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Thread: hiatal hernia repair question

  1. #1
    Join Date
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    hiatal hernia repair question

    One doctor said i could have a hiatal hernia repair.

    do they ever do just this with out the nissen wrap?

    Also, has anyone been to a chiropractor to get adjusted for this and to have them pull the stomach down where it belongs.?

    Ellie

  2. #2
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    Oct 2003
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    I don't know specifically about those questions but I hope you read my reply to your post concerning Fundoplication in the Tampa area. I am a USF student that just met with Dr. Rosemurgy at Tampa General today. He is going to do my surgery on Dec. 23 and I highly recommend him. His fellow relayed that he has done over 800.

  3. #3
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    Ellie,

    From the research that I have done through doctors and the internet it is very improbable that a doctor will do a hiatal hernia repair without a fundo. This is because there is no evidence to suggest that just repairing a HH will result in a stronger LES and even if it was done methods used today would probably lead to re-herniation in a short time. I wish the opposite were true.

    -Dante

  4. #4
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    How about...

    Hi Ellie,

    I agree with Dante about the fundo, but the "Hill Repair" is another possibility if the HH is a small one.

    Many people have hiatal hernias and do not have reflux.
    If an injury like a car crash with whiplash or some heavy lifting preceeded the onset of reflux,
    then, that may require surgery to repair the attachment where the esophagus meets the diaphragm.
    Maybe another opinion would be wise before jumping into surgery?

    I hope you can still have some turkey tomorrow.
    Happy Thanksgiving regardless. :?)

    The Pard

  5. #5
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    Sep 2003
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    I think it would be a waste of time to repair the hernia and not have the fundo. The reflux is where the real problem is not the hernia. A chiropractic adjustment would not pull the hernia down. Most hernias slide up and down themselves.

  6. #6
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    Right about the hernia adjustment

    Hi Maxx,
    Remember a few months ago when somone mentioned
    drinking a liter of water and then jumping up and down to pull the stomach down? It was called the
    "Water Cure"

    Temporarary is the word, but if it helps some people to feel better for a short time, how can we knock it?

    There are some who have had the Hill repair, which consists of attaching a ligament between the diphragm and the esophagus. It prevents the sliding and keeps the angle of "HIS" close to normal. If it prevents the stomach from rising above the diaphragm and it does bring relief by stretching the esophagus and reduces the swallowing difficulties. There is a lot less
    rearranging of the insides and some do like the result.

    When we hear the difficulties that some experience with the fundo, it is strange that the simpler things are not given a chance first. They are
    in fact, not even mentioned by most docs.

    The Pard

  7. #7
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    Montreal
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    Say what?you've been reading in the wrong places

    I so disagree that a hiatal hernia cannot alone cause reflux-- A hernia is a significant finding--have read many reports which support this-- and while true -- not all hernias cause reflux-- a symptomatic one does-- all depending on the right physics -- large or small does not matter.--as the Cleveland Clinic states

    Before the Nissen repair-- people had their hernias only repaired-- and many remained symptom free. My fathers aunt had a hernia repair only-- and never had another swallowing problem in her life.

    A hernia can weaken LES pressure--which CAUSES reflux and that hernia is the direct cause of gerd

    Other factors---

    Such as - the gastroesophageal flap--When there is a hiatal hernia, the entry of the esophagus into the stomach is pulled up into the chest. Therefore, the gastroesophageal flap is distorted or disappears and it no longer can help prevent reflux.

    Dr Hill beleived-- and the Hill procedure is based on the premise that this gastroesophageal flap valve at the GE junction plays an important role in the prevention of reflux. --- and a hiatal hernia causes the distortion of this-- thus compromising the angle of HIS---

    There are lots of interesting studies online( have to pay to view them though) concerning this flap with cadavers with symptomatic hiatal hernias all with GI flaps either distorted or disappeared

    Here is also an other couple of ways a hernia can CAUSE or contribute to gerd-- a copy and paste word for word from the Mayo Clinic

    A hiatal hernia itself can often CAUSE or contribute to gastroesophageal reflux. This happens when a hernia displaces the lower esophageal sphincter a circular band of muscle around the bottom of the esophagus upward a few inches. Ordinarily, the diaphragm is aligned with the lower esophageal sphincter, which relaxes to allow food and liquid to flow into your stomach when you swallow. The diaphragm supports and puts pressure on the sphincter to keep it closed when you're not swallowing. A hiatal hernia displaces the sphincter above the diaphragm, reducing pressure on the valve and allowing it to open at the wrong time. In that case, stomach acid can flow up into the esophagus.

    A hiatal hernia can also cause heartburn if the herniated portion of your stomach becomes a reservoir for gastric acid, which can then easily travel up the esophagus

  8. #8
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    Say WHAT?

    Hi Tricia,

    I hope that that post was not directed at me...
    I agree with everything you have said.

    How long til you go to Shouldice?

    The Pard

  9. #9
    Join Date
    Feb 2003
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    Gastroesophageal flap

    Where does this flap end up after a fundo?

    Jasmine

    [i]Originally posted by Tricia [/i]
    [B]Such as - the gastroesophageal flap--When there is a hiatal hernia, the entry of the esophagus into the stomach is pulled up into the chest. Therefore, the gastroesophageal flap is distorted or disappears and it no longer can help prevent reflux.
    [/B]

  10. #10
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    Montreal
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    the flap

    Hi Jasmine- The esophagus normally joins the stomach at an angle-- not straight on Due to this angle -- the gastroesophageal flap is created-

    What it is exactly is just a flap of tissue---- but it serves as an additional barrier to reflux between the stomach and esophagus-The nissen procedure restores this flap

    No Pard -- Am still waiting on c t results before going there-- then i will be definately going regardless -- need some expert advice-- and they are the best

  11. #11
    Join Date
    Feb 2003
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    329

    Re: the flap

    Thanks!

    [i]Originally posted by Tricia [/i]
    [B]The nissen procedure restores this flap[/B]

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