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Managing a hiatal hernia

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In 2008, I was diagnosed with a hiatal hernia and I've found it difficult to manage my symptoms effectively, and the gastroentorologist I was seeing hasn't been particularly receptive to the information I had provided him with. In terms of medication, I take 20mg of omeprazole daily which reduces acid reflux. However, I am still plagued by wholesale regurgitation of certain foods. I find it extremely difficult to eat fibrous food or red meat without experiencing pretty severe and distressing symptoms. Food which is not easily digested, which remains in my stomach for a long period, eventually protrudes back into my oesophagus which, in turn, leads to violent retching. Immediately after eating my symptoms are often okay, although not always. However, if I consume difficult to digest foods, I can experience a build up of pressure in my oesophagus, anything from 20minutes to 4-6 hours after eating. The pressure builds and I then begin to violently retch; on occasion, I've retched so violently, the capillaries in my nose have burst. I continue to retch and vomit until the food has been expelled from my stomach, sometimes for 2 hours. This form of vomiting doesn't induce nausea - although I can be nauseous at times - it appears to be a mechanical response to a blockage and, once that blockage has cleared, the vomiting subsides. The symptoms are so distressing, I have taken to avoiding eating problem foods, although some of these problem foods are the most nutritious and my diet is suffering. I am now eating soft foods, such as white bread chicken, and cheese etcetera but these are not the healthiest foods to consume. I try to eat little and often but I struggle to consume sufficient calories which results in me binging on high calorie foods like chocolate. I've tried blending vegetables but this turns them to a slop which can leave me bloated and, when I become bloated, I experience the retching. My quality of life is severely impaired, I dread eating, I experience food-related anxiety/panic, and I am also loathe to venture out of the house for hours after I've eaten. As such, I have little or no social life and would like, if anybody has any, advice on managing my symptoms better than I currently am.
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First Helper User Profile Dr. Robert Wascher

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replied March 27th, 2011
If these symptoms are indeed secondary to a hiatal hernia, and if the function of your esophagus and stomach are reasonably normal, then anti-reflux surgery might be helpful in your case. (You would have to undergo a complete work-up, by both a GI doctor and surgeon, to determine if this option is likely to be helpful to you.)


Robert A. Wascher, MD, FACS

Author, "A Cancer Prevention Guide for the Human Race"

A landmark, evidence-based guide to a healthy cancer-prevention lifestyle, based on cutting-edge cancer research.
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Users who thank Dr. Robert Wascher for this post: DaveM__ 
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