That old chestnut, if you have your health you have everything!

Yesterday was my medical test day.  I’m pretty much talking soup to nuts … what with EKG’s, lots of blood work and then an afternoon at Mt. Sinai Hospital getting hundreds of pictures taken of my esophagus and stomach from the “inside” view.

Sheesh.  It was enough to make me heave, which I’m proud to say I didn’t, but having been prone on a surgical table for 45 minutes with lots of tubes, IV lines and the like, I do have pains in odd places today that are inexplicable such as the weird spot on my left jaw and the sore in my mouth just below my lip on the right side.

Hiatal Hernia, Credit: Medicine.net

Things are mostly okay with a few surprises — such as a Hiatal Hernia and some funny looking inflammation in my stomach.

For those *not* in the know (such as myself twelve hours ago), a Hiatal Hernia is when part of the stomach pushes through the diaphragm into the space were the esophagus passes through to the stomach.

According to the Mayo Clinic’s website, “Your diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a Hiatal Hernia.” (Link)

Many patients who have been diagnosed with a Hiatal Hernia (such as myself) don’t exhibit any particular symptoms other than GERD (Gastroesophageal Reflux Disease) and may only discover that they have a hernia after undergoing an Endoscopy. (An Endoscopy is a surgical procedure which entails a GI specialist viewing your esophagus through a tube that passes through the esophagus and the stomach all the way to the small intestine.  It is also known as an Upper GI Endoscopy.)

The diagnosis of a Hiatal Hernia is also found in patients who have Barrett’s Esophagus — and such is the case with me.

For those who’ve never heard of Barrett’s Esophagus, “it is a condition in which the cells of your lower esophagus become damaged, usually from repeated exposure to stomach acid. The damage causes changes to the color and composition of the esophagus cells.” (Mayo Clinic Link.) The process, known as “metaplasia” actually changes the cells from the normal ones found in the esophagus to the type of cells normally found in the intestines!  To quote some more from the Mayo Clinic write-up, “A diagnosis of Barrett’s esophagus can be concerning because it increases the risk of developing esophageal cancer. Although the risk of esophageal cancer is small, monitoring of Barrett’s esophagus focuses on periodic exams to find precancerous esophagus cells. If precancerous cells are discovered, they can be treated to prevent esophageal cancer.”

Acid Reflux, Credit: Greater Baltimore Medical Center

GERD is the usual precursor to Barrett’s Esophagus.  In my case, the thinking is that I’ve had this for many years, but because my symptoms were not related to the classic heartburn of old Alka Seltzer commercials, but rather as sore throats and coughs, what I had always thought were seasonal allergies turned out to be LPR or Laryngopharyngeal Reflux Disease.  In other words, discomfort in my throat, not my stomach!

Often called “silent reflux” this particular permutation of gastric reflux is often linked to GERD as well as a risk factor for developing Barrett’s Esophagus and other Esophageal conditions. As well, Hiatal Hernias are also often seen in GERD and LPR patients.  (LPR Link)

All of these conditions require diagnosis, treatment and follow-up by skilled GI and ENT specialists and should be taken seriously.

There are also important steps that patients such take to help mitigate the discomfort and risks associated with these conditions.  Changes included the following suggestions:

– If you smoke, quit.

– If you are overweight, commit to returning to a normal weight for your height and body type.

– If you don’t exercise on a regular basis, you should strongly consider starting.

– Avoid the “no-no” foods:  Soda/carbonated beverages (even club soda), alcoholic beverages, chocolate, mints, citrus fruits/drinks/juices, spicy foods, tomato-based products, caffeine, fried foods, high fat foods, refined flours/sugars, highly acidic foods.

– Eat small meals/snacks 5-6 times per day, instead of 3 large meals.  This helps to digest food faster, especially if you eat one type of food at a time rather than loading up with lots of different foods as once.

– Try to take a walk after eating. A twenty-minute “constitutional” should do it. This really aids the digestive process.

– Stop eating 3-4 hours before lying down/going to bed

– Invest in a wedge pillow (gradual include to 6 inches) and use this for sleeping at night.

Also realize, that you can affect the outcome of your own health — and while things may not return to perfect, your commitment to yourself and doing what you can to help yourself, really does make a difference.