Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|CallieGirl - Thu Apr 07, 2005 12:56 pm||
I have been diagnosed with a small hiatal hernia. For the past 2 months I've had the sensation of a lump in my throat, and a feeling of tightness in my throat. I have no problems swallowing. I have constant pain in the middle of my abdomen, under my sternum. Also it feels like my diaghram is very sore, and hurts all the time. I burp alot, and have loose stools. I don't think I have acid reflux, as I don't have heartburn.
I've had a CAT Scan/CT Scan with intravenous contrast material injected in vein, Colonoscopy, Upper endoscopy, Upper GI Series(Barium Swallow Test). Everything came back normal, as well as blood tests.
The reason for the Cat Scan, is because a few months before I started having symptoms due to the hiatal hernia, I began having severe back pain right by my left shoulder blade for no apparent reason. It radiated into my front abdoman under my left ribcage. It lasted for several weeks, then finally went away.
I'd appreciate any help with my problem. Also my DR. prescribed Raglan, but I haven't yet started taking it. I'm not taking any other meds.
|Dr. Safaa Mahmoud - Fri Jun 30, 2006 10:53 am||
The anatomical relation between the diaphragm and the Lower Esophageal Sphincter LES prevents the gastric acids to come up into the esophagus (reflux). When the upper part of the stomach prolapses through the diaphragm (where the esophagus pass into the abdomen (esophageal hiatus- opening) into the chest, the condition is known as hiatusl hernia. In this condition people will experience one or more of these symptoms, chest pain, pain in the throat, morning hoarseness, swallowing problems and GERD with or without heart burn.
The size of a hiatal hernia and the severity of the symptoms are not correlated. The presence of hitaus hernia aggravates the GERD condition. Acid reflux causes severe pain and discomfort in the chest. Others may experience a feeling like the food stuck in their throat or tightness in the throat, dry cough and shortness of breath.
Metoclopramide (Raglan) is a prokinetic drug that strengthens the sphincter and improves the gastric emptying. When there is an acid reflux it is not enough to treat the symptoms with one drug instead the addition of Anti acids, Acid H2 blockers or proton pump inhibitors mat help to control the symptoms.
Certain foods are known to aggravate the condition, and you better avoid them. These include chocolate, beverages containing caffeine, fatty and fried foods, garlic and onions, spicy and tomato containing foods.
Surgery is considered only if lifestyle changes and medications did not improve the condition or if complications are present.
Keep on follow up with your doctor, update him with your symptoms, only by complete history and physical examination, he can recommend you the proper medical approach.
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