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I have went to the emergency room two weeks ago due to

Customer Question
I have went to...

I have went to the emergency room two weeks ago due to having really bad chest pain, shoulder blade pain, under my left rib, really bad nausea. I was told I have a hiatal hernia. And though they didn’t pay attention I believe I have an umbilical hernia as well because there’s a ball above my bellybutton. They(ER) told me I have to follow up with my primary ASAP. I did and my primary seemed to be lost on what it is. I’ve been in so much pain it’s hard to eat or drink because it feels like food gets stuck and struggles to go down. Feels like sharp stabbing. Everything I’ve researched has giving me answers of a strangled hiatal hernia and says it requires immediate surgery. I feel if I go back to the ER I will get the same answers. I’m now waiting for referrals to go through but I don’t know how much more I can tolerate this. I have 4 kids and work hard full time. I don’t know what to do

Doctor's Assistant: Have you ever dealt with this before? Are you having any shortness of breath?

Yes especially when I talk

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I’ve had my tubes removed after my 4th child, I do have gastritis, I had asthma when I was a child. I’m 31 years old

Submitted: 3 months ago.Category: Medical
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Answered in 1 minute by:
3/8/2018
Doctor: Dr. Sohaib, Doctor replied 3 months ago
Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 5,337
Experience: MBBS, FCPS Experienced in all Medical Specialities
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Hello and thank you for the question.
I am Dr. Sohaib, a practicing Internal Medicine Consultant with over 13 years of experience and I will do my best to help you today.
Let me review your question for a minute and I will get back to you.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

I would like to ask few details regarding your symptoms/question to assist you more efficiently.

How did they make a diagnosis of hiatus hernia in ER? Was it based on previous endoscopy report?

Are you taking any treatment for these symptoms currently? And for gastritis?

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Customer reply replied 3 months ago
They did a chest x-ray and currently taking no medicine. All they gave me was Tylenol pills which I haven’t taken because it’s painful
Customer reply replied 3 months ago
Any advice??
Doctor: Dr. Sohaib, Doctor replied 3 months ago

Thank for your patience.

The whole clinical picture goes with severe reflux, gastritis, which can be due to hiatus hernia itself, or even with out it.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

And I wonder if the empirically made a diagnosis of hiatus hernia, which is usually sliding in nature, why didn't the put you on Proton Pump Inhibitors with these symptoms like Nexium or Losec.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

As of now it doesn't look like Obstructed, as this is a serious emergency and untreated can lead to severe complications, like severe intolerable pain, forceful vomiting, inability to tolerate anything, and shock.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

Given the history of gastritis, and considering current symptoms, I will suggest you to try Prilosec 20 to 40 mg daily and see how you respond to it in next few days.

If the pain is severe, unbearable, then the only option is to go to ER for urgent help.

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Customer reply replied 3 months ago
I don’t have heart burn. It’s all sharp stab tightness I feel. It’s hard to have a bowel and when I have gas it’s like I have to push it out.
Doctor: Dr. Sohaib, Doctor replied 3 months ago

In obstruction, there will be no bowel movements; and you will end up with severe abdominal distension, not able to pass any thing. Heart burn is not always the symptom of reflux, many a times, it is only pain or a feeling of something stuck in throat/food pipe.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

With these symptoms, if still remain uncontrolled with omeprazole, I would seriously consider doing a CT abdomen to exactly identify what going on.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

And if CT is negative, then next step should be an endoscopy.

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Doctor: Dr. Sohaib, Doctor replied 3 months ago

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