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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 years of experience and an award-winning educator.
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I have a atal hernia and also uterine fibroids outside my

Customer Question

I have a hiatal hernia and also uterine fibroids outside my uterus . My ob gyn said I'm equivalent to 18 weeks pregnant in terms of uterus size . Could the fibroids and uterus size be causing the hiatal hernia ? In terms of options I've been told by my ob gyn if I can bear the pain then no need to operate but I could have a hysterectomy and keep the ovaries if the symptoms are bothering me. Also what do you think of repairing a hiatal hernia ? heard it could cause complications and worse symptoms than I have now ( I suffer from bloating , I look five months pregnant , flatulence, burping , inflammation in esophagus makes me need to eat every two to three hours as food absorbs the acid although I must say mine is a silent reflux ) I don't get heartburn .. Also is it safe to do both operations together ??
JA: Thanks. Can you give me any more details about your issue?
Customer: My issue is I need to eat every two to three hours and bloated badly also some shortness of breath and they discovered I have a hiatal hernia and uterine fibroids . Please read above
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Submitted: 9 months ago.
Category: OB GYN
Expert:  Dr. C. replied 9 months ago.

Hi, It's Dr. C. Board certified Ob-gyne. I can help you today.

I'm sorry to hear about your symptoms and findings. A fibroid as big as that can contribute to a hiatal hernia. There is pressure upwards from the fibroid and if there is any weakness at all in the diaphragm, that pressure will push the abdominal contents upwards and contribute to a hernia.

Options for the fibroids are several but best option depends on your age and overall medical health. If fairly close to menopausal age a medication called Depo-Lupron can be used for 6 months to shrink the fibroid. But in the meantime, we hope that the woman becomes menopausal because if not, the fibroid will regrow after treatment. So this is the least often used option. But it can sometimes be helpful if a woman is very close to menopause and has some medical conditions that make the other options too risky.

The second option is a UAE (uterine artery embolization). This can be used at any age but works better the closer a woman is to menopause. It can be a good option and causes the fibroids to shrink by about 50%. Recovery is pretty fast, most women are back to work within 1 week. But if a woman is still far away from menopause, there is a risk that the fibroids will grow back.

The third option is hysterectomy. The ovaries can be left behind so the surgery would not cause immediate menopause in most women. In my experience, women with a size of fibroid as you have and are not close to menopause, are happiest with this option in the long run. The 100% guarantee that a woman will never bleed again and never have fibroids again is hard to beat. But if a woman really wants to avoid hysterectomy or can't afford the time off, the UAE is a good 2nd choice.

The best person to give you an opinion about whether repair of the hiatal hernia should be done at the same time or wait to see if the hysterectomy or other treatment of the fibroid helps is a gastrointestinal surgeon (GI surgeon). If they think you'd benefit from repair, the procedures usually could be done at the same time. It would require coordination between the surgeons.

Most women get a lot of relief in GI symptoms from removal of a fibroid of that size.The relief may be good enough that hiatal hernia repair may not be needed at all.

I hope this information was reassuring and helpful. Let me know if I can clarify anything or add details. I want to be sure you get the most helpful information for your situation.