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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Hiatal Hernia And Gastroparesis

Hi, I was recently diagnosed with a medium sized hiatal hernia, a friable esophagus that after being biopsied shows pre-malignent cells and on top of everything else, gastroparesis. I have been doing some research and while I totally understand that GP is extremely hard to treat (I do not have diabetes) a pace maker only stands a 50/50 chance of working or there are meds out of Canada that I could try... I did find a few accredited articles stating that having the hiatal hernia corrected could relieve some of my GP symptoms and even reduce the risk of my pre-cancerous cells turning into anything more concerning. My doctor mentioned that IF I could find a surgeon willing to do the *pace maker* surgery and IF my insurance covers it, he doesn t see a problem with moving forward with that route. However, if a hernia correction procedure is less invasive and could also ease my GP symptoms along with my hernia symptoms etc, doesn t that seem like the more logical route to approach? I am having one final test done in a few days to check the motility and strength of my esophagus. If it shows that it is a s weak as my doctor feels it is, what would be my best option to proceed? I am just feeling a bit overwhelmed with so many issues jumping out at me all at once and I am trying to organize my best, safest and most effective ways to approach it all. Any advice is appreciated. Thank you so much!
Fri, 19 Feb 2021
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General & Family Physician 's  Response
Hi,

Primarily you have two conditions, hiatus hernia and gastroparesis. The treatment available for hiatus hernia is surgical correction which has been already suggested by the treating doctor. The symptoms which you are perceiving with both hiatus hernia and gastroparesis may improve with the surgical correction of hernia. Also, there are few dietary modifications which can also ease symptoms in your case like avoiding large meals, fiber rich and spicy food, increase more liquid in your diet avoiding fizzy drinks and alcohol.

There is a procedure called POP (per oral pyloromyotomy) which is done with an endoscope without any active surgery. The opening of stomach is widened so that the food passes through easily. It is recommended that you take this procedure and in the second step you can think of gastric stimulator (mentioned as pacemaker surgery in your info) if this doesn't ease your problems. Change in dietary habits as suggested above along with cessation of smoking and alcohol, if present, may also arrest your pre malignant condition.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Anoop Kumar, General & Family Physician
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Suggest Treatment For Hiatal Hernia And Gastroparesis

Hi, Primarily you have two conditions, hiatus hernia and gastroparesis. The treatment available for hiatus hernia is surgical correction which has been already suggested by the treating doctor. The symptoms which you are perceiving with both hiatus hernia and gastroparesis may improve with the surgical correction of hernia. Also, there are few dietary modifications which can also ease symptoms in your case like avoiding large meals, fiber rich and spicy food, increase more liquid in your diet avoiding fizzy drinks and alcohol. There is a procedure called POP (per oral pyloromyotomy) which is done with an endoscope without any active surgery. The opening of stomach is widened so that the food passes through easily. It is recommended that you take this procedure and in the second step you can think of gastric stimulator (mentioned as pacemaker surgery in your info) if this doesn t ease your problems. Change in dietary habits as suggested above along with cessation of smoking and alcohol, if present, may also arrest your pre malignant condition. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Anoop Kumar, General & Family Physician