Question Title: Hiatal Hernia or Anorexia?

My niece is nineteen and has thrown up after every meal since
just before Thanksgiving. Her family doctor sent her to a
gastro?specialist who diagnosed a hiatal hernia but insists that
the real problem is anorexia and has prescribed no treatment for the hiatal hernia. An associate confirmed the diagnosis though
no additional tests were done. We are searching for another doctor for a third opinion. Could the hiatal hernia be the real problem. My niece has lost over 40 lbs. and is, needless to say, becoming depressed over the situation. Should she see another gastro? specialist or may there be something still not
diagnosed that may be beyond gastro-digestive? Thank you for your advice.

Dear Cris,

A hiatal hernia (unless it is very large and causing obstruction)is a fairly common finding and usually asymptomatic. Hiatal hernia can sometimes be associated with gastroesophageal reflux disease. The weight loss, nausea and vomiting are concerning symptoms. An eating disorder is certainly a possibility, but other gastrointestinal illnesses such as a primary motility disorder (achalasia, gastroparesis, scleroderma, intestinal pseudo-obstruction)or mechanical obstruction should also be considered. There are definite criteria necessary to confirm or exclude an eating disorder and if there is any possiblity that your niece may have an eating disorder she should be evaluated by a psychologist or psychiatrist.
Other causes of chronic nausea and vomiting include: pregnancy, central nervous system disorders, hyperthyroidism and drugs. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: chronic nausea and vomiting, weight loss, differential diagnosis

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