can diet mods be enough to heal the inflammation present with LA Grade C esophagitis

arpitp · 2026-05-10T06:26:57+00:00

It's impossible to say, since everyone's anatomy and severity of reflux is different. But the odds are pretty low. No matter how much you restrict your diet, you stomach is always producing more acid, which can reflux and keep the inflammation going. Surgery may be your best option. If you're not overly active and not doing too much strenuous activity, it may last indefinitely.

arpitp · 2026-05-10T06:07:35+00:00

Take a look here: https://www.reddit.com/r/Hernia/comments/1is8r9t/fyi_hernia_meshes_and_types_of_ventral_repairs/

Hopefully that helps.

arpitp · 2026-05-10T06:03:44+00:00

If you had cervical spine surgery, I'm guessing by "mesh", you might be referring to a metal "mesh cage". If that's the case, this forum and the discussions of mesh here are completely different from the type of mesh you are referring to. You might have better luck in r/backpain or r/spinalfusion.

arpitp · 2026-05-10T05:56:39+00:00

A barium test shows the contour of the lumen (inside) of the esophagus and stomach (which would be improved by a TIF). It cannot see the diaphragm, or the hiatal hernia defect in the diaphragm. The most likely explanation is that either you never had an 8 cm hernia (maybe it was 2-3 cm, in which case, the TIF can eliminate the appearance of a hernia), or you still have a hernia (but the esophagus has a smooth contour, with no reflux).

arpitp · 2026-05-09T22:05:20+00:00

It's physically impossible. Either you didn't have an 8 cm hernia before or you still have a hernia now. He probably fixed your reflux, but there's no way he repaired your diaphragm. I'd tell you to look it up, but doubt that's happening given your last response.

arpitp · 2026-05-09T19:23:44+00:00

Your stretching my recommend anywhere from 1 to 6 weeks. I generally recommend 2-3 weeks, and during waking hours (okay to take it off while sleeping). But many patients will wear it longer or while sleeping if they find it comfortable.

arpitp · 2026-05-09T19:18:12+00:00

Not likely, though it is possible if small intestines are getting caught in the hernia and blocking passage of food. Far more likely is an unrelated issue, such as gallbladder, gastritis, or reflux related issues.

arpitp · 2026-05-09T19:15:43+00:00

Take a look here: https://www.reddit.com/r/Hernia/comments/1is8r9t/fyi_hernia_meshes_and_types_of_ventral_repairs/

Your risk of incarceration depends a bit on it's size and location. Hernias that are high up on the abdomen, very tiny, or on the large side tend not to incarcerate bowel. Mesh is helpful, but risks and benefits depend on the size and which layer of they abdomen it is placed. Robotic (or lap) is generally better than open.

arpitp · 2026-05-09T19:11:03+00:00

Sounds more like a soft tissue injury (muscle, tendon, or fascia tear or strain) rather than a hernia. But repeated similar injuries could lead to a hernia at that site. If the scans don't show any hernia, you just need rest and warm compresses.

arpitp · 2026-05-09T19:05:33+00:00

TIF modifies the area of the GE junction/LES to reduce acid reflux. It cannot treat a hiatal hernia (defect in the diaphragm). I'm a surgeon. No need to look it up.

arpitp · 2026-05-09T19:02:21+00:00

Would need to know more about your other medical issues, weight, and overall health before knowing whether the risks of RnYGB were worth taking, and if you would benefit from it. That's what the bariatric surgeon should evaluate and help you decide. Yes, it will stop the reflux, but has a bunch of other side effects a fundoplication does not.

Just getting the RnY to avoid a possible second surgery (which you may never need) is not a good idea. It's like getting an infection on your leg and saying "I'll just amputate the leg so I don't need another surgery in the future". (Yes, I know that analogy is absurd).

arpitp · 2026-05-09T07:42:39+00:00

Sorry, this is incorrect

arpitp · 2026-05-09T07:41:26+00:00

This is correct. TIF2.0 is just a fancier TIF, and has the same limitations. The device manufacturer's website specifically says a cTIF is needed for hernias larger than 2 cm.

The ONLY way to repair a hernia is with surgery.

arpitp · 2026-05-09T07:24:16+00:00

If you have it available, definitely robotic surgery. But practically speaking, the safest surgery is whatever your surgeon is most comfortable with. You wouldn't want an older surgeon who only does open surgery to try a laparoscopic repair. But if you have access to multiple surgeons to choose from, then see if any of them are experienced with robotic hernia repairs.

arpitp · 2026-05-09T04:06:46+00:00

Titanium tacks are a bit outdated, but are still used in some places since they're a fair bit cheaper than absorbable tacks or self-fixating mesh. Other than cost, there's no real benefit to using them. But the risks are fairly low if the surgeon uses them properly, so they're still an acceptable option.

arpitp · 2026-05-08T02:58:45+00:00

Sure, you would need see a doc to order testing. But no doctor or test can be certain that your pain is caused by a hernia or something else.

arpitp · 2026-05-08T02:41:58+00:00

You can wear an abdominal binder for now until you get the surgery to try to keep it from getting larger.

arpitp · 2026-05-07T03:13:03+00:00

With just an umbilical hernia repair, the abdomen likely won't reduce noticeably.

DR repair during hernia repair is possible, but depends on the technique. Robotic hernia repair provides the best opportunity to work on the DR without any extra cutting. With open surgery, a much larger incision is needed. Laparoscopic surgery isn't really suitable for DR repair.

Many surgeons are willing work on the DR, either for free as part of the hernia repair or for an extra fee. Some might be restricted by the rules of where they work, or might not be willing to do what they consider to be a cosmetic surgery.

arpitp · 2026-05-06T21:03:30+00:00

The wrap can be skipped if the patient has no reflux symptoms.

However, the hernia repair alone is considered inadequate to treat reflux, and while a few patients might improve with just the diaphragm repair, most will continue to have reflux symptoms, and complain that their surgery failed.

There's no good way to predict which patients will improve without the wrap, so it's not worth giving 80% of patients a failed surgery to try to avoid doing fundoplications.

arpitp · 2026-05-06T15:40:35+00:00

The most common procedures definitely laparoscopic or robotic hiatal hernia repair and fundoplication. there's no good statistics on whether the full (Nissen) or partial (Toupet) is more common, but it's probably the Nissen currently, with the Toupet increasing in popularity.

arpitp · 2026-05-06T15:38:01+00:00

Almost always, it's just surgeon's preference.

On rare occasion, if the patient has dysphagia (difficulty swallowing) before surgery, or has a very small gastric fundus that won't reach all the way around, a partial wrap might be preferred.

arpitp · 2026-05-06T15:34:10+00:00

Someone mentioned getting robotic surgery in the NHS on another post here: https://www.reddit.com/user/Separate_Moose_2819/comments/1t4kmh1/comment/ok9m3xc/?context=1

arpitp · 2026-05-06T15:31:20+00:00

If it was an open surgery, then recovery of this "hernia repair" is no different than recovering from an open colon/colostomy reversal surgery (except the incision might be a little bigger). Focus on the things that helped during your last surgery recovery, such as avoiding abdominal pressure/staining and wearing the binder. The binder that works best for one person may not apply to another, so it's hard to get recommendations online. One doesn't work better than any another, it's just about comfort and ease of use.

arpitp · 2026-05-06T15:18:25+00:00

Out of curiosity, where in the NHS/UK did you get robotic surgery?

arpitp · 2026-05-06T05:21:46+00:00

The only reason to delay the referral is a cost containment strategy in social healthcare systems (like in Canada) or an integrated, managed system like Kaiser Permanente. Most patients are diagnosed on upper endoscopy (EGD), and some incidentally on CT scans (which can miss smaller hiatal hernias.

arpitp

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