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Digestive Disorders

Hiatel Hernia and Anemia

05/26/2011

Question:

I am 47 yo obese female. Due to BCP, I usually do not have menses. I`ve had very large hiatal hernia for 3-4 yrs @ least. I have iron deficiency anemia but Dr also says I am losing blood. My HgB dropped to 7.5 2 wks ago, was 9.9 6 wks prior. Dr estimates I`ve lost 3 pints of blood since November. (I`ve had IV infed, transfusion, etc) I had EGD, colonscopy and sm bowel series. There were flecks of blood in hiatal hernia sac, but no erosions, or other obvious causes. Biopsies fm EGD and colonscopy all negative. The next step is camera endoscopy to completely check out small bowel. If that is negative, Hematologist feels blood loss is coming from hiatal hernia and need to have it repaired. The surgery, even laproscopic, makes me cringe. I`m concerned about complications, especially not being able to burp (I have a lot of gas). Dr says I can`t go on losing blood like I am. Wondering what you think, if surgical repair seems like next step assuming pill endo is negative. Anywhere else need to look before going to that extent? Who does most of these surgeries successfully in US? Thanks

Answer:

I think all we can say is wait for pill cam results and then do what is best, but surgery for this seems extreme especially since no signs of blood loss found on EGD.

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Response by:

Annette  Kyprianou, MD Annette Kyprianou, MD
Senior Clinical Instructor of Medicine
School of Medicine
Case Western Reserve University