Re: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

[Guest guest]

I was at the doctors today to discuss my upcoming treatment for two rather

significant kidney stones, and the doctor showed me my CT scans. I had seen

in the CT report that it mentioned I had a hiatal hernia but I thought the

report must have been wrong, but he showed it to me today and it clearly

exists. I am confused as I just had an endoscopy 4 or so months ago and this

wasn't mentioned to me. Surely this is something that the doctor would have

seen doing an endoscopy, isn't it?

I am wondering if anyone has any input about hiatal hernias after a myotomy

and if this is something that you would just live with or if it would

require surgical intervention?? Would it be causing more damage to live with

it? I cannot find much information, however, I did see this article by Dr.

Maish and Dr. Demeester and it states that when doing a myotomy

on a patient with a hiatal hernia, they use a Toupet fundoplication instead

of a Dor, which is what I have. Lots of videos and information here:

http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-5.html

So anyway, I was told today that I need to make an appointment to see my GI

doctor for the cause of the kidney stones (most probably malabsorption) and

because of the hiatal hernia, so now I am wondering who to call. Is a hiatal

hernia something they would want to do a re-do myotomy for? Dr Patti said I

wasn't a candidate.

[Guest guest]

wrote:

> I was at the doctors today to discuss my upcoming treatment for two rather

> significant kidney stones, and the doctor showed me my CT scans. I had seen

> in the CT report that it mentioned I had a hiatal hernia but I thought the

> report must have been wrong, but he showed it to me today and it clearly

> exists. I am confused as I just had an endoscopy 4 or so months ago and this

> wasn't mentioned to me. Surely this is something that the doctor would have

> seen doing an endoscopy, isn't it?

>

It is likely that a hiatal hernia would not be seen endoscopically. It

means that some of the stomach has pushed up through the diaphragm. It

would be hard to see where the diaphragm was from inside the stomach.

There are different types of hiatal hernias. The most common is where

the LES moves up into the chest and part of the stomach follows it. In

another type the LES stays in place and part of the stomach lower down

is forced up along side the esophagus. Over time, if not stable, the

entire stomach may fallow the part that went into the chest until all of

the stomach is in the chest above the diaphragm. I have one of these,

from heaving after surgery, but it is stable and there is no need to do

anything about it. Many people have hiatal hernias and have no symptoms.

In may of those cases there in no need to do anything. It is believed

that my hiatal hernia is why I have mild acid reflux if not on PPIs. You

are now one of the rare of the rare. You won't find much written about

hiatal hernias after heller myotomy. It may or may not require surgery

depending on if it is causing you trouble or not.

> ... I did see this article by Dr.

> Maish and Dr. Demeester and it states that when doing a myotomy

> on a patient with a hiatal hernia, they use a Toupet fundoplication instead

> of a Dor, which is what I have. Lots of videos and information here:

>

The Toupet makes a bigger knot which is very unlikely to push through

the diaphragm. That means it is unlikely that you would have the common

type of hiatal hernia with a Toupet but you could have the type where

another part of the stomach pushes up around and past the Toupet and

into the chest. I have a Toupet and that is what happened. This is

likely to be in spite of the myotomy and wrap and not because of it.

> So anyway, I was told today that I need to make an appointment to see my GI

> doctor for the cause of the kidney stones (most probably malabsorption) and

> because of the hiatal hernia, so now I am wondering who to call.

I see a urologist for my kidney stones. In my case they are calcium

oxalate from dehydration and oxalate containing foods. I had a large one

removed from my kidney by shock wave. No big deal, it is an out patient

procedure done while you are out. If you have a different type they may

need to do something else.

notan

[Guest guest]

I had a hiatus hernia before surgery and when Dr Rice did the surgery he

corrected it!!! Oh but guess what?? It has come back!!! I have a toupet

fundoplication also!!! I do have some reflux and I think that is why I have

a problem with foam again!!! Mine was mentioned after a cat scan also!! They

have also told me not to mess with it unless it causes me severe pain or

other issues!! So I guess I just live with it!

From: achalasia [mailto:achalasia ] On Behalf

Of Holt-

Sent: Thursday, November 13, 2008 12:32 AM

achalasia

Subject: RE: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

I was at the doctors today to discuss my upcoming treatment for two rather

significant kidney stones, and the doctor showed me my CT scans. I had seen

in the CT report that it mentioned I had a hiatal hernia but I thought the

report must have been wrong, but he showed it to me today and it clearly

exists. I am confused as I just had an endoscopy 4 or so months ago and this

wasn't mentioned to me. Surely this is something that the doctor would have

seen doing an endoscopy, isn't it?

I am wondering if anyone has any input about hiatal hernias after a myotomy

and if this is something that you would just live with or if it would

require surgical intervention?? Would it be causing more damage to live with

it? I cannot find much information, however, I did see this article by Dr.

Maish and Dr. Demeester and it states that when doing a myotomy

on a patient with a hiatal hernia, they use a Toupet fundoplication instead

of a Dor, which is what I have. Lots of videos and information here:

http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-5.html

So anyway, I was told today that I need to make an appointment to see my GI

doctor for the cause of the kidney stones (most probably malabsorption) and

because of the hiatal hernia, so now I am wondering who to call. Is a hiatal

hernia something they would want to do a re-do myotomy for? Dr Patti said I

wasn't a candidate.

[Guest guest]

wrote:

> I had a hiatus hernia before surgery and when Dr Rice did the surgery he

> corrected it!!! Oh but guess what?? It has come back!!! I have a toupet

> fundoplication also!!!

It is likely that the type of hiatal hernia you have now is different

from before. The part of the stomach that commonly moves through the

diaphragm in a hiatal hernia now has the wrap around it. That would be

too big to get through. If it is as I suspect, that another part of the

stomach has push up along the esophagus then it could be pushing on the

esophagus causing the area of the LES to be tighter than it should be

and giving you the foam problem.

> Mine was mentioned after a cat scan also!!

That is how mine was found too.

> They have also told me not to mess with it unless ...

If it happened shortly after surgery adhesions may hold it in place so

it will be stable and not progress.

notan

[Guest guest]

Thank you and notan,

This makes me feels much better as it doesn't seem to give me any problems

at all. It just made me worried to find out on top of everything else that

has been going on.

Living with it is definitely an option I can live with!

Thanks,

_____

From: achalasia [mailto:achalasia ] On Behalf

Of C. Warren

Sent: Thursday, November 13, 2008 5:38 AM

achalasia

Subject: RE: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

I had a hiatus hernia before surgery and when Dr Rice did the surgery he

corrected it!!! Oh but guess what?? It has come back!!! I have a toupet

fundoplication also!!! I do have some reflux and I think that is why I have

a problem with foam again!!! Mine was mentioned after a cat scan also!! They

have also told me not to mess with it unless it causes me severe pain or

other issues!! So I guess I just live with it!

From: achalasia@grou <mailto:achalasia%40> ps.com

[mailto:achalasia@grou <mailto:achalasia%40> ps.com] On

Behalf

Of Holt-

Sent: Thursday, November 13, 2008 12:32 AM

achalasia@grou <mailto:achalasia%40> ps.com

Subject: RE: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

I was at the doctors today to discuss my upcoming treatment for two rather

significant kidney stones, and the doctor showed me my CT scans. I had seen

in the CT report that it mentioned I had a hiatal hernia but I thought the

report must have been wrong, but he showed it to me today and it clearly

exists. I am confused as I just had an endoscopy 4 or so months ago and this

wasn't mentioned to me. Surely this is something that the doctor would have

seen doing an endoscopy, isn't it?

I am wondering if anyone has any input about hiatal hernias after a myotomy

and if this is something that you would just live with or if it would

require surgical intervention?? Would it be causing more damage to live with

it? I cannot find much information, however, I did see this article by Dr.

Maish and Dr. Demeester and it states that when doing a myotomy

on a patient with a hiatal hernia, they use a Toupet fundoplication instead

of a Dor, which is what I have. Lots of videos and information here:

http://www.ctsnet.

<http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-5.htm

l> org/sections/clinicalresources/thoracic/expert_tech-5.html

So anyway, I was told today that I need to make an appointment to see my GI

doctor for the cause of the kidney stones (most probably malabsorption) and

because of the hiatal hernia, so now I am wondering who to call. Is a hiatal

hernia something they would want to do a re-do myotomy for? Dr Patti said I

wasn't a candidate.

[Guest guest]

Notan,

Part of my stomach is above my diaphragm. It was repositioned in surgery,

because they actually cut my diaphragm to correct everything and when they

removed a portion of my E.they just kind of moved everything up! So I

believe that is what is causing the problem!!

From: achalasia [mailto:achalasia ] On Behalf

Of notan ostrich

Sent: Thursday, November 13, 2008 9:38 AM

achalasia

Subject: Re: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

wrote:

> I had a hiatus hernia before surgery and when Dr Rice did the surgery he

> corrected it!!! Oh but guess what?? It has come back!!! I have a toupet

> fundoplication also!!!

It is likely that the type of hiatal hernia you have now is different

from before. The part of the stomach that commonly moves through the

diaphragm in a hiatal hernia now has the wrap around it. That would be

too big to get through. If it is as I suspect, that another part of the

stomach has push up along the esophagus then it could be pushing on the

esophagus causing the area of the LES to be tighter than it should be

and giving you the foam problem.

> Mine was mentioned after a cat scan also!!

That is how mine was found too.

> They have also told me not to mess with it unless ...

If it happened shortly after surgery adhesions may hold it in place so

it will be stable and not progress.

notan

[Guest guest]

wrote:

> ... when they

> removed a portion of my E.they just kind of moved everything up!

I didn't remember that you had part of it removed. Your case is

different then. I am trying to picture this. Is your LES now above your

diaphragm? If so, where is the wrap?

notan

[Guest guest]

Oh, . I am sorry to hear that. I didn't know they could come

back. You hang in there....

InVA

>

>

>

> I had a hiatus hernia before surgery and when Dr Rice did the surgery he

> corrected it!!! Oh but guess what?? It has come back!!! I have a toupet

> fundoplication also!!! I do have some reflux and I think that is why

I have

> a problem with foam again!!! Mine was mentioned after a cat scan

also!! They

> have also told me not to mess with it unless it causes me severe pain or

> other issues!! So I guess I just live with it!

>

>

>

>

>

> From: achalasia [mailto:achalasia ]

On Behalf

> Of Holt-

> Sent: Thursday, November 13, 2008 12:32 AM

> achalasia

> Subject: RE: Hiatal Hernia, Kidney Stones,

Malabsorbtion, Oh my!

>

>

>

> I was at the doctors today to discuss my upcoming treatment for two

rather

> significant kidney stones, and the doctor showed me my CT scans. I

had seen

> in the CT report that it mentioned I had a hiatal hernia but I

thought the

> report must have been wrong, but he showed it to me today and it clearly

> exists. I am confused as I just had an endoscopy 4 or so months ago

and this

> wasn't mentioned to me. Surely this is something that the doctor

would have

> seen doing an endoscopy, isn't it?

>

> I am wondering if anyone has any input about hiatal hernias after a

myotomy

> and if this is something that you would just live with or if it would

> require surgical intervention?? Would it be causing more damage to

live with

> it? I cannot find much information, however, I did see this article

by Dr.

> Maish and Dr. Demeester and it states that when doing a

myotomy

> on a patient with a hiatal hernia, they use a Toupet fundoplication

instead

> of a Dor, which is what I have. Lots of videos and information here:

>

http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-5.html

>

> So anyway, I was told today that I need to make an appointment to

see my GI

> doctor for the cause of the kidney stones (most probably

malabsorption) and

> because of the hiatal hernia, so now I am wondering who to call. Is

a hiatal

> hernia something they would want to do a re-do myotomy for? Dr Patti

said I

> wasn't a candidate.

>

>

[Guest guest]

Notan

Only a small portion of it was removed, it was the portion that has

ballooned out into a " second stomach " as we called it!! Then when he did the

surgery and redid the wrap, cuz it was a nissen from the first stupid

doctor, he had to compromise where everything went!! You know I'm not really

sure where things are located exactly LOL!!! I just know that part of my

stomach is above my diaphragm now!! If I eat to much my left shoulder will

hurt from all the pressure in my chest cavity!! I guess it's a good way to

keep me from over eating LOL.

From: achalasia [mailto:achalasia ] On Behalf

Of notan ostrich

Sent: Thursday, November 13, 2008 10:59 AM

achalasia

Subject: Re: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

wrote:

> ... when they

> removed a portion of my E.they just kind of moved everything up!

I didn't remember that you had part of it removed. Your case is

different then. I am trying to picture this. Is your LES now above your

diaphragm? If so, where is the wrap?

notan

[Guest guest]

wrote:

> ... I just know that part of my

> stomach is above my diaphragm now!! ...

A hiatal hernia is part of the gut from below the diaphragm that has

moved up through it. Usually this is part of the stomach and then it is

usually the top part that connects to the LES. That is the part they

moved up in surgery. So, if they are saying you have a hiatal hernia are

they talking about something other than what was moved up in the

surgery? Could it be that whoever looked at your CT didn't understand

that you had this done in surgery and it is suppose to be that way now?

notan

[Guest guest]

Notan

I suppose that could be a strong possibility!!! I never thought of that!!

Once again Notan you go where I wouldn't have even thought of!!! I know I

don't have any real problems, so I don't take and PPI's cuz the last time I

did, it seemed to make it worse..go figure!!!

From: achalasia [mailto:achalasia ] On Behalf

Of notan ostrich

Sent: Thursday, November 13, 2008 11:37 AM

achalasia

Subject: Re: Hiatal Hernia, Kidney Stones, Malabsorbtion, Oh my!

wrote:

> ... I just know that part of my

> stomach is above my diaphragm now!! ...

A hiatal hernia is part of the gut from below the diaphragm that has

moved up through it. Usually this is part of the stomach and then it is

usually the top part that connects to the LES. That is the part they

moved up in surgery. So, if they are saying you have a hiatal hernia are

they talking about something other than what was moved up in the

surgery? Could it be that whoever looked at your CT didn't understand

that you had this done in surgery and it is suppose to be that way now?

notan

[Guest guest]

,

You will live well beyond 50---don't say such things! I also have a

very low-iron level and take massive doses of iron, which does not

cause constipation for me, but the opposite, and with the dumping

issues from the 'ectomy, I also take massive doses of Immodium.

Have they ever though about giving you iron infusions? I had those

before the 'ectomy and the infusions helped a lot.

Can you tell any difference with the diet?

Hugs from,

InVa

> >

> >

> >

> > I had a hiatus hernia before surgery and when Dr Rice did the

surgery he

> > corrected it!!! Oh but guess what?? It has come back!!! I have a

toupet

> > fundoplication also!!! I do have some reflux and I think that is why

> I have

> > a problem with foam again!!! Mine was mentioned after a cat scan

> also!! They

> > have also told me not to mess with it unless it causes me severe

pain or

> > other issues!! So I guess I just live with it!

> >

> >

> >

> >

> >

> > From: achalasia <mailto:achalasia%40>

> [mailto:achalasia <mailto:achalasia%40> ]

> On Behalf

> > Of Holt-

> > Sent: Thursday, November 13, 2008 12:32 AM

> > achalasia <mailto:achalasia%40>

> > Subject: RE: Hiatal Hernia, Kidney Stones,

> Malabsorbtion, Oh my!

> >

> >

> >

> > I was at the doctors today to discuss my upcoming treatment for two

> rather

> > significant kidney stones, and the doctor showed me my CT scans. I

> had seen

> > in the CT report that it mentioned I had a hiatal hernia but I

> thought the

> > report must have been wrong, but he showed it to me today and it

clearly

> > exists. I am confused as I just had an endoscopy 4 or so months ago

> and this

> > wasn't mentioned to me. Surely this is something that the doctor

> would have

> > seen doing an endoscopy, isn't it?

> >

> > I am wondering if anyone has any input about hiatal hernias after a

> myotomy

> > and if this is something that you would just live with or if it would

> > require surgical intervention?? Would it be causing more damage to

> live with

> > it? I cannot find much information, however, I did see this article

> by Dr.

> > Maish and Dr. Demeester and it states that when doing a

> myotomy

> > on a patient with a hiatal hernia, they use a Toupet fundoplication

> instead

> > of a Dor, which is what I have. Lots of videos and information here:

> >

>

http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-5.html

> >

> > So anyway, I was told today that I need to make an appointment to

> see my GI

> > doctor for the cause of the kidney stones (most probably

> malabsorption) and

> > because of the hiatal hernia, so now I am wondering who to call. Is

> a hiatal

> > hernia something they would want to do a re-do myotomy for? Dr Patti

> said I

> > wasn't a candidate.

> >

> >