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How Can Hiatal Hernia And Lax Sphincter Be Treated Apart From Surgery?
Question: If you have a hiatal hernia and a lax sphincter, is surgery the ONLY way of fixing this? Or can you do anything naturally to fix this or change the course of the muscle and hernia?
Brief Answer:
Can't fix it naturally or by medicine, We can control symptoms but the cure is surgery.
Detailed Answer:
Hello,
Hernia or lax muscle anywhere in the body can be fixed only by surgical procedure.
This is an anatomical problem so the cure is only surgery. Medicines are used for physiological problems only.
By medical therapy, we can control your symptoms but can't cure hernia or sphincter. For that, you have to go for surgery.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
Can't fix it naturally or by medicine, We can control symptoms but the cure is surgery.
Detailed Answer:
Hello,
Hernia or lax muscle anywhere in the body can be fixed only by surgical procedure.
This is an anatomical problem so the cure is only surgery. Medicines are used for physiological problems only.
By medical therapy, we can control your symptoms but can't cure hernia or sphincter. For that, you have to go for surgery.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hi
I'm having a barium swallow. Would it be able to tell about the sphincter and the hernia and if so, what size hernia or sphincter lax would be indicative of surgery? I mean do they do surgery on 2cm hernias? And what is the best surgery for this? Can you just fix the hernia?
Thanks so much!
I'm having a barium swallow. Would it be able to tell about the sphincter and the hernia and if so, what size hernia or sphincter lax would be indicative of surgery? I mean do they do surgery on 2cm hernias? And what is the best surgery for this? Can you just fix the hernia?
Thanks so much!
Brief Answer:
Follow up answer.
Detailed Answer:
Hello,
There is no size or degree of laxation required to perform surgery.
The protocol is patient is treated with maximal medical therapy consisting of proton pump inhibitors, Levosulpiride and Acotiamide.If patient remain symptomatic despite of maximal possible therapy we proceed for surgery.
Barium swallow will show the exact size and location of hernia.
No, they won't do surgery on two cm hernia instead they would give your proper medication for symptom control.
Fundoplication is the best one and safest and most commonly done.
What medications have you tried?
Why are you so desperate for surgery (just curious)?
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
Follow up answer.
Detailed Answer:
Hello,
There is no size or degree of laxation required to perform surgery.
The protocol is patient is treated with maximal medical therapy consisting of proton pump inhibitors, Levosulpiride and Acotiamide.If patient remain symptomatic despite of maximal possible therapy we proceed for surgery.
Barium swallow will show the exact size and location of hernia.
No, they won't do surgery on two cm hernia instead they would give your proper medication for symptom control.
Fundoplication is the best one and safest and most commonly done.
What medications have you tried?
Why are you so desperate for surgery (just curious)?
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I wonder because I am on a facebook group where lots of people have LPR, and Gerd, and they all question whether or not to have the surgery. My good friend on there has just found out she has a 4cm sliding hiatal hernia, and a lax sphincter. We are in Canada and she's about to go ahead with the surgery, where I think it's a bad idea. So I wonder really is it the best choice?
Brief Answer:
Surgery should always be last resort treatment.
Detailed Answer:
Hello,
Surgery or any other invasive procedure should always be the last resort treatment.
Secondly, it's not necessary that fundoplication is always successful. It has its own limitations and side effects.
Please request your gastroenterologist to start you on PPI-antacids like esomeprazole.Esomeprazole can be used in the dosage as high as 80 mg twice daily.
Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms.
Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back. Prokinetic should be added to your regimen.
An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.
Try them.in combination for 3 months and see how you feel.
Surgery should be considered if symptoms persist despite therapy.
Hope I have answered your query.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
Surgery should always be last resort treatment.
Detailed Answer:
Hello,
Surgery or any other invasive procedure should always be the last resort treatment.
Secondly, it's not necessary that fundoplication is always successful. It has its own limitations and side effects.
Please request your gastroenterologist to start you on PPI-antacids like esomeprazole.Esomeprazole can be used in the dosage as high as 80 mg twice daily.
Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms.
Also, request him/her to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back. Prokinetic should be added to your regimen.
An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.
Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.
Try them.in combination for 3 months and see how you feel.
Surgery should be considered if symptoms persist despite therapy.
Hope I have answered your query.
Take care
Regards,
Dr Ramesh Kumar, Gastroenterologist
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Above answer was peer-reviewed by :
Dr. Kampana
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