Dear Sir,
Last month (November 2008) I requested a Gastroscopy because of severe epigastric fullness, early satiety, waterbrash, pain, vomiting and mild oesophageal burning.
The result of the Gastroscopy was that I had a moderately large paraoesophageal hernia (rolling) and a moderate sized sliding hiatus hernia. I commenced PPI's on the same day following Gastroscopy, with some alleviation of symptoms such as burning, waterbrash and vomiting but NOT the epigastric fullness, early satiety, palpitations or nausea.
I was referred three weeks ago to an upper GI surgeon to follow through on the Gastroscopy results. He immediately commenced me on an all liquid diet until the surgery date schduled for 9th January.
He also ordered a Barium meal which I had done earlier this week for him to have 'pictures' prior to the surgery to work from.
However it was quite a shock to be told following the Barium meal that they could see no abnormalities - a normal looking stomach! The surgeon said it would now be necessary for him to do his own repeat Gastroscopy which is scheduled for January 16th, plus he has ordered a nuclear gastric emptying study (scintigraphy) prior to the Gastrocopy to exclude Gastroparesis.
Under what circumstance would this happen? Why would the paraoesophageal hernia disappear? Did the Gastroenterologist who did the Gastroscopy get it wrong - he is very experienced? Can these hernias slip in and out of the thoracic cavity? Does it mean that there is a large enough opening or breach in the diaphragmatic opening for this to happen? How will a Gastroscopy determine the size of the diaphragmatic hiatal opening if all is in its correct position during gastroscopy ie. will they be able to tell if the stomach has been rolling upward?
I'm confused about all this to say the least! Can you cast any light on the why's and wherefores of this occurence?