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From: CKP
Date: 11/02/01
Time: 18:45:32 -0600
Sure, that's a good question.
Hiatal hernia repairs can be done, and the mesh is pretty commonly used with children and sometimes with adults as well. The reason that they don't just do that repair is that it usually doesn't cure the GERD symptoms. Many folks have both GERD and a hiatal hernia, but the hital hernia may not cause or contribute to the GERD in any way. They just have both conditions:) Doctors used to think that a hiatal hernia causes GERD, and certainly in some people it does, if it's a mechanical thing where the angle of the hiatal hernia prevents the LES from closing properly. But many people have a hiatal hernia without ever experiencing GERD symptoms or esophageal erosions.
That's why the fundoplication is needed, to create a new LES and actually stop the reflux.
Any hiatal hernia absolutely needs to be repaired as part of that surgery because the extra bulk of the fundoplication might tear the diaphragm worse, and it might be that the hiatal hernia is contributing to the GERD--it's really tough to tell that.
Actually, patients do not "typically" have gas build-up problems. It's a common complaint, yes, but in one study I saw from the group at Emory, about 60% of patients had no bloating at all (at one year post-op).
I was grateful to be in the majority; I didn't have any gas problems, and I love refried beans and broccoli. But since that was working well, I didn't think to post, "No gas problems." We tend to see the negative stuff on this board, but that doesn't mean it is typical overall.