If you've been considering Hiatal Hernia surgery I'm glad you're here.

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I am not typically a fan of the surgery but that doesn't mean I never think it should be done.

The majority of hiatal hernias are small and sliding, and much can be done conservatively to regain optimal functioning of your GI tract. If this is you, then this video, and in fact this channel is for you!

Large hiatal hernias and paraesophageal hiatal hernias are a different story where surgery is often the only option.

Today we're discussing a side effect of the surgery that is truly horrible and life altering and can affect up to 20% of those receiving the surgery. Predominantly those affected have undergone the Nissen Fundoplication, but considering that is the most popular surgery occurring, this would apply to most people undergoing the surgery.

The side effect is called Dumping Syndrome and it refers to the rapid emptying of the stomach contacts into the small intestine, causing a cascade of unpleasant symptoms.

When does it happen?
The LES (lower esophageal sphincter or valve) is tightened during surgery - this is commonly done

The stomach is repositioned or wrapped - this is exactly what the surgery is designed to do, so you can expect this to happen.

The pyloric sphincter (it connects your stomach to your small intestine) becomes dysfunctional and thereby cannot hold back food from the stomach adequately. The result is that the small intestine receives undigested food too quickly. 

On this last point, it is important to realize that while the surgery is targeting the upper stomach and esophagus, it can unintentionally affect the lower stomach and pylorus due to a combination of nerve disruption, anatomical shifts (the stomach being moved around), and altered gastric motility. 

Surgery is a major disruption to your body. Yes, it's sometimes very needed, but it doesn't come without risks.

What's the mechanism?
The stomach can lose its ability to properly stretch to accommodate food.
The surgery can damage or bypass branches of the vagus nerve which regulates the stomach's emptying speed.
Pyloric sphincter dysfunction that prevents the pyloric valve from being able to hold food back adequately resulting in the small intestine receiving undigested food too quickly.

What are the types of Dumping Syndrome? Early and Late
Early occurs within 15 to 30 minutes. Food should stay in the stomach for 2 to 4 hours. PLEASE NOTE: I misspoke this timing on the video. Apologies...

The symptoms of Early Dumping Syndrome include: nausea, cramping, bloating, diarrhea or urgent bowel movements, dizziness, faintness and rapid heartbeat.

Late occurs 1 to 3 hours after eating due to rebound hypoglycemia (low blood sugar) which occurs after blood glucose is absorbed too quickly.

The symptoms of Late Dumping Syndrome include: weakness, sweating, feeling shaky, brain fog, and heart palpitations.

If you have acid reflux or hiatal hernia there is much that can be done for you conservatively. We'd be delighted to help, so that surgery can be avoided for most.

If you'd like help we're here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

#hiatalhernia #acidreflux #rootcausemedicine