Hiatal Hernia and Esophagitis

In Feb. 09 I had an endoscopy for pain while swallowing. I was diagnosed with mild esophagitis caused by GERD. I was put on Aciphex. I was also diagnosed with hiatal hernia during endoscopy. I already knew I had one because an upper GI series 6 years ago detected it. Even so, the doctor who performed the endoscopy, sent me to get another more current upper GI series. The results came back “no obvious hiatal hernia”, even though the endoscopy showed one and the upper GI series from 6 years ago did too.

Since the recent upper GI series said “no obvious hiatal hernia” my gastroenterologist said she doesn’t believe my GERD is caused by hiatal hernia.

I went to a surgeon who specializes in repairing hiatal hernias for another opinion. He told me that he believes my GERD is caused by hiatal hernia and I should get surgery to fix it. He said the upper GI series isn’t always accurate because you’re lying down during it so the severity of hiatal hernias isn’t always detected. Is this true? Is it possible hiatal hernias can be seen on endoscopy, then not seen on upper GI series?

I’m very confused. In your opinion, is my GERD caused by hiatal hernia? And, if so, should I get it fixed? Is taking proton pump inhibitors just putting a band-aid on the problem if the real cause is the hiatal hernia?

[Ratnakar Kini, MD]

Hi,
Not all GERD are caused by hiatal hernia and it is just one of the risk factors.

Upper GI series if not done properly can miss a hiatal hernia.
Upper Gi endoscopy can help to diagnose hiatal hernia. If not done properly, endoscopy can miss it too.
Surgery is only the last resort if the symptoms are not controlled by medications.

[Crystal8]

Thank you. Which alkaline powder should I buy? I do have a juicer. I'll definitely juice the celery. I'm frazzled right now and it seems the esophagitis is only getting worse because I can't totally get rid of the reflux, even with Aciphex. Any help is so appreciated.

[Crystal8]

Also, will you repost your original answer to me because for some reason it's disappeared from the forum. Thanks.