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Hiatal hernia and gastric sleeve



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I’m scheduled to get my sleeve in a month (yay!) but I’m afraid it’ll worsen my gerd. I’ve heard on here that some people get their hiatal hernias fixed when they get their surgery. Does having a gastric surgery automatically fix the hernia or is it something extra that your doctor has to do? I developed a tiny hiatal hernia over the last year and I’d like to have it fixed with my surgery. My surgeon knows about it but hasn’t mentioned anything regarding fixing it. Should I bring it up beforehand or is it something that gets fixed with surgery anyway?

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Certainly mention it to him so that he is prepared for it, but it is typically something that they do automatically as pare of the WLS (they probably can't do the WLS without correcting the hernia.) Many don't know that they had one when they went in for surgery and the surgeon just mentions that he fixed it while he did the sleeve.

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Thanks! Because of the logistics of the procedure I thought they would have to repair it anyway (in diagrams it looks like they remove the top part of the stomach that would be herniated) but I’ll let him know beforehand that I have one and want it fixed if possible while he’s in there

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I’m one who had an unknown hiatal hernia repaired during surgery. I had situational reflux (only happened with certain foods) so I’m hoping the repair will eliminate it altogether. I’ve been put on omeprazole for a while so no reflux at all so far.

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I, too, had an unknown hiatal hernia repaired during surgery. They essentially need to otherwise the food could get stuck. I would just be sure the surgeon knows ahead of time. Mine was surprised but acted as if it was no big deal.

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On 2/23/2021 at 6:02 PM, NiceAnkles said:

I’m one who had an unknown hiatal hernia repaired during surgery. I had situational reflux (only happened with certain foods) so I’m hoping the repair will eliminate it altogether. I’ve been put on omeprazole for a while so no reflux at all so far.

Hi

Why are you on a omeprazole or any PPI? (It's a very hard medicine to get off of and has horrible side effects.) There are a ton on PPI lawyers that make a nice living off of that drug. Wondering why your doc would automatically put you on it. Is this a new standard? I had my surgery 14 years ago and am on the hunt a some sort of help with crippling VSG GERD. I've been trying to get of PPI's for years - but wasn't put on them until a few days after surgery and I struggled...

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2 hours ago, KateinMichigan said:

Hi

Why are you on a omeprazole or any PPI? (It's a very hard medicine to get off of and has horrible side effects.) There are a ton on PPI lawyers that make a nice living off of that drug. Wondering why your doc would automatically put you on it. Is this a new standard? I had my surgery 14 years ago and am on the hunt a some sort of help with crippling VSG GERD. I've been trying to get of PPI's for years - but wasn't put on them until a few days after surgery and I struggled...

I don’t know if it’s standard for my clinic’s practice or for those who had a hernia repair during surgery. I am on omeprazole to prevent a stress ulcer. I have a clinic visit in a couple of weeks when I believe we’ll visit taking me off it. Why do you say it’s hard to get off? I’m so sorry about your situation. I will definitely ask lots of questions at my next appointment. You’ve given lots to think about.

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Posted (edited)

For those who report not knowing you had a HH before surgery, did your surgeons not do a EGD before your surgeries and tell you if he saw anything? My program schedules everyone for one and that's when he noticed mine and explained that he would fix it during my sleeve surgery. I interviewed two surgeons and both had that procedure in their pre-op process. Ironically my program's booklet, it mentions doing an EGD during the sleeve surgery and fixing any hernias that they see at that time with the goal of reducing issues with acid reflux for patients after the surgery. So, maybe some people dont do one in advance. I had read on here horror stories about acid reflux after the sleeve. I do not want that issue. So, from the very beginning, I've talked with my surgeon a lot about my concern about having that issue after the sleeve. He assured me from that first visit that he would look for a HH or anything else that might trigger acid reflux during the EGD and if he found anything, he would fix it during surgery so I won't have to worry about acid reflux later. When I did my EDG in Jan, my surgeon said he saw a small HH. He showed me a picture of it inside my stomach, and explained that he would fix it during my surgery. I don't want to be taking medication or have major Gerd afterwards. I see my surgeon Monday for my pre-op appointment. I will talk with him again about my concerns. Like others have said, I also dont want to be taking PPIs. Not ok with me.

Edited by Blueslily

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On 3/27/2021 at 7:05 AM, Blueslily said:

For those who report not knowing you had a HH before surgery, did your surgeons not do a EGD before your surgeries and tell you if he saw anything? My program schedules everyone for one and that's when he noticed mine and explained that he would fix it during my sleeve surgery. I interviewed two surgeons and both had that procedure in their pre-op process. Ironically my program's booklet, it mentions doing an EGD during the sleeve surgery and fixing any hernias that they see at that time with the goal of reducing issues with acid reflux for patients after the surgery. So, maybe some people dont do one in advance. I had read on here horror stories about acid reflux after the sleeve. I do not want that issue. So, from the very beginning, I've talked with my surgeon a lot about my concern about having that issue after the sleeve. He assured me from that first visit that he would look for a HH or anything else that might trigger acid reflux during the EGD and if he found anything, he would fix it during surgery so I won't have to worry about acid reflux later. When I did my EDG in Jan, my surgeon said he saw a small HH. He showed me a picture of it inside my stomach, and explained that he would fix it during my surgery. I don't want to be taking medication or have major Gerd afterwards. I see my surgeon Monday for my pre-op appointment. I will talk with him again about my concerns. Like others have said, I also dont want to be taking PPIs. Not ok with me.

My surgeon did not do an EGD prior to surgery. I was also diagnosed with H-pylori when they biopsied my stomach tissue and had to do a 2 week run of antibiotics at 4 weeks PO. The antibiotics gave me reflux but once that was done I have not had any at all.

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1 hour ago, mweiss1998 said:

My surgeon did not do an EGD prior to surgery. I was also diagnosed with H-pylori when they biopsied my stomach tissue and had to do a 2 week run of antibiotics at 4 weeks PO. The antibiotics gave me reflux but once that was done I have not had any at all.

My surgeon did do a EGD. He did not find a hernia, and because I never had GERD, he assured me that the odds of me developing acid reflux were “extremely unlikely”. They’ve learned a lot since my surgery- it was so long ago. The real question is - how many of your surgeons patients suffer from it? What is the exact percent - not a guesstimate. How do they keep track? How do they address it when it happens?

My surgeon told me “it’s really rare”, and his partner recently wrote a paper (2020) stating 30% of their patients ended up on PPI’s. That’s not “rare” to me. And the practice I went to was highly regarded and considered “the best” in California. I did extensive research. Unfortunately the internet wasn’t what it is today.

When patients started begging to get a bypass because the pain/medicine side effects were too great, I think some Doctors started listening and altered techniques.

Ask if he automatically puts you on a PPI after surgery. Not a good sign. Many put you on PPI’s, and are completely out of the picture when you start developing PPI problems - dependency months , years down the line.

Some doctors attach the sleeve to something else in the body to keep it from slipping up and causing a hernia, some do a “hernia repair” using mesh. Some will tell you upfront - you should have bypass because....

always get a second opinion (and a third), and find a surgeon who doesn’t downplay it.

I recently listens to a surgeon giving a presentation at a medical conference. He advised his fellow surgeons to decline sleeves to certain patients because “the reflux would keep them banging at your door”. He jokingly suggested that you send patients with HH or GERD to “your enemy” if they want the sleeve. This was a video from 2019.

I am grateful for those door bangers, because while I just suffered silently- they demanded help and brought awareness. They are hero’s.

Please share your story and your surgeon, especially if you are PPI free.

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On 2/25/2021 at 11:19 PM, ElPasoSleeveGal said:

My doctor repaired a hiatial hernia while doing my sleeve. I didn't even know I had one! But I will say, I have not had heartburn once since surgery

Sent from my SM-N981U using BariatricPal mobile app

Sounds great! How long ago was your surgery?

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On 2/24/2021 at 12:29 PM, mweiss1998 said:

I, too, had an unknown hiatal hernia repaired during surgery. They essentially need to otherwise the food could get stuck. I would just be sure the surgeon knows ahead of time. Mine was surprised but acted as if it was no big deal.

How long ago was your surgery? Do you have any avid reflux?

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On 2/23/2021 at 3:49 PM, Circus321 said:

I’m scheduled to get my sleeve in a month (yay!) but I’m afraid it’ll worsen my gerd. I’ve heard on here that some people get their hiatal hernias fixed when they get their surgery. Does having a gastric surgery automatically fix the hernia or is it something extra that your doctor has to do? I developed a tiny hiatal hernia over the last year and I’d like to have it fixed with my surgery. My surgeon knows about it but hasn’t mentioned anything regarding fixing it. Should I bring it up beforehand or is it something that gets fixed with surgery anyway?

Hi there, how was your surgery? How are you doing? Did the surgeon fix the hernia?

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42 minutes ago, Blueslily said:

Sounds great! How long ago was your surgery?

My surgery was 8 weeks ago today.

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