I'm experiencing a problem 4 years post op, please advise!!!

Been experiencing pain/discomfort while/after eating over a year now. I chalked it up to just having a sleeve & maybe I was eating too fast or drinking a little while eating. But pain became more prominent in recent months. Feels like im having heart attack, dry heave, sometimes throw up. Finally went back to my bariatric surgeon to check this out. He ordered upper GI, went yesterday for results. Apparently I have a severe hiatal hernia & its allowing my stomach to be pushed up into my esophagus/media steinum area. They say I have a tourturous esophagus too. They're surprised I'm not in more pain & say I have bad reflux. Never knew because I only feel reflux once in a while, but don't even take meds for it. Doctor suggests conversion surgery to RNY surgery along with hernia repair. WHY is my question?? Why can't he just do hernia repair & be done with it??? He claims hernia will probably reoccur in 2-3 years. Please help. Anyone else experience this? Apparently, I'm only 1 of 2 of his patients in his practice that's had this. My luck!

I'm sorry to hear this. As far as changing to RNY, have you reached your weight loss goals? If you have, I'm not sure why he wants to do an RNY. You could always go and ask another surgeon for a second opinion.

There is a reason why the rny is better for acid issues, but not a clue why that is. My only decent input would be to seek a 2nd opinion. Sorry I couldn't be more helpful.

well i am no doctor. but my husband had similar problems a year or so after veg. doctor cirangle said he had developed a hiatal hernia and stretched his sleeve also. doctor said he was seeing more of this - hiatal hernias showing up after weight loss - the fat used to kind of hold everything in place and weight loss allowed this to happen. So hubby had our wls surgeon repair the hiatal hernia - he also tightened the sleeve a bit. helped a great deal. Dr. C repaired my hiatal hernia during the vsg but its not always obvious.

again, i am no doctor but i would get another opinion . diane

The sleeve turns your stomach into a high pressure system. With VSG your esophageal sphincter and pyloric valve are able to open and close (as human anatomy is designed to do). With the reduced capacity of the sleeve this creates a high pressure system when both are closed during the post eating digestive period. That feeling some people get up near their throat when they've had too much to eat is the pressure exerted on the esophageal sphincter from food and acid. With your hernia it puts even more pressure on your esophageal sphincter forcing it open (think reflux). Just because you don't have reflux symptoms doesn't mean you aren't experiencing tissue damage in your esophagus from released stomach acid.

RNY creates an open system on the bottom side of the stomach. When the stomach pouch is created the intestine is rerouted to the bottom of the pouch. A hole is left in the lower portion of the stomach opening directly to the rerouted portion of the small intestine. This opening, or anastomosis, turns the RNY gastric system into basically a no pressure system since the anastomosis is always open allowing acid and food to escape the stomach into the intestines.

Your surgeon is most likely more concerned about the acid issue because continued exposure to stomach acid is a major cause of esophageal cancer. The RNY is a sure bet to alleviate the acid-tissue issue greatly reducing your risk of esophageal cancer down the road.

Hope that make sense.

Edited to add: Oh, and yes, get a 2nd opinion!

Perfect explanation.

I am 5+ years out from SG and had a scope done today for excessive acid reflux. Same thing with me, hiatal hernia and going to have to have it fixed.

Dr is going to tighten my stomach up at the same time too so that is a positive thing.

Tighten up your sleeve? Or a tummy tuck?

Just PM'd you...

I am 15 months post VSG. I have been having hoarseness, chest burning and lump in throat, worsening in past 6 months. I am having an UGI swallow on Thursday, but am sure it is a hiatal hernia. I had a HH fixed when sleeved, but what Kairk said. Sleeve is a closed pressure system and it can "blow" out a hiatal hernia. I was banded in 2010 and converted to sleeve in 2014 due to some reflux issues. I am wondering why my surgeon did not lead me toward the RNY at that time? I guess I will find out when I see him next week. I really hate to think of converting again to another WLS like the RNY, but really can't live with this hoarseness either.

I will let you know what we decide.

Bonnie