Q. If you have a hiatal hernia is it unusual for that spot to hurt and feel tender to the touch? – Lisa

 

Dear Lisa,

A hiatal hernia is a when part of your stomach actually slides north into your thoracic (chest) area. This can result in stomach acid refluxing up into your esophagus and leads to a burning sensation.Many hiatal hernia occur without symptoms. If symptoms do occur the typical treatment is with a medication called a proton pump inhibitor that decreases your ability to produce acid. That sounds like a good idea and it will work to ease symptoms but you must be careful with prolonged use of these types of medications as they will interfere with your ability to digest food, they will nearly arrest any absorption of calcium which will lead to bone problems over time, they will contribute to intestinal problems as undigested food enters the small intestine and they don’t fix the actual problem of a hiatal hernia. 

To answer your question, yes the area around your stomach can be tender to touch.  Things that can exacerbate this problem are coughing, sneezing, obesity, constipation or anything that increases pressure in the abdomen.  Keep that stool soft with a high fiber diet and plenty of water.  Lose weight if you are heavy to reduce symptoms.  Talk with your doctor if your case is severe to see if surgery is a viable option.

There are some natural products that can help to reduce reflux symptoms such as zinc carnosine and sialic acid.  Glutamine, aloe vera leaf extract, and deglycyrrhizinated licorice root can help the cells to repair and work well in conjunction with a proton pump inhibitor.  Avoid acidic foods like alcohol and coffee.

Take care,
Dr. Gary Huber

Comments

13 Responses to “Q. If you have a hiatal hernia is it unusual for that spot to hurt and feel tender to the touch? – Lisa”
  1. Mary says:

    I feel pressure under my right rib cage. I think I do have a hatal hernia from the information I have gathered from the internet. Sometimes when I eat maybe spicy or greasy food it can be hard to swallow and hangs in my chest, then saliva or sticky stuff comes back up in my throat before it goes all the way down to my stomach. My stomach has gotten bigger. My stomach does not hurt. Once in awhile I feel a little pain about across from my navel.

    • Dr. Gary Huber says:

      Hi Mary,
      Pressure or pain under the right rib cage corresponds with the location of your gall bladder and could be indicative of a gall stone, sludge or poor gallbladder function. This is particularly true with ingestion of greasy foods. You also report some symptoms of acid reflux. I would suggest you see your doctor who will likely order a gallbladder ultrasound and may initiate a trial of a proton pump inhibitor. In the mean time you may benefit from some probiotic as well as some of the natural agents I mentioned above. It is important to get this type of issue resolved as prolonged symptoms can worsen and lead to more serious problems.
      Stay in touch and let me know what your doctor finds.
      Sincerely,
      Dr. Huber

  2. Theresa says:

    I have been experiencing daily pain in mid abd directly under my sternum, with pain in my back directly behind abd pain. Burning in mid abd. especially after eating with a fullness that takes severl hours to subside. Symptoms are relieved with laying down or arching my back, sitting up very straight. Prilosec for 8 days with no relief noticed. I have experience this pain before but it only lasted a few hours and was more severe. It doesnt worsen with breathing but I do have frequent pain that runs up the left side of my neck with inspirations. Any suggestions?

    • Dr. Gary Huber says:

      Hi Theresa,
      Well the real estate you mention in your report contains a lot of very important anatomy. Pain is this area (the epigastrium) could reflect stomach, pancreatic, lung, heart or bowel problems so there is a long list of issues that could be responsible for your pain. I would be doing you a disservice by trying to diagnose this issue on such an informal forum. I recommend that you see your doctor to rule out some potential serious problems. This could be a simple digestive issue or a serious heart problem and some test need to be performed.

      My best wishes go out to you but lets chat after your doctor has had a chance to examine you.
      Sincerely,
      Dr. Gary Huber

  3. John Smith says:

    Hello Dr.

    I am a 26 year old male and I just recently was diagnosed with a hiatal/hiatus hernia with barret’s (suspected) I am going in to see a gastro-ontologist tomorrow for a second gastroscopy, however my nerves are getting the best of me.

    I never suspected a hernia and never felt any pain in the location of the hernia. I did however go through pain in the chest, sternum and similar episodes of Heart-Attack pain associated to GERD last October. However this recent pain is very different from previous pain.

    Just recently – about 7/10 days – I have been feeling pain in my stomach, and where my hernia is located, *note this pain did not exist pre/post hernia discovery, until now*. Its quite uncomfortable and I am not sure if this is normal. I have been researching about this finding that in most instances people should not feel pain from their hernia. This pain is not similar t the earlier pains that I had in my sternum and rib-cage. There is no such pressure in my chest or symptoms that pressure in being placed on my diaphragm.

    So, in general, should one feel pain from their hernia or in their stomach. Yesterday I could feel pain on both the left and right side of my stomach. If you could let me know I would appreciate it . I am on Apo-Domperidone 10MG (twice a day) and Ran-Pantoprazole 40 MG (twice a day) as well.

    Thank You

    • Dr. Gary Huber says:

      Hi John,
      You have a lot going on down there. You mentioned that were headed for a second consult and I am relieved to hear that as a scope (endoscopy) to look at this area of concern would be important to rule out serious issues. Just be sure to get involved in your bowel recovery with some agents that will actually repair the tissue. The medicine may help with symptoms but has little to no ability to repair your problem. Your Ran-Pantoprazole will reduce acid production but this is not the same as repairing your tissue. Use of this medication for an extended period of time can lead to increased risk for further bowel problems, increased risk for food allergies, loss of bone mineralization due to inability to absorb calcium, and other issues.

      Make sure you are also dealing with your gut flora, start a good probiotic and work with a clinician to ensure that you don’t have yeast overgrowth in your bowel. Use of natural agents to repair your gut lining include things such as glutamine, zinc carnosine, vitamin A and omega 3 oils. Beware of excessive grain intake as this exacerbates reflux symptoms especially if you are taking the meds you are on. And look into whether you may have food allergens.

      Yes your hiatal hernia can most definitely cause pain in the stomach or epigastric area. But your doctor should be able to work with you to rule out other issues related to gallbladder and ulcerative conditions as well.

      Sincerely,
      Dr. Gary Huber

  4. Marisol says:

    Much like Theresa, I began experiencing pain in my upper abdomen/upper back, like I had done a ton of situps and I attributed it to slouching. Soon after, my ribs (right where they form a V between the breasts) felt bruised and tender to the touch. I have been having severe GERD since then and my symptoms are typically worse when I sit or put pressure on my upper abdomen. An upper endoscopy showed gastritis and esophogatis but the doctor told me nothing else. PPI’s calm the nausea but eventually make it difficult for me to breathe so I have to stop. I can eat about half of what I was eating before, even with the PPI’s. Any idea what could be happening here?

    • Dr. Gary Huber says:

      Hi Marisol,
      Lots can be happening. It always amazes me when people have GERD and get a PPI and thats the end of the story. Really? No one is curious as to WHY this is going on? And how can we be so sure that an overproduction of acid is the problem? You were diagnosed with GERD and if the problem was overproduction of acid then the PPI should have resolved all of your symptoms but it didn’t so are we certain that this is really your issue? I am not convinced. It could just as easily be that you are not producing enough acid. And what caused it in the first place? Food allergies been evaluated? A history to look at antibiotic exposure? Toxic exposure to processed foods and antibiotics and steroids in meat and milk? Stress or sleep issues affecting the immune system which is located in the bowel?

      What I have been witness to is that in our present medical culture we hear “heartburn” and assume that a PPI will “fix” it. PPI’s are medicines that reduce acid production in our stomach. I have a news flash for you. Our bodies were intended to make acid, it is what we use to digest our food. When we take medication to reduce it then we start other problems in motion. PPI’s were studied and recommended for use for 8 to 16 weeks. But many physicians just leave patients on them indefinitely which creates problems. So why would a doctor do that? Because it treats the SYMPTOMS and this makes patients happy. It does not treat the problem and this leads to other illness.

      Chronic use of PPI’s have been studied and here is a short list of problems that occur as a result:
      1. Reduced gallbladder function
      2. increased risk for pneumonia
      3. increased risk of hip fracture and loss of bone density
      4. Malabsorption of vitamin B12
      5. Malabsorption of iron
      6. Undesired weight gain
      7. increased risk for food allergies.

      So back to you Marisol. What are to do to repair you?
      1. Get rid of all grain products from the diet. Wheat in particular.
      2. Go 6 days with “0″ dairy products and then on day 7 eat them all day long and tell me what your symptoms were. Did you have less problems when you skipped the dairy? Very likely.
      3. Take a GOOD probiotic and not some cheap option you found at the grocery store. A couple of good ones are Kyo-Dophilus, Vinco brand Probiotic Multi, or Dr. Ohhiras brand. Call my office for help if you can’t find one.
      4. Take 10,000 units of pure vitamin A (retinoic acid) not beta carotene for one month and see how you feel.
      5. Avoid alcohol and coffee for a week and see how that effects you.
      6. Avoid processed sugar and high glycemic foods for a month.
      7. Eat whole foods and avoid processed foods for a month.
      8. Try some natural elements such as zinc carnosine, curcumin, glutamine and see if these things start to repair your tissue. The proper dosing and brands can be obtained from my office. Call 513-924-5300 and ask for Liz in the pharmacy. She can help you find what you need.

      If that doesn’t help or completely fix your problem then I want to you to call me or contact me thru the website and I will chat with you personally. Treating GERD is not that hard but you have to stop poisoning the gut and treat it nice. You haven’t done anything wrong, it’s just that our culture has a lot of abusive elements that we love to toss down our throats and our medical system is not equipped to spend the time or give patients the proper education on how to take care of their bowels.

      I want to hear back from you after you have addressed some of these interventions.
      I’m waiting.

      Take care,
      Dr. Gary Huber

  5. Julie says:

    I had lap band surgery in nov. 2008 and have since lost 117 lbs. I also had to have my gall bladder removed a short time after the lap band surgery. I noticed what felt like a lemon sized hard mass right below my diaphragm and asked Doctor that did both surgeries about it. He said it wasn’t anything to worry about.

    In September 2009 my husband was laid off bc his plant closed. Since my insurance wouldn’t pay (BCBS state SC), his insurance paid for the Lap- band. Now, It seems that the “mass” is bigger. Or maybe it is just that it is making that area uncomfortable, especially when I bend over. AND, I have been having acid reflux, nausea, some vommiting, left shoulder pain, and most recently difficulty swallowing food, especially meat. It won’t go down, comes back up in throat causing my mouth to water and eventually have to throw it up.

    Could this be a hernia?, scar tissue?, band slippage?

    Since the initial weight loss, I have been stagnant, even though I have completed P90x, Insanity workout, and Couch to 5k. I also have supplemented with the elliptical machine and exercise bike. I have lost inches, but weight has stayed relatively the same +/- 10 lbs. I am still60 lbs from goal weight.

    Are these problems related to my lap band and if so, since my primary insurance wouldn’t pay, and no longer have secondary insurance, will my insurance even pay for testa to determine the cause? I cannot afford to pay out of pocket for repair surgery or hernia/scar tissue surgery if it is not covered by insurance due to being related to lap band. Ii wouldn’t be able to get financial assistance bc my credit is ruined bc of husbands lay off and a Lot of student loans. What will happen I don’t get this fixed?please help!!!!

    • Julie says:

      Btw, right before I had my gall bladder out, I tested positive for H Pilori and had horrible smelling burps, and acid reflux. The same doctor put me on Nexium and didn’t really tell me anything about H Pilori. Sine then, 2009, I have tested positive for it on every blood work I have had done ( preventative bloodwork through school district I work for) but since I didn’t know I should be concerned about it, I never said anything to the doctor. Now, since I have had the symptoms mentioned in previous post, my family doctor checked it again and of course I tested positive. I know the H- Pilori could be causing some if not most of the symptoms, but it shouldn’t be making the ‘mass’ have so much discomfort should it? Also, since I started the antibiotics/ acid blocker last Thursday, I have lost 7.5 lbs. I read that the h- Pilori can cause weight gain, but since I have lap band, could this be why I haven’t lost any weight even though exercising insensly and regularly. Also, could the h- Pilori cause very very very heavy menstrual flow and iron deficiency??

      I am just so frustrated that some of this could’ve been avoided(assuming h-Pilori can cause these) if it had been treated correctly back in 2009, or at least explained to me how serious it could be so that I could have monitored it. Thanks so much for your help! Also, I am enjoying reading about you guy’s approach to medicine.

    • Dr. Gary Huber says:

      Hi Julie,
      Your story has many chapters and perhaps more than I can address here. The issue of weight loss is 80% diet and 20% exercise. It sounds like you have the exercise thing worked out and if you have been doing a system like P90X then I know you are doing interval work and intensity training which are the best ways to burn fat. So that leaves diet.

      Lap bands do not guarantee successful weight loss. And what you have going on with the mass is anyones guess but requires a physical exam and a surgical consult with whom ever put the lap band in place. I have seen patients with lap bands fail at losing weight but succeed losing weight with diet changes and lifestyle alterations. With regard to the reflux, the H. pylori and the weight loss I would suggest a wheat free, dairy free diet as these foods are problematic. I would suggest a low glycemic diet and remove starchy foods like bread, pasta, white rice and pasta. You need a good probiotic and perhaps some anti-fungal treatment. Now these are all things that can be easily accomplished but you will need medical assistance and dietary guidance. I can recommend a few starting points for you. The best dietitian I know is in my office and her name is Katherine. She can work with you by phone or in person. Her contact information is available through our website at lmihealth.com or call the office at (513) 924-5300. The probiotic you need and other assistance can be acquired at my office as well. I know you wrote on this blog looking for assistance but you case is too complex to unravel with simple direction. I have given you some leads and I truly hope you follow up and try to put this together.

      Talk with Katherine about the changes in your diet and see how far that takes you.
      Sincerely
      Dr. Gary Huber

  6. AshleyG says:

    Hi I’m 17, and I have a hernia. Lately its been getting worse.but I don’t eat the proper food, can you list the food I can and can’t eat .

    • Dr. Gary Huber says:

      Hi Ashley,
      What type of hernia do you have? There are many. For people with a hernia the issue is not solved by food choices unless you have a food allergy that is creating exacerbation of a hiatal hernia. See if you can find out what type of hernia you have and then blog me back with some information regarding the location of discomfort, the type of things that make it worse, are there any bad reactions to foods in specific, or other symptoms you are having. Is your body weight optimal? Excess belly fat can place pressure on hiatal hernias and create more pain.

      I look forward to hearing back form you,
      Sincerely,
      Dr. Gary Huber

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