Hiatal hernia after already having the sleeve?

[SleevedK 25]

Have any of you dealt with a hiatal hernia AFTER getting sleeved? What ended up happening?

I am currently dealing with this. I haven’t yet found out what my surgeon wants to do, but I am afraid that I will be told the only option is to convert to RNY, and I absolutely do not want that. Have any of you had luck with simply repairing the hernia and keeping the sleeve instead of converting to RNY?
Do any of you have suggestions on doctors who may be experienced at dealing with this problem?
i appreciate any advice since it is hard to find info on this problem. It seems like tons of people have hernia repairs at the time they have the sleeve done but it seems less common to have it come up later.

[JRL1989 3]

There's a really interesting paper published on this topic, it is currently in press. I can send you the full paper PDF if you'd like. You can see abstract etc here: https://pubmed.ncbi.nlm.nih.gov/33483233/

I have been having "BARF Syndrome" as they describe in the paper, and my 1-month post-sleeve barium swallow showed a recurrence of my hiatal hernia (it was repaired during sleeve). My surgeon also wants to convert to bypass.

This paper shows improvement of symptoms with even just HH repair.

Edited March 15, 2021 by JRL1989

[KateinMichigan 24]

On 3/4/2021 at 2:27 AM, SleevedK said:

Have any of you dealt with a hiatal hernia AFTER getting sleeved? What ended up happening?

I am currently dealing with this. I haven’t yet found out what my surgeon wants to do, but I am afraid that I will be told the only option is to convert to RNY, and I absolutely do not want that. Have any of you had luck with simply repairing the hernia and keeping the sleeve instead of converting to RNY?
Do any of you have suggestions on doctors who may be experienced at dealing with this problem?
i appreciate any advice since it is hard to find info on this problem. It seems like tons of people have hernia repairs at the time they have the sleeve done but it seems less common to have it come up later.

I have covered this topic and I'm currently on the hunt for a better solution. Read my latest post and follow me for updates. I was recently told that RNY confession was my only option and as someone with Anemia - this isn't an option.

[KateinMichigan 24]

On 3/15/2021 at 5:39 PM, JRL1989 said:

There's a really interesting paper published on this topic, it is currently in press. I can send you the full paper PDF if you'd like. You can see abstract etc here: https://pubmed.ncbi.nlm.nih.gov/33483233/

I have been having "BARF Syndrome" as they describe in the paper, and my 1-month post-sleeve barium swallow showed a recurrence of my hiatal hernia (it was repaired during sleeve). My surgeon also wants to convert to bypass.

This paper shows improvement of symptoms with even just HH repair.

This is great! I'm going to steal the link to this article and repost on my post. I have covered this topic and I'm currently on the hunt for a surgeon. Read my latest post and follow me for updates. I was recently told that RNY confession was my only option and as someone with Anemia - this isn't an option.

[leebick 448]

I am 5 years post-op from my sleeve surgery and 3 days post-op from my hernia repair. All my surgeon did was hernia repair with a dissolving mesh. The surgery notes said that >50% of my sleeve was residing in my esophagus, so I don't think it was a trivial repair- and she was able to do it laparoscopically, so win-win!!

[KateinMichigan 24]

Hi! I’m scheduled for this surgery as well. Wow! Did they detect that much sleeve in the esophagus before surgery or did it come up in pre tests? How are you feeling? Any acid?

[leebick 448]

11 minutes ago, KateinMichigan said:

Hi! I’m scheduled for this surgery as well. Wow! Did they detect that much sleeve in the esophagus before surgery or did it come up in pre tests? How are you feeling? Any acid?

The notes from the upper GI series says they detected a "moderately large" hernia. Actual surgical notes on the repair say "Given that the patient has already had a sleeve gastrectomy and is not a candidate for any form of wrap, I choose to place a bio A absorbable Gore mesh to reinforce the diaphragmatic repair. Once positioned appropriately the mesh is secured in all 4 corners with Ethibond suture. The apex of the sleeve is secured to the diaphragm medially and laterally with single interrupted Ethibond suture."

I'm doing... ok, I guess. I found the hernia surgery harder to tolerate than my sleeve surgery was. My hernia surgery was on Tuesday morning and they discharged me on Thursday afternoon after they "achieved appropriate pain management," making me 3 days post-op. I thought they were only giving me Tylenol via IV, and oxycodone on request. Turns out this was true, but they were also giving me gabapentin and the oxycodone in addition to the Tylenol; I could have had additional oxy if requested, as well as dilaudid. I won't lie; it's been rough being home. I have five oxycontin pills to get me through, as well as Tylenol, of course. I have had enough pain that I'm calling this afternoon to get more oxy; my pain this morning was easily a 7 on a scale of 1-10. I haven't had any acid issues, but I haven't had any real food yet. I'm allowed a soft diet but I know I'm not ready. I've stayed on full liquid (which is where I was in the hospital) with a few bites of yogurt or pudding with not great results. It just hurts right now, feels like I have a giant block in my chest and a huge lump in my throat. I am SO GLAD I took 2 weeks off from work for this!

[KateinMichigan 24]

I’m so sorry you are going through this pain! Thank you so much for sharing your experience. I’ve met with several doctors, and they never tell you about things like this. It’s so important for people to share their experiences. Please keep me updated as the days go on. I praying to hear that it all gets better. How long did your surgeon tell you you’ll be in pain for?

[leebick 448]

4 hours ago, KateinMichigan said:

I’m so sorry you are going through this pain! Thank you so much for sharing your experience. I’ve met with several doctors, and they never tell you about things like this. It’s so important for people to share their experiences. Please keep me updated as the days go on. I praying to hear that it all gets better. How long did your surgeon tell you you’ll be in pain for?

I don't really think the surgeons/doctors know what it's like- they aren't there. The ones who know what it's like are the floor nurses, the ones who were at my bedside, administering my meds, taking my vitals. I saw my surgeon for 10 mins on the morning of surgery and then for 10 mins on the day she discharged me. Her basic question was, "do you think your pain is managed well enough for you to go home?" I did... just didn't realize that I was being given more pain support meds in the hospital that would be prescribed for me to take at home. As I was leaving my hospital room, the CNA who'd been taking care of me said "Don't hesitate to call the floor nurses' station if you need anything." I wonder if she knew more about my pain management at the time than I did!

[KateinMichigan 24]

2 minutes ago, leebick said:

I don't really think the surgeons/doctors know what it's like- they aren't there. The ones who know what it's like are the floor nurses, the ones who were at my bedside, administering my meds, taking my vitals. I saw my surgeon for 10 mins on the morning of surgery and then for 10 mins on the day she discharged me. Her basic question was, "do you think your pain is managed well enough for you to go home?" I did... just didn't realize that I was being given more pain support meds in the hospital that would be prescribed for me to take at home. As I was leaving my hospital room, the CNA who'd been taking care of me said "Don't hesitate to call the floor nurses' station if you need anything." I wonder if she knew more about my pain management at the time than I did!

This is always true. Nurses know; I'm glad they are advocating for you.

The stinginess with the pain meds has gotten out of control...I get they don't want to create an addiction but 5??!!! Let me know how your surgeon responds to your request.

I just had a call with someone who had the same surgery in March - she had the same issues but said the pain subsided within 2 weeks. She's happy she did it. She said she did have a bit of Reflux the first week but it went away (could have been an intense rebound from the PPI's working their way out of her system). She also said her stool is now loose/runny. I have no idea why/how this would happen - but it's still only been a few months so she's still recovering. I'm going to be checking in on you. Please keep me filled in - bad and good.

[leebick 448]

Day 5 Post-op... I am still doing OK. I overdid it a bit yesterday (I did NOT move furniture, my husband did, but I helped by supporting on occasion and it was too much) so took 5mg oxy before bed and I'm so glad I did. I could feel my body relax and the pain dissipate. Today I am feeling better. I spent a good part of the day sorting out papers and such from our bookcase and desk. I am frustrated with eating. I am on a soft diet but am struggling to eat much more than pudding without chest pain (diaphragm pain, actually). It's too hot for Soup. I'm sip, sip, sipping my drinks so I don't have to worry about dehydration. I guess I hadn't realized what my post-surgical diet would be like, so I didn't stock up on anything. Tomorrow I'll go to the grocery store and see what I can find. Who knew I'd wish for cottage cheese!

I am doing my breathing exercises but progress is slow. I can inhale 1500mL without coughing, but when I do to 1750mL it makes me cough. Tonight my chest/diaphragm is sore... not sure if it's from "working" today (seriously, all I did was sort papers out of the desk drawers) or just post-surgical pain. It's hot and I want to eat something and my chest hurts and it doesn't help watching my husband have a sliced chicken sandwich with lettuce and Tomato on a lovely roll, with chips, for his supper. Grrr... I must be getting better as I'm getting cranky! I'm going to give it another hour to see if I feel any better and can relax, and if not I might take another 2.5mg oxy to help me sleep. I seem to be OK during the day but start to really run down around 8pm. Oh well... I still feel like I am making progress and am SO GLAD my surgeon did this hernia repair instead of revision to a full bypass.

[KateinMichigan 24]

You are a saint for keeping us updated! We are all rooting for you and I’m so glad to hear that it’s getting better! I’m assuming that there is no acid reflux - but without food to trigger it Im sure it must be an odd feeling. These updates are going to help so much when I have the surgery- now I know what to expected. I can’t wait until the day where you don’t have any diaphragm soreness and the day you have your first real meal!!!! Hang in there:)

[leebick 448]

27 minutes ago, KateinMichigan said:

You are a saint for keeping us updated! We are all rooting for you and I’m so glad to hear that it’s getting better! I’m assuming that there is no acid reflux - but without food to trigger it Im sure it must be an odd feeling. These updates are going to help so much when I have the surgery- now I know what to expected. I can’t wait until the day where you don’t have any diaphragm soreness and the day you have your first real meal!!!! Hang in there:)

Thanks for the support!!

I'm not eating a whole lot- pudding, Soup, Protein Shakes, cottage cheese, but not much else. Today I made chicken salad and pureed it. Gross... but it helps to have something different to eat, and so far I've had no acid issues. The weather isn't my friend right now. I live in north-central Maine, about a 4+ hour drive north of Boston, and we are having a heat wave! It's 92F outside with a heat index of 102F. The thermometer on my family room wall says 88F. Of course we don't have a/c in our home- hardly anyone does up here. I'm sitting with the fan blowing directly on me but it's so freaking hot!! I'm making my Protein shakes with Water and pouring them over ice so I get my fluids in. It's so hot I don't really want to eat much anyhow- although popsicles or fudgsicles sound pretty good right about now!

[KateinMichigan 24]

OMG - that kind of heat without air conditioning while recovering is a big challenge! The weather is just crazy everywhere.

I'm in Michigan and our town flooded. Everyone's basements completely ruined because the sewer backed up into the homes. Everyone has spent the weekend emptying out their basements onto the sidewalk - it looks like a tornado hit.

When we bought our house the previous owner had cemented the basement sewer drains and put in a sump pump, and we couldn't understand why. Now we know. They lived here for 80 years. Apparently, this sewer backup happens every 10-15 years - and they had had enough - lol. We were one of the only houses not flooded.

I'm so glad to hear you're not getting any acid. I was wondering if you'd have the rebound effect from the PPI medication. How bad was your acid reflux? Was it at night, after meals, etc?

[SleevedK 25]

On 6/28/2021 at 3:09 PM, leebick said:

Thanks for the support!!

I'm not eating a whole lot- pudding, Soup, Protein Shakes, cottage cheese, but not much else. Today I made chicken salad and pureed it. Gross... but it helps to have something different to eat, and so far I've had no acid issues. The weather isn't my friend right now. I live in north-central Maine, about a 4+ hour drive north of Boston, and we are having a heat wave! It's 92F outside with a heat index of 102F. The thermometer on my family room wall says 88F. Of course we don't have a/c in our home- hardly anyone does up here. I'm sitting with the fan blowing directly on me but it's so freaking hot!! I'm making my Protein shakes with Water and pouring them over ice so I get my fluids in. It's so hot I don't really want to eat much anyhow- although popsicles or fudgsicles sound pretty good right about now!

Thank you so much for sharing your experience here. I felt so alone when I first started to have issues with the hiatal hernia because it seems like you see so many stories about people getting hiatal hernias repaired when they get the sleeve, but not much about the people who have to deal with it after the sleeve. Hope that you are able to stay cool and that your recovery continues smoothly.