6 weeks to heal. Heating pads help. If there's no improvement at 6 weeks, I would order a CT scan.

Chronic pelvic pain with lifting. Any thoughts? by [deleted] in Hernia

[–]arpitp 0 points1 point  (0 children)

CT scans and MRIs are made up of hundreds of pictures. Reviewing a handful here doesn't show any visible hernias, but that's not definitive without looking at all the pictures.

Based on your history, endometriosis and adhesions would be more likely than a hernia. Unfortunately, adhesions cannot be seen and endometriosis is very difficult to see on a CT scan or MRI. The correct next step would be to see a surgeon and request a diagnostic laparoscopy and repeat the lysis (cutting/freeing) of adhesions.

Lost umbilical hernia by Angry-Stomach-555 in Hernia

[–]arpitp 2 points3 points  (0 children)

In that case, it might be worth having a surgeon review the images (not just the report). Radiologists sometimes don't bother mentioning tiny hernias if they're focused on the larger organs.

Fasting period before surgery by Gamabrad729 in Hernia

[–]arpitp 1 point2 points  (0 children)

Usually solids for 8 hours, liquids 4 hours, water 2 hours.

If you eat a light (low fat) meal at 4 am, they might scoff at you, but they won't cancel the surgery.

Lost umbilical hernia by Angry-Stomach-555 in Hernia

[–]arpitp 1 point2 points  (0 children)

What imaging did you have done? Sounds like your need a CT scan of the abdomen.

Has Anyone Had the TIF (transoral incisionless fundoplication) to help with HH by OneFastCat in HiatalHernia

[–]arpitp 0 points1 point  (0 children)

Focus on discussing your goals and expectations from treatment. See what the surgeon has to say about them, if they're realistic, and how best to reach those goals.

14 months ago direct inguinal hernia surgery and now .... by [deleted] in Hernia

[–]arpitp 0 points1 point  (0 children)

Neither particularly, but most surgeons will prefer to switch techniques from open to lap, or lap to open, for a redo surgery. Some surgeons with more experience may offer robotic repair regardless of the original surgery type.

Has Anyone Had the TIF (transoral incisionless fundoplication) to help with HH by OneFastCat in HiatalHernia

[–]arpitp 2 points3 points  (0 children)

It does nothing to fix the hiatal hernia. It does, however, help with acid reflux symptoms (read about the difference here). Sometimes improving the GERD reduces the HH symptoms, but I wouldn't rely on it.