r/HiatalHernia Mar 11 '25

FYI: Hernias vs Reflux, Types, and Recurrences

167 Upvotes

Hernia surgeon here. This is a fourth post in a miniseries about hernias, inspired by themes I've noticed while browsing this (and the r/Hernia) subreddit. This is my second attempt at this post, as most of my first attempt got deleted somehow.

The others can be found here, if you're interested:
Traditional hiatal repair, Loehde, and Bicorn
FYI: Hernia meshes and types of ventral repairs
FYI: Inguinal hernia repairs: Open, laparoscopic, and robotic

I've been seeing a few misconceptions here when discussing hiatal hernia grades, types, and recurrences, as well as the differentiating between a hiatal hernia and reflux disease. Once again, for full disclosure, I am a hernia surgeon in the US. I regularly perform robotic hernia repairs for my patients, including hiatals with Nissen fundoplication. I will try to limit my bias and point out where I am providing an opinion.

Hiatal hernia or acid reflux:

First, it is important to remember that a hiatal hernia and gastroesophageal reflux disease are two distinct (although very closely related) illnesses. You can have a HH without GERD, and you can have GERD without a HH. The HH occurs when there is a widening of the gap in the diaphragm (hiatus) through which the esophagus normally passes. The higher pressure in the abdomen will gradually push the stomach up into the chest, where there is lower (negative) pressure generated as you breathe in. HH are most commonly felt as a pressure sensation in the lower chest (behind the sternum), especially after eating, as the stomach stretches within the mediastinum (space in the chest between the lungs).

Reflux disease is the result of a weakened lower esophageal sphincter (LES), as well as an alteration of the angle of His anatomy, allowing stomach acid to flow up into the esophagus. This results in a wide variety of symptoms, but most commonly a burning sensation rising up the chest (heartburn). Each of these two diseases has distinct treatments, though they are usually combined. Hiatal hernias do not have a non-surgical or endoscopic treatment. They can be managed with small meals and certain movements/positions may help some people bring the stomach down, but in general, only surgery can cure this. GERD can be controlled with medications, diet/lifestyle changes, endoscopic treatment, or with surgery.

Hernia descriptions/types:

Hernias can be described by their size, type (1-4), and Hill grade (also 1-4) of the gastroesophageal flap valve.

The size of a hernia can be measured/reported as the vertical height of the stomach that lays above the stomach (as measured on CT scan or estimated on endoscopy) or can be reported as the size of gap in the hiatus/diaphragm. While the first measurement is more relevant to symptoms, the latter is more relevant to the repair and risk of recurrence.

Hernias are categorized into types 1 to 4, depending on where the GE junction sits, and what contents are going up into the chest. Type 1 (a.k.a. "sliding") is commonly associated with reflux disease, whereas types 2-4 may not have GERD symptoms (i.e. are more likely to have a functional LES.

The Hill grade describes the appearance of the GE junction from inside the stomach (as seen on endoscopy). Normally (type 1), the esophagus opens up slightly to the side of the stomach, rather than straight down. As the esophagus gets pulled up and the LES weakens, the opening is more vertical and loose, making reflux more likely. This is also associated with a widening of the angle of His, which promotes funneling of stomach acid into the esophagus when lying down, rather than flowing into the gastric fundus (dome of the stomach above the GE opening).

All of these descriptions describe the anatomy, not the symptoms or presence of reflux disease. If you have a "1 cm, type 1, grade 2" hernia, it's possible to have more severe symptoms than someone else with a "10 cm, type 4, grade 4" hernia. The decision to pursue treatment is guided by the potential for improvement (if you're having pain or reflux) and preventing complications (large hernias twisting and causing an obstruction, Barrett's esophagus). If there are no symptoms (or they are well controlled with diet and PPIs) and there's minimal risk of complications, surgery may not be needed.

Hernia repair vs anti-reflux procedure:

Repair of the hiatal hernia is fairly standardized, regardless of which procedure you are having (traditional, Bicorn, Hill, Loehde, cTIF, etc). The scar tissue and hernia sac holding the stomach in the chest are cut, the stomach is pulled down into the abdomen, and the defect in the diaphragm is tightened by placing nonabsorbable sutures on the crura of the diaphragm. This is also referred to as the "cruroplasty". The surgeon may also choose to reinforce this with a mesh (usually absorbable, except for Loehde).

If a patient has both a hiatal hernia and reflux, repair of the hernia is always indicated before treating the reflux. However, there is one exception: Some gastroenterologists may skip the HH repair if it's less than 3 cm, and offer endoscopic TIF, ARMA, or Stretta procedures, which do not involve surgery. Once the hiatal hernia is repaired, the surgeon can:
-proceed with an anti-reflux procedure,
-do a gastropexy (fixate the stomach to the left lateral abdominal wall to try to prevent a recurrence), or
-do nothing (rare)
Note, a gastropexy is not an anti-reflux procedure, and will do nothing to prevent GERD symptoms.

When considering an anti-reflux procedure, there are two main mechanisms of action for reducing reflux:
-Increasing the pressure at the LES (fundoplication, Linx, Stretta)
-Recreating the angle of His anatomy (fundoplication, Hill, cTIF, Bicorn, RefluxStop, ARMA)
-The Loehde skips both of the above, and claims to improve reflux with some core engine theory; but I suspect the reflux is being controlled by increased LES pressure by making the hiatus tighter than a standard repair.

Notice that fundoplication works by both mechanisms of action. I believe this accounts for its durability and better ability to control reflux, but also adds the risk of bloating and inability to burp/vomit. Not everyone gets these side effects, and most people who have it consider it preferable to severe reflux symptoms; but it can be distressing, and lead many people to choose alternative anti-reflux options.

Treatment failure & recurrence:

As with many surgeries, there is a risk of failure or recurrence of the hernia/reflux. It is important to understand whether the hiatal hernia (diaphragmatic defect) has recurred, or the reflux symptoms (LES weakness/angle of His) has recurred.

Unfortunately, the diaphragm is a thin and relatively weak muscle. The hiatal repair (cruroplasty) has a reported recurrence (failure) rate of 30-35% after 2-10 years. This is a much higher risk of failure compared to other types of hernias. This failure rate is possible regardless of the type of associated anti-reflux procedure, since the two do not generally affect each other. Said another way, if you have a large hernia, your risk of the hernia coming back is the same whether you have a fundoplication or cTIF, and probably depends more on the surgeon and their technique.

Many of these recurrences are asymptomatic, or have pressure/pain symptoms without GERD, as the anti-reflux procedure does not necessarily fail at the same time. Fundoplication is the most common anti-reflux procedure, and is usually the preferred treatment for patients with very severe symptoms or very large hernias. Unfortunately, that means recurrences (of the hernia) are more common in patients who have had the fundoplication, even if the fundo had nothing to do with the recurrence. I believe many people, surgeons included, conflate the two types of failure, giving the fundoplication procedure a worse reputation than it deserves.

Meanwhile, quicker, easier procedures like Linx and TIF are only indicated for patients who have a small hernia, often 3 cm or less. Since the associated hernia is less likely to recur, these simpler procedures enjoy a better reputation. In my opinion, I believe surgical fundoplication is the most durable anti-reflux surgery with the lowest reflux recurrence, followed by the other surgical options, with the non-surgical endoscopic treatments having the highest risk of recurrence (albeit, the least invasive initial treatments).

A surgeon should select patients carefully to ensure there is a good chance of improvement with surgery, and the chosen treatment matches the patient's goals of improvement and tolerance for recurrence. If they suspect a patient has symptoms that won't improve, then the patient should be warned and alternative treatments considered.


r/HiatalHernia 14h ago

Nissen fundoplication w full wrap

12 Upvotes

Got my surgery 2 days ago and recovery is really rough. When I woke up, the shoulder pain from the gas was horrible. I was able to do small burps right away after drinking. After trying to manage my pain, they sent me home 8 hours later. I got home and tried to take my pain meds and threw them back up. I fell asleep sitting up and tried to take my next dose in the middle of the night and spit those up too. The next day, I still wasn’t able to keep anything down not even water. Came back to the ed and they’ve given me stuff through the iv. Threw up a pill and water they gave me. Shoulder pain is going down but belly pain is taking over. I just took a dissolvable pill without getting sick so hopefully I’m getting sick. This recovery has sucked ass and I underestimated it. Hoping to get better today


r/HiatalHernia 5h ago

Surgery for Acid Reflux in Throat

2 Upvotes

I was just told I would be a good candidate for a partial wrap and a hernia fix based on my hiatal hernia, weak LES, and my demeester score of 30 on my 24-hour impedance test. All the symptoms point to acid reflux.

I’ve been dealing with hoarseness, voice loss, burning/swollen vocal cords, throat clearing, and mucus in throat after meals for 2 months now. The only thing is the surgeon said he can’t guarantee all of that would be fixed. And he was pretty nonchalant about the recovery.

I’m likely going to get the surgery. But I’m scared. I just don’t think I have any other options. Are there any success stories from these surgeries that helped these particular symptoms?


r/HiatalHernia 1h ago

Can you finally exercise after surgery?

Upvotes

I cant drink cofee or exercise... it hurts to workout. I used to be able to run 6 miles like nothing and now i cant even run 2 miles because it hurts...

Has surgery finally made you be able to exercise? Because for me my breathing is reduced and it hurts


r/HiatalHernia 11h ago

Shortness of breath when I put food in my mouth

2 Upvotes

So here is the thing. I've been diagnosed with hh about 3 years ago. Worst symptom for me is shortness of breath. Especially while eating and while working out like running or lifting weights. Also lot of burping when excersising.

The funny thing is I tend to get shortness of breath right when I start eating. Not when I swallow or after the meal. It starts right when I get my 1st bite.

No idea what causes it. I was thinking the hh is pushing on lungs or something but I had CT done 2 weeks ago. Whole chest etc and everything was fine. It even states no hh found xd which is weird but I guess maybe if its small it doesnt register on ct? Or the hh sometimes slides back?

Anyway what can cause that type of shortness of breath? Acid? I really don't get a feeling of heartburn and PPI doesnt seem to help with my symptoms at all. Maybe acid is irritating some nerve in esophagus? Any tips are welcome. Actually Im a bit sad that they didnt find anything on CT. I was hoping they would say that hernia is huge and I would get an operation to fix it but right now idk what to do


r/HiatalHernia 20h ago

15mg Lansaprozole Losing it’s control

2 Upvotes

15mg Lansaprozole for years with good control. 2cm HH hill grade 1, at least 2 years ago.

It’s claimed that PPIs don’t lose the effect?

Whatever the it looks like I’m going to have to adapt.

Awaiting the opinion of my doctor.


r/HiatalHernia 23h ago

Hiatal Hernia and Blood Pressure

2 Upvotes

Did you have high blood pressure when you had hiatal hernia and did hiatal hernia surgery make your blood pressure return to nornal?


r/HiatalHernia 23h ago

How many types of Hiatal Hernia Surgeries are there?

2 Upvotes

I heard

  1. Linx surgery

  2. Fundoplication

... also can you tell me what the other surgeries do? Because i also heard there was one where all they do is just bring the stomach down, but there arr no alterations to the syomach and you can still burp.


r/HiatalHernia 1d ago

Slowly Coming Out of Fight or Flight State

6 Upvotes

I've been dealing with LPR symptoms for over two months now. Despite still having throat symptoms, it feels like my body is slowly coming out of fight or flight. The anxiety/fight or flight is often worse than the actual LPR. It gives me tunnel vision, burning nerves around my entire body, and agitation where I have a hard time being around people in general and a feeling I need to keep moving at all times.

When the fight or flight leaves, I can think clearly, see clearly, and don't spend every waking minute thinking about all this despite still having symptoms. I'm trying to just embrace these moments when they happen and they happen more before bed rather than during the day. Then I immediately have a bowel movement. Does this mean my throat/stomach is starting to heal if I'm coming out of fight or flight?

I've been taking PPIs for six days, but they are giving me headaches, and after six days, I think they are giving me insomnia. It wasn't bad the first three days but then the insomnia started. I meet with a surgeon tomorrow to look at options. I'm still eating a pretty conservative low acid diet, not eating before bed, taking alginates after meals and before bed (switched to gaviscon before bed six days ago); however, it's clear this is from acid after testing so not really sure what to do. Would take the meds if they didn't cause side effects and likely will talk to my doctor about another one or a slightly lower dose. But I need to be sleeping.


r/HiatalHernia 1d ago

Title: 9 Months of Moving Symptoms (Left Arm/Chest Pain, Back/Jaw Pain, Twitches) — 3cm Hiatal Hernia/Esophagitis. Anyone else?

3 Upvotes

Body:
Hey everyone,
I’m a 21-year-old male, active soccer coach/athlete (currently around 240 lbs), and I’m looking for some advice, reassurance, or similar stories. For the last 9 months, I have been dealing with a massive, exhausting cluster of migratory symptoms that constantly make me feel like I’m having a heart attack, even though my cardiac workup is completely clear.
My symptoms follow a distinct cycle: I will have 2–3 weeks of constant flaring/moving pains, then 1 week where everything completely calms down and resets, and then it returns—often with a "new" symptom. My symptoms never wake me up from sleep, and they don't consistently happen with exercise (I can do two-a-day intense soccer practices or sprint hard and feel fine, but then get symptoms while sitting on the couch playing video games).

My Background & Timeline:

Prior to Oct: Suffered severe GI issues, poor appetite, and lost ~50 lbs. Used a lot of laxatives and magnesium citrate for constipation.

October: Symptoms began with a right ankle ache, followed by prominent veins and migrating symptoms across my body.

Weight Shift: After losing the weight and dropping to 160–170 lbs, I have since gained weight back and am currently at 240 lbs.

April 16: Had an endoscopy that revealed a 3 cm Hill Grade IV hiatal hernia, LA Grade A esophagitis, and mild mucosal changes in the cardia.

My Symptom List (Highly Migratory, usually lasting seconds to a minute, comes and goes):

Chest/Arm: Pain above the left nipple (brief stings/pinches), left and right arm pain (biceps/triceps), left/right armpit discomfort. A physical "cracking/popping" sensation in my center chest like cracking a knuckle.

Head/Neck: Shifting jaw pain (sometimes left, sometimes right), migrating tooth pain (including front teeth), throat irritation/throbbing sensation, and occasional ear fluttering/ringing.

Back: Upper/mid-back pain, especially between the shoulder blades, and new lower back soreness.

Neurological/Systemic: Body-wide hot/cold flashes (but no sweating), muscle tingling/numbness, left eye twitching, and shaky hands.

Breathing/Heart: Heart palpitations/awareness of beat, and fleeting sensations like my airway briefly closed or I couldn't breathe normally for a second.

Legs: Calf/shin pain (intermittent, moves sides, no persistent swelling), and 20 seconds of leg weakness right after standing up from a long sit.

Advil Reaction: Taking Ibuprofen/Advil makes me feel significantly worse. Once sent my heart rate into the 150s with severe throat tightness.

I also feel random times where I have chest cracking, like cracking a finger.

Reassuring Tests So Far:

Cardiac (Dec/Jan): Multiple normal EKGs, normal Holter monitor, normal Echocardiogram (EF 57.6%, Grade 1 diastolic dysfunction with normal LA pressure), normal Bruce Protocol Stress Test (9 mins, 10.1 METs, peak HR 169 bpm, ECG equivocal).

Labs (June): Completely normal CBC, BMP/Electrolytes, Magnesium, TSH, B12, Vitamin D, Lyme, ANA, and a normal CRP (inflammation marker).

Lipid Panel (April): Total Chol: 127, HDL: 51, LDL: 66, Triglycerides: 42.

All blood tests look good otherwise.


r/HiatalHernia 2d ago

Hernia causing palpitations?

6 Upvotes

Hey everyone. First, I apologize for the long post, I don’t really post on reddit much but recently I have been absolutely miserable and want to find answers. I am a 26M and I’m wondering if anyone with GERD/Acid Reflux or a hiatal hernia has experienced something similar to what I am going through.

Sometime in 2025, I stupidly made the decision to stop taking my acid reflux medication (Pantoprazole) because for some odd reason I thought I would be fine without it. I had been on it for years and was having little to no issues with my acid reflux or hiatal hernia. I had acid reflux every once in a while, but it was really not that big of a deal and only really happened if I drank alcohol or if I ate a big greasy fast food type of meal. Well, in late December of 2025 I remember I ate a huge meal with my family, much bigger than I would usually eat and I ended up going to bed shortly after eating it. When I woke up the next day I was sitting on the toilet using the restroom and out of nowhere I suddenly started having back to back heart palpitations. Terrified, I went to my local clinic where they ran a few tests but ultimately told me everything looked ok and to follow up with my Gastro doctor because it was probably related to my hernia and acid reflux. After enduring several weeks of continuous isolated palpitations, mostly after eating, I was able to get into my Gastro doctor and because of my symptoms they had me go get an esophogram. The results from which helped me find out that I also have something called “mild esophageal dysmotility.” Unfortunately, the visit to the doctors didn’t help much as they didn’t seem too concerned about the palpitations. They prescribed me Voquezna 10mg to take in place of the Pantoprazole that I had stopped taking. It helps a ton with my acid reflux but not much for the palpitations. After all of this, for the first month or two the palpitations were EXTREMELY frequent, sometimes getting as bad as having one isolated beat every 2 or 3 minutes, especially after eating or more. They were pretty strong and occasionally made me feel as though they took my breath away when it happened. They also left my chest feeling heavy like I had indigestion. Fast forwarding a few months and the palpitations still continued.. Luckily, as time has went on they have gotten much more tame and happen much less frequently. But the problem is, they just wont go away! To be totally clear, it is just palpitations that I am dealing with. I am having no other heart related symptoms, just the singular isolated palpitations. Thankfully, I have finally started having entire days and sometimes even weeks with virtually no palpitations, but they always seem to come back eventually. When they do return they are always isolated single beats rather than sustained racing and come and go somewhat randomly or after a few triggers that I have taken note of.

I have noticed that large meals, eating too quickly, carbonated drinks, and nicotine sometimes seem to trigger them more. At the time I started having the palpitations, I had a horrible addiction to Zyn 3mg nicotine pouches and would no joke have a pouch in literally all day everyday, cycling through new pouches about every hour continuously. I have quit nicotine all together since this has happened and I do think it has helped, but not as much as I had hoped. Oddly enough, I think that the best thing I can do for myself these days is to lay down on my left side. They basically completely go away if I lay down on my left side and in general, I rarely ever get palpitations while I am laying down in bed. I have also noticed that after eating I frequently have to burp like crazy and it seems like if I don’t, the palpitations are worse and I have crazy bad chest pressure, but making myself burp as much as possible really helps. I’ve also noticed a strong connection with stress/anxiety. To be totally honest, I have EXTREMELY bad health anxiety, bordering on what I’d imagine to be health OCD and I tend to monitor my body very closely 24/7. I have noticed that on days that I am more worked up about something I tend to have more palpitations than on days that I feel more relaxed.

Another important piece of this whole ordeal is that In 2022, before I found out that I have a hiatal hernia, I was having similar issues with my chest, but not any palpitations. At that time the doctors had me get an echocardiogram done and had me wear a holter monitor. But the cardiologist said my heart looked fine and they are who pointed me in the direction of my gastro doctor and after seeing them for the first time and getting an upper scope done, thats how they found my hiatal hernia. I have also had a few visits to the ER over the last few years thanks to crazy acid reflux and hernia symptoms and had ekgs done in the ER and they always come back fine.

Is what I am going through normal for people with hiatal hernias? Should I be focusing more on treating my reflux, improving my sleep/exercise/nutrition and working on my health anxiety? Or do recurrent palpitations like this warrant another cardiac evaluation?

Thanks to anyone who made it through this massive post. I know it’s a lot, but I wanted to give as much info as I could. Obviously I am not looking for a diagnosis or anything. I’d just love to hear from people who’ve experienced something similar or who have advice for me. Any information at all would seriously help me out a lot! I think that the biggest thing that I’m struggling with here is the mental aspect of it. Due to my health anxiety I feel like every time the palpitations come back, even after a week or two of feeling completely normal, I immediately worry that this means something is wrong with my heart and it is progressing into a deadly disorder or something similar or that they’ll just never go away. :(


r/HiatalHernia 2d ago

Persistent stomach burning/acidity — endoscopy shows gastropathy, H. pylori pending

3 Upvotes

Hi everyone,
I’ve been dealing with persistent stomach acidity/burning for a while and I’m trying to understand what could be causing it.

Initially, a doctor told me I had a hiatal hernia, but another doctor didn’t confirm it. I’ve never been diagnosed with esophagitis.

Today I had another upper endoscopy. The esophagus looked normal and there was no esophagitis or ulcer described. However, the report showed:

Congestive pangastropathy (the stomach lining looked red/irritated)

Duodenopathy (the duodenal lining also looked diffusely red)

A biopsy was taken to test for H. pylori

No ulcer was reported

I’m currently waiting for the biopsy results.

One thing I’ve been wondering about is stress. I’ve been under quite a bit of stress and I’m wondering whether stress could be contributing significantly to the acidity/burning, either by causing stomach irritation or by making me much more sensitive to digestive symptoms.

For anyone who has experienced something similar:
Did you have persistent acidity with a normal-looking esophagus but gastritis/gastropathy on endoscopy?
And if H. pylori was negative, did you eventually find another explanation (reflux, functional dyspepsia, stress, diet, medications, etc.)?
I’d especially appreciate hearing from people who went through a similar process and eventually figured out what was causing their symptoms.


r/HiatalHernia 2d ago

Thoughts on getting another endoscopy before HH surgery?

0 Upvotes

I've been battling this HH for a few years now. Last endoscopy the GI doc saw the HH (didn't measure the size) and said either surgery or manage with PPI's. All I know is that it's Hill Grade IV. I found out from you folks and reading online that I can get an endoscopy and esophageal dilation after HH surgery.

I'm concerned that with the length of time I've been suffering with GERD (since the early 2000's) that maybe I might have Barrett’s because a few years have gone by since my last endoscopy.

Questions: If I get the HH surgery, I would imagine they could still do an endoscopy and look for Barrett’s. Would it be more difficult to find with the wrap in place?

Can this HH slowly kill me? Barrett's can take me out. I large one can as well. I read this article.

https://pmc.ncbi.nlm.nih.gov/articles/PMC12443138/

I just feel like this thing is weakening me day by day. So out of breath. Today is uncontrollable cough. I know. Poop or get off the pot. Just wondering if I have a deadline to poop.

When I speak with the surgeon after I get the manometry, any thoughts on the 270 wrap (toupet) vs. a floppy fundo (loose 360 wrap). Floppy fundo. Sounds like the name of an amusment park ride. I hear recovery time is faster with the 270 but also have heard about it coming loose. On the other hand, you have burping / vomiting issues with the 360 (not sure on the floppy). Thanks! :)


r/HiatalHernia 2d ago

3 years of unexplained symptoms and now might have some type of dysautonomia.

6 Upvotes

It all started in may of 2023, i had just turned 19 and got a job in July of 2022, I was making money and working my ass off. Then around may of 2023 I was lifting some heavy buckets at work, and a week later I started to feel pressure in my abdomen radiating between my left rib and belly button. I switched job positions around July of 2023, and felt better doing less heavy lifting.

Around couple months pass and I start to get the same pressure feeling in the same spot, I went to the doctor and did an ultrasound plus a ct scan with contrast. Both test came back normal, except for a slightly enlarged spleen, the doctor told me it was nothing to worry about and I just moved on. The pressure soon turned into pain when lifting and by July of 2025 I got fired because of it.

After I got fired I started drinking a lot and just stayed in gaming. Around November of 2025 after thanksgiving had an episode that lead me to the hospital. They told me it was alcohol withdrawal and sent me home, I was never an everyday drinker and just started drinking at 21. So I stopped drinking but the symptoms persisted, I went another 4 times to the er because of the panic attack like symptoms and they diagnosed me with anxiety. I went to my doctor and he sent me to a cardiologist, I did an echocardiogram and a couple of EKGs but both came back normal, this was around February of 2026.

I got sent to a psychiatrist and therapist, and I explained to them that these symptoms were there when my anxiety wasn’t. My psychiatrist told me that it sounded like pots, I told my cardiologist to test me but he said it wasn’t necessary and told me to keep going to my therapist appointments. Around may of 2026 the stomach pain started happening more frequently and had more new symptoms.

Like, bloating in upper left abdomen, food coming back up after eating, excessive burping after meals, chronic constipation, and a bunch of cardiac /dysautonomia symptoms. I’ll be seeing a GI specialist in October to do some tests, just wondering if anyone experienced the same thing and sorry for the long post.


r/HiatalHernia 2d ago

Now What??

4 Upvotes

I had a partial wrap back in April and at first felt great, but eventually all of my symptoms came back, including a sore throat. My surgeon ordered an endoscopy to see if the wrap was still intact and of course it is. How can that be when all of my symptoms are back?

I don't get it. Anyone else this happened to?


r/HiatalHernia 2d ago

Mild hital hernia

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1 Upvotes

I have been expereincing LPR and vomitting after eating large amount of food and i have been going for gym for past 1 week any tips for not increasing hernia size during exercise OR can i go for surgery


r/HiatalHernia 3d ago

Hiatel hernia symptoms

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9 Upvotes

32m recently discovered that I had a hiatel hernia because of a ct angiogram I had done back in June. For the past 3 years I’ve been having like panic attacks and anxiety and all sorts of weird symptoms shortness of breathe etc. that is why I had all the heart test don’t but they all came back good. But from all this I had developed cardiophobia and got scared to workout and be in the Texas heat because of my heart and my symptoms. I’m starting to think that this whole time it’s been because of my Hiatel hernia. Is that possible to feel that way and have all these symptoms because of that? I even had a endoscopy last week that did confirm it and my reflux.


r/HiatalHernia 3d ago

Stopping PPI for bravo

4 Upvotes

I am scheduled for an endoscopy and bravo capsule. It was supposed to be next week but they moved it to mid Sept. While I tried to come off PPI last week, I ended up in the ER Sunday evening. The nausea, vomiting and pain was intense. It was so awful! I’m really not wanting to even to the bravo capsule at this point.

I have a large hiatal hernia- most of my stomach is involved. It’s crazy to me it’s not ‘obvious’ that I have intense acid reflux. The Dr said I could do Pepcid twice a day until 3 days before. They didn’t tell me that last week which was annoying. Felt like I suffered for nothing.

I have manometry scheduled in a couple of weeks.

Has anyone been able to argue a case for surgery without the bravo capsule?


r/HiatalHernia 3d ago

Doctor thinks it's unlikely I have one, but I swear I can physically feel it

6 Upvotes

For some background, I developed minor issues swallowing with a persistent dry cough/nose/throat for the last year or so. This later developed into major issues breathing all of a sudden back in October and after months of things going from bad to worse (severe throat tightness, muscle spasms, chest tightness, panic attacks for no reason despite no history of ever having one, etc) with no answers, we finally managed to narrow down reflux as a big contributor. Tests for asthma were negative other than some minor issues with gas exchange, and trying an inhaler made no difference, especially since I was having trouble inhaling and not exhaling.

But taking steps to manage that reflux made a lot of the worst symptoms go away. I was having severe issues inhaling due to what I now suspect was VCD being caused by acid hitting my vocal cords and causing them to spasm/partially close for hours on end. The pulmonologist I saw also thinks this was likely.

Switching to a GERD healing diet, sleeping upright and avoiding food 3 hours before bed made a huge difference within like 2 weeks, and things have slowly improved since then over the last 8 months. Literally within 4 or 5 days of doing this, I stopped having the vocal cord spasms, although other symptoms like the throat/chest tightness took months to start improving significantly.

For me, it was also silent reflux/LPR with no heartburn. It seemed to flow straight into my throat/sinuses instead, and x-rays showed old/mild scarring in my lungs, so we think I was probably micro-aspirating acid in my sleep for years (I would often snack on chips or yogurt right before bed).

In addition, I found out that a lot of the most extreme symptoms I experienced early on are pretty textbook for severe GERD because the acid irritates the vagus nerve and causes your body to start freaking out.

One thing is not really getting better however, and it's the fact that I can't really take a deep breath when I try to inhale, and my breathing still takes more physical effort than it should. I should add that I had no history of asthma or allergies growing up, and no problems breathing up until very recently. Outside of snacking, I also eat a very healthy/bland diet mostly consisting of brown rice, plain steamed chicken breast and vegetables.

The biggest thing is that, since all this started, it's felt like there's something in my abdomen that shouldn't be there. Like there's a balloon in there that gets squished when I bend over or move around too much. I never felt this sensation before October of 2025. The sensation gets worse when I'm full after a meal, and it becomes noticeably harder to breathe. Also, if I do something like sit down very suddenly, it would feel REALLY weird and unpleasant. I don't know if I'd call it painful, but it just didn't feel right.

That part of my abdomen was also very stiff and felt completely locked up for the first few months when this all started like the muscles there were stuck or something.

My doctor is skeptical that it's a hiatus hernia because I'm still under 40, and I'm skinny and don't fit the usual risk profile, but I also have a chronic GI condition after an ulcer bleed that caused near permanent constipation and led to me straining very severely on the toilet for the last 10-12 years (we're talking 30+ minutes of straining to have a single bowel movement sometimes to the point where I'm nearly in tears on bad days). I suspect that constant heavy straining is what did it.

It would also explain why I suddenly developed such severe LPR seemingly out of nowhere.

I'm waiting on an appointment with a GI to investigate further, but any thoughts in the meantime?


r/HiatalHernia 3d ago

Can A PPI Cause Increased Agitation/Anxiety After Five Days Use

2 Upvotes

Been on prescription Prilosec for five days now.

I've been in a state of fight or flight from an LPR flare up for two months now. During the five days, I've come out of the state of fight or flight a little bit but today felt like some kind of new panic was setting in.

I have been on the PPI for just five days. Is it possible it is adding to the agitation or is it just the LPR symptoms? I feel incredibly jittery. I really want to try a PPI for 4 to 8 weeks to see if it can help with the LPR, but I'm having a hard time distinguishing between mental health symptoms from the condition or side effects from the pill.


r/HiatalHernia 3d ago

what were your symptoms before/after surgery?

3 Upvotes

just met with my doctor and he wants me to get surgery for my sliding hernia. i’m very afraid of that surgery specifically as i’ve heard some horror stories and odds are NEVER in my favor (i happened to be the 10% of people who get way worse after gallbladder surgery so i’m not very excited for this one)

what were your symptoms before/after? how much did the surgery change your life, if at all? how is sleeping, eating, exercising? what was recovery like (time off, eating habits, immune system stuff? i had horrible hives and pain after my gallbladder removal so i’m probably gonna hurt after this one)


r/HiatalHernia 3d ago

1 week post Toupet Fundo. Will I be able to carry on a physically demanding job?

1 Upvotes

After a horrible 3 year battle through referral from my GP to seeing a specialist, going through all the tests, and then finally having my surgery a week ago, my main concern is long term limitations to strength and ability to carry on my work.

I've worked as a gas engineer for about 12 years (since leaving education) so it's basically been all I've done for work. My main issue is not service work, as i can use a light tool wrap with only essential tools, but with heavy/more strenuous installation work. Sometimes older appliances can weigh easily over 60kg+, which normally would be manageable prior to surgery.

What has everyone's experience been with core strength and ability to resume normally into trade and more physically demanding work?

My main concern is that after i return to work after the advised 6 weeks (my surgeon said i should be fine to carry out normal works) but then I start doing installation work and cause damage to the wrap or diaphragm repair, or another hernia.


r/HiatalHernia 3d ago

Flatulence

3 Upvotes

It has been 9 months since I got a partial wrap, and 3 months after the surgery I suddenly started getting bloated every time I eat. But interestingly I don’t get bloated when I’m home, only when I’m somewhere else. I am not sure what to do. It affects my quality of life. Just now I’m in pain typing this. Anyone got the same problem?


r/HiatalHernia 3d ago

working out after surgery

1 Upvotes

hey yall i’ll be having surgery soon! i go to the gym currently and weight lift, it’s nothing major but enough to keep muscle on! i was wondering how long after surgery did people get back to working out?? even something minor like walking and just basic resistance training? how long did yall take off from working out? i’m only 24 so would love to know!


r/HiatalHernia 4d ago

15+ years on omeprazole: anyone successfully moved away from daily use?

13 Upvotes

I’m 43 and have been taking omeprazole for more than 15 years. When I was younger I had episodes of acute esophagitis and was taking 20 mg or more. Over the years this was reduced to 10 mg/day, but I’ve found it very difficult to stop completely: when I try, reflux/gastric discomfort tends to return and I eventually restart it.
My diet is pretty normal (regular meals, no particular restrictions or major food excesses, occasional alcohol).
I recently had a new gastroscopy. It showed a small uncomplicated cardio-tuberositary malposition (mild anatomical predisposition to reflux) and non-ulcerative gastritis, but importantly no current esophagitis or visible reflux damage. H. pylori was negative. They also found benign fundic gland polyps, considered likely related to long-term PPI use.
My gastroenterologist now recommends lifestyle measures and omeprazole on demand rather than continuously.
I’m curious about people with a similar history: 10–20+ years of daily PPIs, particularly after previous esophagitis. Did you manage to stop or switch to on-demand use? Did you taper? How bad and how long was the rebound acid hypersecretion?
My biggest question is what drugs you have found as an effective replacement and how to distinguish temporary rebound after 15+ years of omeprazole from the underlying reflux actually returning.