Hiatus Hernia

[Daz217]

Quite a common problem i suspect. I have one and wondered what effect it would have on my Diving.
I spoke with a Diving Doc and he advised me that it was not a contradiction.
With the usual advice not to eat heavy meal prior to diving etc. However and this may be useful to someone if you have surgery to repair the said Hernia then Diving is a no go. This is because post Op you lose the ability to belch and therefore put yourself at risk of Gastric Rupture due to the fact you could not expel gastric gas on it's expansion during ascent if you needed to.
Hope that snippet was as useful to someone else as it was to me.

[Rod]

Originally Posted by Daz217

However and this may be useful to someone if you have surgery to repair the said Hernia then Diving is a no go.

Not heard that before and I know a couple of divers who have had the op and still dive. I must look into it some more

[Rod]

Latest advice from DAN seems to read that SOME people can have a problem and should only not dive if the distension persists.

"A few who have had surgical repair of their hiatal hernia (e.g., fundoplication) can suffer from gas-bloat syndrome, which is associated with gaseous distension of the stomach. This is believed to occur due to one’s inability to expel swallowed air by belching. During an ascent, this distension can also lead to gastric rupture. The symptom usually resolves within a few weeks. If the distension persists, however, diving is not advised."

[BJ]

It seems to be something that awaits us all as we get older. It really only affects us when we go horizontal (as when diving or lying down to sleep!). After going throught the Gaviscon, Zantac route over the years, I got prescribed Omeprazole, which seems to do the job. A top diver friend swears that a spoonfull of honey and a spoonfull of wine vinegar swallowed each day is just as effective. As someone says, surgery can be a contraindication to diving.

[Daz217]

Thanks Rod i looked it up on DAN aswell.
I'm confused one Diving Doc says definate "No Diving" post op, another says "Yes to Diving" post op.
Totally contradictory advice and i haven't a clue but even by my limited intelligence one of them has got to be mistaken.
Think i'll err on the side of caution and keep popping the antacids and avoid the op as long as possible.

[Sixsquid]

I had a hiatus hernia and it is/was considered a contra-indication re diving

If you've had one, you know what the issues are but this is how Dr Jules Eden summed it up

"The problems with a hiatus hernia and gastric acid reflux are well known in diving. Picture the scene. You are finning along with your weight belt pulled tight across your tummy. You dip down to look at the reef, and the acid ascends up your oesophagus into the back of your mouth. A cough, an inhalation, and lo, the acid now descends into your trachea. Your bronchi then go into spasm and you can't breath. Not a welcome result at 30metres.

That's the theory anyway.

But like all things medical there are ranges of this problem. If you still get reflux at the drop of a hat despite the medication, forget diving until you have had an op on the hernia. However if your acid problems are controlled with those tablets and reflux is a rare event then you will be fine to dive.

It is also worth using integrated BCD or tank weights to stop any excess pressure on your abdomen. Lay off spicy food and try to lose as much weight as you can, as this can make the problem worse. "

e-med Private Medical Services - Scuba Diving Medical Advice - Gastrointestinal Problems | Gastro-Oesophageal

I have had the op and yes, you can't burp for a while and 2 years on I still can't burp quite how I'd like to and consequently any 'trapped wind' takes the alternate route. Still, avoid fizzy drink and gas inducing food before diving and all should be okay.

I dived with my hernia as it was well controlled on Losec (omaprozole) but, after 20 years since diagnosis, I had quite severe symptons (enough to suffer immensely without the tablets to the point I couldn't eat at all!) and took advantage of the keyhole surgery option once the NHS were happy with it.

Having the op was like a whole new lease of life for me (irrespective of diving) and I whole-heatedly recommend it. Lost a stone in 2 weeks aswell

I have a diving friend who seems to have a hernia and it has caused him to vomit while diving. Each person can have varying symptons and triggers. No way could I eat anything remotely spicy but I also had issues with spring onions and champagne (not together obviously) Real bugger at all those celebration events. I could only drink my champagne with orange juice

If I can help any further just let me know

[Daz217]

Thanks mate, That was useful. I have looked all over the T'internet for advice/info on this.
Basically i am not quite as bad as not being able to eat (yet). I control the reflux with Meds and they seem to work.
My local medical referee will not shift on his decision namely OK to Dive with it and on Meds but if i have surgery he will NOT pass me fit to dive due to the risk of gastric rupture.
Another Diving Doc says don't Dive until you have had it repaired???????????
As i say obviously everyone is entitled to an opinion but how can professionals in Diving Medicine vary so vastly in advice on the same subject. You would have thought the answer would be the SAME from every Doctor.

[Snash]

Daz

A mate of mine has had the op for this and he still dives. He is also a diving doc (in a professional caspacity as opposed to a doc who dives).

However given one of his nicknames is Doc Savage, I wouldn't take that as a recommendation for the all clear .

I'll ask him his views (in a hypothetical situation type of way). Although it may come back as a "do as I say and not as I do" situation.

Snash

[ericdv]

My Doc is a doctor who dives rather than a medical referee. Whilst I was waiting for the operation he advised me not to dive but made no mention of any restriction post op. and I resumed diving with no problem a month after surgery.

The operation 6 months ago was keyhole surgery and I have had no problems at all since.

[sas steve]

I was diagnosed with a hiatus hernia about 3 years ago and have been taking Omeprazole since(1 a day) I work full time as a Hyperbaric technician and dive dry to 15mts every day without any problems. I also dive regularly for HSE work and pleasure and have never encountered a single problem. I am a big fan of spicy foods and Red wine which i regularly enjoy again without any problems despite the warnings against them. I think essentialy this is a common ailment amongst us 40 somethings and you have to weigh up the risks and benefits of an operation for yourself, I have chosen to not have an invasive operation until i really have to. It looks like we could have a separate Hernia forum from the replies so far.