Hiatal hernia after already having the sleeve?

[SleevedK 25]

On 6/28/2021 at 2:38 PM, 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:)

I hope that your surgery goes well! I know you've been suffering with this awful problem for such a long time. I am excited for you that hopefully it will be fixed soon. Please do keep us updated on how you are doing!

[KateinMichigan 24]

Hi Lee,

just checking in. How are you doing?

[leebick 448]

1 hour ago, KateinMichigan said:

Hi Lee,

just checking in. How are you doing?

I'm getting there. I'm a little over 2 weeks post-op, no GERD or vomiting at all. I am back to eating tiny portions, most all soft foods. I need to monitor my liquid closely- I know I'm not getting enough fluid- but I get full so easily! It's kinda like the first few weeks after the sleeve surgery.

[KateinMichigan 24]

Wow! I’m so glad it’s getting better. Are you off all PPI’s? I can’t even image what that would be like. I can’t even have a few sips of Water without gerd. I’m surprised to hear it’s like the first few weeks of sleeve - did they do any resleeve/reshape touch up? I’m going under in 2 weeks. How’s the brick on chest feeling? How’s the pain? Any tips/advice or surprises would be super helpful.

[KateinMichigan 24]

20 hours ago, leebick said:

I'm getting there. I'm a little over 2 weeks post-op, no GERD or vomiting at all. I am back to eating tiny portions, most all soft foods. I need to monitor my liquid closely- I know I'm not getting enough fluid- but I get full so easily! It's kinda like the first few weeks after the sleeve surgery.

I forgot to ask - did your doc use mesh? Did she tell you how many stitches?

[leebick 448]

7 hours ago, KateinMichigan said:

I forgot to ask - did your doc use mesh? Did she tell you how many stitches?

Hi-

My doctor did use mesh to repair the hernia opening, but didn't say how many stitches. I am not taking any PPIs, only took Tums once since the surgery (so almost 3 weeks). There is nothing in the surgical note about her having done any kind of touch-up on the sleeve. It's like the first few weeks when the sleeve was new in that I was on full liquids, finally worked up to a soft diet, but I can only eat a little bit before I get the "too much" signal from the sleeve. I have no GERD, no vomiting, no acid fumes, no block-like feeling in my chest, nothing. It's amazing. I have to pay close attention when I eat, take tiny bites, chew a LOT, and eat slowly. I can eat 3 bites of something and then on the 4th bite I am TOO FULL and it hurts; I definitely can feel the restriction from my sleeve again, which was something I was worried about. I was just out of town for a week at a family gathering (wedding and a memorial service, both postponed from originally scheduled due to covid) and I was able to eat much of the food being served. We were in New Orleans, so that is saying something! I just followed the rules for the soft diet and for mindful eating and it was OK, most of the time. Biggest challenge right now is staying hydrated, but that's always been an issue for me (even before having the sleeve surgery). I'm kind-of in awe how easy and life-changing this has been. All week I'd eat something and think WOW, I'm not throwing this up, it's staying down where it belongs!

[Ekgrn 6]

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.

Hi I just had my VSG on July 7th. I did not know and neither did my surgeon that I had a hiatal hernia. She discovered it when she opened me up. So she clipped it while she was in there. Sometimes they are not picked up with EGD. She said it's a fairly simple procedure just a little more pain for me post op

[Lily66 425]

So sorry to hear you ladies are going through this, can totally relate. I had RNY 3/20, had never had a hiatal hernia in my life and now one was discovered during an upper endoscopy earlier this week, 16 months post RNY. I’m totally baffled as to how this happened, not sure what my next steps can and will be. Right now Omeprazole every morning, being very careful. Hernia measures 2cm. Wish you all the best!

[KateinMichigan 24]

10 hours ago, leebick said:

Hi-

My doctor did use mesh to repair the hernia opening, but didn't say how many stitches. I am not taking any PPIs, only took Tums once since the surgery (so almost 3 weeks). There is nothing in the surgical note about her having done any kind of touch-up on the sleeve. It's like the first few weeks when the sleeve was new in that I was on full liquids, finally worked up to a soft diet, but I can only eat a little bit before I get the "too much" signal from the sleeve. I have no GERD, no vomiting, no acid fumes, no block-like feeling in my chest, nothing. It's amazing. I have to pay close attention when I eat, take tiny bites, chew a LOT, and eat slowly. I can eat 3 bites of something and then on the 4th bite I am TOO FULL and it hurts; I definitely can feel the restriction from my sleeve again, which was something I was worried about. I was just out of town for a week at a family gathering (wedding and a memorial service, both postponed from originally scheduled due to covid) and I was able to eat much of the food being served. We were in New Orleans, so that is saying something! I just followed the rules for the soft diet and for mindful eating and it was OK, most of the time. Biggest challenge right now is staying hydrated, but that's always been an issue for me (even before having the sleeve surgery). I'm kind-of in awe how easy and life-changing this has been. All week I'd eat something and think WOW, I'm not throwing this up, it's staying down where it belongs!

This is such great news! I'm so excited to see this!!!!! Thank you for sharing... it's given me such hope.

[KateinMichigan 24]

Observations. I’ve noticed a ton of people on this site who get VGS are waking up to a HH repair from a “surprise” HH. I had all the tests, and it didn’t show pre-op. It wasn’t until I experienced excruciating acid for the very first time when I awoke from surgery that I was sent to a specialist who found it. in my life I’m guessing that when they remove the stomach, the newly reduced and lighter banana stomach

[KateinMichigan 24]

Cont..

the new stomach is lighter and thinner, slides into the esophageal area because the new shape allows it to.

The seasoned docs now realize that the sleeve surgery actually causes this, so after they create the sleeve, they tighten the diaphragm so a hernia can’t slide up right away. (HH repair has a large fail rate).

why not be upfront about this? Why are so many waking up to the “hiatal hernia surprise!”

[SleevedK 25]

On 7/14/2021 at 5:34 PM, KateinMichigan said:

Cont..

the new stomach is lighter and thinner, slides into the esophageal area because the new shape allows it to.

The seasoned docs now realize that the sleeve surgery actually causes this, so after they create the sleeve, they tighten the diaphragm so a hernia can’t slide up right away. (HH repair has a large fail rate).

why not be upfront about this? Why are so many waking up to the “hiatal hernia surprise!”

You are absolutely correct that the shape of the sleeve stomach makes developing a hiatal hernia more likely later on than with a normal stomach. That is exactly what one of the research articles I found talking about hiatal hernias after sleeve surgery said.
I think the issue with people being surprised by a hernia repair during sleeve surgery is that sometimes sliding hernias are not detectable on the testing before surgery and are only discovered once the surgeon is actually looking at the stomach during the operation. I had no hernia repair during my sleeve surgery (which was in Dec 2016). I really don't think I had a hernia until about December 2020 (when I first noticed some weird symptoms that at the time I didn't understand but now in retrospect believe were from the hernia).

Your surgery must be coming up soon, so best of luck. Please do update us on how it goes.

Edited July 20, 2021 by SleevedK

[leebick 448]

7 hours ago, SleevedK said:

You are absolutely correct that the shape of the sleeve stomach makes developing a hiatal hernia more likely later on than with a normal stomach. That is exactly what one of the research articles I found talking about hiatal hernias after sleeve surgery said.
I think the issue with people being surprised by a hernia repair during sleeve surgery is that sometimes sliding hernias are not detectable on the testing before surgery and are only discovered once the surgeon is actually looking at the stomach during the operation. I had no hernia repair during my sleeve surgery (which was in Dec 2016). I really don't think I had a hernia until about December 2020 (when I first noticed some weird symptoms that at the time I didn't understand but now in retrospect believe were from the hernia).

Your surgery must be coming up soon, so best of luck. Please do update us on how it goes.

I totally agree, it's the shape/size of the sleeve that allows it to slip up through the opening in the diaphragm. My surgeon said more than half of my sleeve had slipped up into the thoracic cavity. No wonder I could hardly eat, had pain when I did, and would vomit more times than not!

I had my HH repaired a month ago, and it's been slow going since then. I am still trying to find foods that are comfortable when I eat. Mostly I'm still on full soft foods, as it just plain hurts when I try to eat meats, fresh fruit/veggies, etc. I saw the surgeon last week and she said to keep working at it, keep up with the mindful eating, and to add a 2nd Protein Shake to my daily intake. I was surprised to find that recovery from the HH surgery is VERY much like it was post-sleeve, eating-wise, and maybe even more challenging. I've lost 8 pounds in the month since the HH surgery. I am pleased about that, but it's due to not being able to eat much at once. I really don't care about eating, going out to dinner, etc., at all anymore. Probably good, maybe I'll hit that VGS goal weight after all!

[KateinMichigan 24]

9 hours ago, SleevedK said:

You are absolutely correct that the shape of the sleeve stomach makes developing a hiatal hernia more likely later on than with a normal stomach. That is exactly what one of the research articles I found talking about hiatal hernias after sleeve surgery said.
I think the issue with people being surprised by a hernia repair during sleeve surgery is that sometimes sliding hernias are not detectable on the testing before surgery and are only discovered once the surgeon is actually looking at the stomach during the operation. I had no hernia repair during my sleeve surgery (which was in Dec 2016). I really don't think I had a hernia until about December 2020 (when I first noticed some weird symptoms that at the time I didn't understand but now in retrospect believe were from the hernia).

Your surgery must be coming up soon, so best of luck. Please do update us on how it goes.

Hi K-

My surgery (and surgeon) has changed to August. (original Surgery clinic told me last minute that my insurance was “out of network and I’d be on the hook for the bulk of the cost).

Found a surgeon locally and just saw him this morning. He does it robotically. He was a straight shooter. Said my success rate is more like 70% - not 90. Why? Because over time scar tissue causes the HH bubble that formed above the diaphragm to become less amicable to reshaping back into a natural shape once pulled below the diaphragm. a lot depend on how much scar tissue and how I heal.

This misshape could still cause gerd. I’m just hoping that the surgery doesn’t make it worse. My new surgeon doesn’t feel it’ll make it worse. Gosh - such a hard decision.

[KateinMichigan 24]

1 hour ago, leebick said:

I totally agree, it's the shape/size of the sleeve that allows it to slip up through the opening in the diaphragm. My surgeon said more than half of my sleeve had slipped up into the thoracic cavity. No wonder I could hardly eat, had pain when I did, and would vomit more times than not!

I had my HH repaired a month ago, and it's been slow going since then. I am still trying to find foods that are comfortable when I eat. Mostly I'm still on full soft foods, as it just plain hurts when I try to eat meats, fresh fruit/veggies, etc. I saw the surgeon last week and she said to keep working at it, keep up with the mindful eating, and to add a 2nd Protein Shake to my daily intake. I was surprised to find that recovery from the HH surgery is VERY much like it was post-sleeve, eating-wise, and maybe even more challenging. I've lost 8 pounds in the month since the HH surgery. I am pleased about that, but it's due to not being able to eat much at once. I really don't care about eating, going out to dinner, etc., at all anymore. Probably good, maybe I'll hit that VGS goal weight after all!

Hi Lee,

I thought after a month it was supposed to get a lot better. The weight loss is a bonus, but the pain when eating sucks! Has the pain stayed constant - or is it slowly getting better? Is it really tight when you eat meats? Does it feel like it’ll get stuck? When does your surgeon say it’ll get better? What are some of your favorite foods/go to’s during this time? I’m guessing a lot of shakes - but do mash potatoes hurt too?

Thanks!