[beach]

My boyfriend has been suffering for the past 6 months and we are really at a lost cause. He has tried reglan and other med's, but nothing seems to be working.....PLEASE HELP!!!

 

[BQ]

Reply: No I don't have one but my Mom does.

 

[BQ]

Reply: No I don't have one but my Mom does.

 

[eric]

I don't and honestly don't know much about it, but this is from the 17th International Symposium on Gastrointestinal Motility, 14-17 sept. 1999,Conference Centre "Oud Sint-Jan", Bruges, Belgium.It has some info on gerd and hiatal hernia."Esophagus At the last International symposium a motor event was described in the esophagus that correlates withnon-cardiac chest pain. This unique motor pattern, sustained esophageal contraction (SEC) had nowby the same group (Mittal et al. San Diego USA) been shown to be closely associated with heartburnsymptoms. Reflux of acid in the esophagus can cause heartburn or chest pain. However, themechanism of acid induced pain is not known and both of these symptoms can occur in the absenceof acid reflux. Prolonged pH recordings show a poor correlation between the drop in pH in theesophagus and heartburn. SEC is recorded by high-frequency intraluminal ultrasound imaging of theesophagus. In 12 patients with heartburn, a close association between SEC and symptom of heartburnwas observed. SEC may therefore be the motor event that causes heartburn sensation and couldexplain why later can occur in the absence of heartburn. Despite the logical rationale whereby delayed gastric emptying and prolonged intragastric retention offood can increase the rate of transient LES (TLESRs) and reflux, only a moderate correlation has beenpreviously described between proximal gastric retention and TLESRs in patients withgastroesophageal reflux disease (GERD). Investigators from Leuven (Sifrim et al. Belgium) tested thehypothesis that simultaneous measurement of reflux by both intraluminal impedance and ph monitoringas well as gastric emptying, would better characterize the relationship between gastric emptying,TLESRs and reflux. Esophageal manometry and ph was recorded 4 hours postprandially in healthysubjects and gastric emptying was measured by octanoic breath test. The impedance techinque wasable to identify both acid and/or non-acid liquid or gas reflux. A significant correlation was foundbetween gastric retention, the number of TLESRs and occurrence of predominantly liquid reflux (acidand non-acid). Impedance detected early postprandial acid and or non-acid liquid reflux whosefrequency corrlelated weakly but significantly with the degree of gastric retention. In contrast, acidreflux detected by the pH monitoring did not correlate with gastric retention, perhaps due to bufferingof acid in the early postprandial period. Thus, new techniques such as intraluminal impedance and high-frequency intraluminal ultrasoundimaging of the esophagus can better elucidate the normal physiology and the pathophysiology of the esophagus and help us understand the underlying mechanisms in health anddisease. The role of hiatal hernia in patients with GERD has been a matter of debate. In patients with heartburnand acid regurgitation, hiatal hernia size correlated significantly with 24 h GER episodes (Lenglinger etal. Austria). Hiatal hernia size together with LES pressure, but not the amplitude of contractileresponses to swallowing and oesophageal clearance time, are of major impact for the extent ofgastroesophageal reflux."

 

[eric]

I don't and honestly don't know much about it, but this is from the 17th International Symposium on Gastrointestinal Motility, 14-17 sept. 1999,Conference Centre "Oud Sint-Jan", Bruges, Belgium.It has some info on gerd and hiatal hernia."Esophagus At the last International symposium a motor event was described in the esophagus that correlates withnon-cardiac chest pain. This unique motor pattern, sustained esophageal contraction (SEC) had nowby the same group (Mittal et al. San Diego USA) been shown to be closely associated with heartburnsymptoms. Reflux of acid in the esophagus can cause heartburn or chest pain. However, themechanism of acid induced pain is not known and both of these symptoms can occur in the absenceof acid reflux. Prolonged pH recordings show a poor correlation between the drop in pH in theesophagus and heartburn. SEC is recorded by high-frequency intraluminal ultrasound imaging of theesophagus. In 12 patients with heartburn, a close association between SEC and symptom of heartburnwas observed. SEC may therefore be the motor event that causes heartburn sensation and couldexplain why later can occur in the absence of heartburn. Despite the logical rationale whereby delayed gastric emptying and prolonged intragastric retention offood can increase the rate of transient LES (TLESRs) and reflux, only a moderate correlation has beenpreviously described between proximal gastric retention and TLESRs in patients withgastroesophageal reflux disease (GERD). Investigators from Leuven (Sifrim et al. Belgium) tested thehypothesis that simultaneous measurement of reflux by both intraluminal impedance and ph monitoringas well as gastric emptying, would better characterize the relationship between gastric emptying,TLESRs and reflux. Esophageal manometry and ph was recorded 4 hours postprandially in healthysubjects and gastric emptying was measured by octanoic breath test. The impedance techinque wasable to identify both acid and/or non-acid liquid or gas reflux. A significant correlation was foundbetween gastric retention, the number of TLESRs and occurrence of predominantly liquid reflux (acidand non-acid). Impedance detected early postprandial acid and or non-acid liquid reflux whosefrequency corrlelated weakly but significantly with the degree of gastric retention. In contrast, acidreflux detected by the pH monitoring did not correlate with gastric retention, perhaps due to bufferingof acid in the early postprandial period. Thus, new techniques such as intraluminal impedance and high-frequency intraluminal ultrasoundimaging of the esophagus can better elucidate the normal physiology and the pathophysiology of the esophagus and help us understand the underlying mechanisms in health anddisease. The role of hiatal hernia in patients with GERD has been a matter of debate. In patients with heartburnand acid regurgitation, hiatal hernia size correlated significantly with 24 h GER episodes (Lenglinger etal. Austria). Hiatal hernia size together with LES pressure, but not the amplitude of contractileresponses to swallowing and oesophageal clearance time, are of major impact for the extent ofgastroesophageal reflux."

 

[HereIam]

Hey Beach,Sorry to hear of your boyfriend's troubles w/hiatal hernia. I have one, and it is really awful. It causes terrible chest pain and I often have the feeling that something is "stuck." I can't swallow any pills larger than an advil right now. I am taking Zantac, 150mg 2x/day and that has cut down on the burning. I have to eat very small amounts at a time. For the most part, any quantity of food larger than an English muffin pushes the hernia up into my chest and I get the pain and stuck feeling. I avoid all acidic and hard foods. Steak is very tough to eat, as is apples, raw veggies of any kind (except lettuce). Spaghetti is especially tough, it really is hard unless you chew it forever before swallowing it. I'm not sure what the cure will be for me, as this seems to be getting worse and worse. I also cough alot with it, and I'm sure the coughing just makes it worse. Right now I am doing a chiropractic self-adjustment to try to get the hernia down below the diaghphragm. Each morning I drink a pint of warm water (first thing, on an empty stomach). Then, I do this exercise: Raise myself up on my toes and suddenly drop. I do this 20 times. This is a bit of a last ditch attempt to treat this non-surgically. This method has worked for some people, who report that after 10 days of this they have a dramatic improvement. It doesn't cost anything, so I though I'd give it a whirl. For me, the biggest help is not loading my stomach up too much and not sitting for too long. If I sit and knit or watch TV for a couple of hours, the chest pain starts up and is hard to stop. Hope this info helps.

 

[HereIam]

Hey Beach,Sorry to hear of your boyfriend's troubles w/hiatal hernia. I have one, and it is really awful. It causes terrible chest pain and I often have the feeling that something is "stuck." I can't swallow any pills larger than an advil right now. I am taking Zantac, 150mg 2x/day and that has cut down on the burning. I have to eat very small amounts at a time. For the most part, any quantity of food larger than an English muffin pushes the hernia up into my chest and I get the pain and stuck feeling. I avoid all acidic and hard foods. Steak is very tough to eat, as is apples, raw veggies of any kind (except lettuce). Spaghetti is especially tough, it really is hard unless you chew it forever before swallowing it. I'm not sure what the cure will be for me, as this seems to be getting worse and worse. I also cough alot with it, and I'm sure the coughing just makes it worse. Right now I am doing a chiropractic self-adjustment to try to get the hernia down below the diaghphragm. Each morning I drink a pint of warm water (first thing, on an empty stomach). Then, I do this exercise: Raise myself up on my toes and suddenly drop. I do this 20 times. This is a bit of a last ditch attempt to treat this non-surgically. This method has worked for some people, who report that after 10 days of this they have a dramatic improvement. It doesn't cost anything, so I though I'd give it a whirl. For me, the biggest help is not loading my stomach up too much and not sitting for too long. If I sit and knit or watch TV for a couple of hours, the chest pain starts up and is hard to stop. Hope this info helps.

 

[awcfly]

Beach,I have a milder case of hiatal hernia.There are newer proton pump inhibitor drugs like omeprazol and lansoprazol which really wipe out stomach acid production (brand names like Prevacid and Prilosec).There are older histamine blocker drugs available over-the-counter like Tagamet, Zantac and Pepcid AC, which also reduce stomach acid production, but not as effectively as above.However!I personally don't tolerate any of these drugs very well, and was forced to abandon them. I found that Gaviscon is an excellent over-the-counter antacid which helped me quite a bit. It contains sodium alginate, which forms a foam above the contents of the stomach. In my case, it works for hours vs. most antacids that are only useful for around 45 minutes. Really good stuff.In any event, if his case is severe enough, and also includes inability to swallow, surgery may be warranted. My father had that surgery about 20 years ago and it was exceptionally effective in his particular case.Good luck.

 

[awcfly]

Beach,I have a milder case of hiatal hernia.There are newer proton pump inhibitor drugs like omeprazol and lansoprazol which really wipe out stomach acid production (brand names like Prevacid and Prilosec).There are older histamine blocker drugs available over-the-counter like Tagamet, Zantac and Pepcid AC, which also reduce stomach acid production, but not as effectively as above.However!I personally don't tolerate any of these drugs very well, and was forced to abandon them. I found that Gaviscon is an excellent over-the-counter antacid which helped me quite a bit. It contains sodium alginate, which forms a foam above the contents of the stomach. In my case, it works for hours vs. most antacids that are only useful for around 45 minutes. Really good stuff.In any event, if his case is severe enough, and also includes inability to swallow, surgery may be warranted. My father had that surgery about 20 years ago and it was exceptionally effective in his particular case.Good luck.