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Gastroenterology (Expert Forum)
HIATAL HERNIA AND "SEVERE" GERD
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
HIATAL HERNIA AND "SEVERE" GERD
by JO-AN, Jan 16, 1999 12:00AM
I WAS DIAGNOSED WITH A HIATAL HERNIA 2 YEARS AGO AND AS A RESULT WAS PUT ON 20MG OF PRILOSEC. THE HEARTBURN HAS PROGRESSIVELY GOT WORSE. I JUST HAD ANOTHER AN UPPER GI AND I WAS DIAGNOSED WITH A "SEVERE" CASE OF GERD. I AM CURIOUS TO KNOW WHAT THE SEVERE MEANS. WILL I BE ABLE TO CHOOSE TO HAVE THE SURGERY? I AM NOW TAKING 40 ML. OF PRILOSEC AND IT IS NOT GIVING ME MUCH RELEIF EITHER. IS PRILOSEC THE MOST EFFECTIVE MEDICINE PRESCRIBED FOR GERD. I HAVE BEEN ON EVERY OVER THE COUNTER ANT-ACIDS AND NOTHING WORKED.
I AM CURIOUS TO KNOW WHAT THE NEXT STEP IS WHEN PRILOSEC IS NO LONGER EFFECTIVE. COULD YOU ALSO TELL ME WHAT PERCENTAGE OF GERD PATIENTS DEVELOPE CANCER? I AM ONLY 29 (F) AND I CANT IMAGINE LIVING WITH THIS THE WAY IT IS NOW THE REST OF MY LIFE. IT IS RUINING MY LIFE.
WHAT ARE THE PERCENTAGES OF THE SURGERY BEING EFFECTIVE? I AN LIVING ON BAGLES AND WATER AT THIS POINT AND EVEN WATER GIVES ME HEARTBURN.
YOUR RESPONSE IS GREATLY APPRECIATED.
THANK YOU.
_____
Dear Jo Ann,
thank you fopr your email which has clearly ewcongnized a major problem, as evidenced by the number of responses that have been generated. Regarding therapy, proton pump inhibitors (either Prilosec or Prevacid) are potent inhibitors of acid secretion and relieve symptoms of esophageal reflux in most patients so treated. For the minority who fail PPI therapy, addition of a prokinetic agent can sometimes provide relief. If maximal medical therapy fails, then surgery should be conasidered.
Before undergoing an operation, it is necessary to verify that you have esophageal reflux which is responsible for your symptoms and that you do not have an esophageal motility disorder which can cause problems with swallowing after surgery. An esophageal motility study and 24 hr pH probe study will provide the necessary information. For some patients, gastric emptying studies are also done if there is a question of bloating and post prandial vomiting.
This information is presented for educational purposes only. Ask specific questions to your personal physician.
HFHSM.D.-rf
*keywords: esophageal reflux
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