Has anyone had a catch feeling in their diaphragm with a hiatal hernia?

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58 year old female with no other underlying health conditions than a hiatal hernia.  Recently was lifting boxes and felt like something inside folded over and “ catch “ on my ribs. Intense pain. Had trouble straightening, but eventually was able to stretch out.  Remained sore for a few days, but intense pain went away.  Couple weeks later another episode with same pattern. Then a week later another episode.  Went to dr. Had X-ray, blood work, and ultrasound.  Nothing was shown.   Had been diagnosed with a small hiatal hernia a few months back. Now even bending to pick up a basket, or lifting a heavy pan can cause it.  Reading seems to show this possible with hiatal hernia. On prescribed acid reflux med.

2 Answers

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X-ray, blood work, and ultrasound scans are not useful tests for hiatal hernia. If a hiatal hernia is strongly suspected, then a CT scan and an endoscopic examination are the best choice of tests to confirm the diagnosis. If the hiatal hernia causes you so much pain, it should be treated.

If you experience heartburn and acid reflux, your doctor may recommend:

  • Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. Overuse of some antacids can cause side effects, such as diarrhea or sometimes kidney problems.
  • Medications to reduce acid production. These medications — known as H-2-receptor blockers — include cimetidine (Tagamet), famotidine (Pepcid) and nizatidine (Axid). Stronger versions are available by prescription.
  • Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec, Zegerid). Stronger versions are available in prescription form.

Sometimes a hiatal hernia requires surgery. Surgery is generally used for people who aren't helped by medications to relieve heartburn and acid reflux, or have complications such as severe inflammation or narrowing of the esophagus.

Surgery to repair a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing an esophageal sphincter or removing the hernia sac.

Or your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen. The operation is then performed while your surgeon views images from inside your body that are displayed on a video monitor (laparoscopic surgery).

Many people with hiatal hernia don't notice any symptoms. Others may have:

  • Heartburn from gastroesophageal reflux disease (GERD)
  • Chest pain
  • Bloating
  • Burping
  • Trouble swallowing
  • Bad taste in your mouth
  • Upset stomach and vomiting
  • Backflow of food or liquid from your stomach into your mouth
  • Shortness of breath

If you don’t have any symptoms, you might not need treatment. If you have acid reflux, your doctor may suggest medications to treat those symptoms, including:

  • Antacids to weaken your stomach acid
  • Proton pump inhibitors or H-2 receptor blockers to keep your stomach from making as much acid
  • Prokinetics to make your esophageal sphincter – the muscle that keeps stomach acid from backing up into your esophagus -- stronger. They also help muscles in your esophagus work and help your stomach empty.

Your doctor might do surgery if you have a paraesophageal hernia (when part of your stomach squeezes through the hiatus) so your stomach doesn’t become strangled.

Many hiatal hernia surgeries use a method called laparoscopy. Your doctor will make a few small (5 to 10 millimeter) cuts in your belly. They insert a tool called a laparoscope through these incisions, and it sends pictures to a monitor so your doctor can see inside your body. These “minimally invasive” procedures have smaller cuts, less risk of infection, less pain and scarring, and faster recovery than traditional surgeries.

Some changes to your daily life can help with acid reflux symptoms. They include:

  • Don’t exercise or lie down for 3 or 4 hours after you eat.
  • Avoid acidic foods like orange juice, tomato sauce, and soda.
  • Limit fried and fatty foods, alcohol, vinegar, chocolate, and caffeine.
  • Eat smaller meals.
  • Lift the head of your bed about 6 inches.
  • Don’t wear tight belts or clothes that put pressure on your belly.
  • Lose extra pounds.
  • Don’t smoke.
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