Hiatal Hernia This is a 34 year old postal worker who was seen with a compliant of heartburn awakening him from sleep in the middle of the night. Sometimes he would awaken choking on bitter stomach contents that came up into his throat while asleep. On one occasion, he was unable to catch his breath for several minutes and was afraid of dying. For the past three weeks, he had been sleeping sitting up in a chair. When we heard his story, he was asked to undergo a gastroscopy examination. Normally the opening between the esophagus and stomach acts like a one-way valve. This is called the Lower Esophageal Sphincter, or LES. It only opens when you swallow. Otherwise it is always tightly closed which prevents stomach acid from backsplashing up into your esophagus. This short video clip shows that this patient has a large hiatal hernia "pouch" and that his LES valve is always widely open. This allows stomach contents to reflux back up into his esophagus. This condition is often called Gastroesophageal Reflux Disease, or GERD. This patient was treated with daily medication to reduce the acid reflux and has been without symptoms every since. He sleeps like a baby.... Best viewed via a broadband connection such as cable modem or DSL service. A 56K dialup modem may take up to 10 minutes to load.
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