Is it IPF or Hiatal Hernia?

[Judith Stryker-McGill]

I have a hiatal hernia diagnosed from a CT scan. My symptoms are a sensitive gag reflex with frequent vomiting especially after drinking a large amount of liquid or taking multiple pills at once. I fill full after eating a small amount. I have nausea and lack of appetite but that may be due to OFEV. I do not have chest tightness or pain that you described. It seems reasonable that some of your symptoms are related to hiatal hernia and PF. A hiatal hernia can cause regurgitation which they believe is one cause of pulmonary fibrosis. I had a surgical consult for a HH repair but the surgeon said that I am too high risk due to PF. I am going to get a second opinion. My personal opinion is that you should find out what type of HH you have and its size. Then you doctor can determine if either meds or surgery is the best option – or hopefully will tell you that you need neither!! Good luck – it is a complicated situation.

[José]

I am a IPF at end state. My HH is a horrible thing to have. I can’t even bend over to pick something up or I will pass out. I ask about the surgery to repair HH, but due to my lungs condition they would not even think about it. Also I was told that they may repair your HH (which you can see a video of the procedure I think is on Youtube), but not many make the surgery.

[Sis]

I have a large HH. I’ve had it for 30 years or more (I’m 76) but it is getting larger. My last CT Scan for my PF mentioned how large it is. I never have relief from it my food takes forever to go down, my chest and throat burn constantly sometimes I spit up liquids and my stomach is always swollen. It’s very uncomfortable. I have an Endoscopy next week and am hoping I can have a Mesh over it to hold it down. I read about the Mesh on internet but I can’t remember how I found it. I think I just Googled HH Repair. I’m sure you can find it. I was diagnosed with PF in August 2024 so I’m still learning a lot. My other concern is doctors still don’t know what kind of PF I have. Can anyone advise me on how to find out. Went to UCLA in Los Angeles but they did nothing. I’m on OFEV 100 mg 2 times daily and tolerate it well. Don’t cough as much since been on it. On 3 level oxygen. This summer my oxygen has gotten lower . I live in the desert and we’re having a heat wave. Don’t go outside much.

My first time to post so greetings to all my off my PF friends and prayers for all.

PS: I will let you all know what I find from my Endoscopy

Thanks to all!

[Temple Mayo]

You may have idiopathic PF, which means they don’t know what causes it. There is a large number of PF patients who have had GERD. That’s where I am. In March 2024 I had HH surgery and have has no problem with GERD issues since. Good luck

[Denise Stogdill]

I have both a hiatal hernia and IPF. I had the hiatal hernia first, for around 25 years before I was diagnosed with the IPF. Since I’ve been diagnosed with IPF, I haven’t felt any worsening with my HH. My symptoms have continued to be similar. My gastroenterologist however, has put me on pantoprazole 40mg and that is working very well for me. There hasn’t been one GI doctor that has suggested I have the hernia removed.

For Sis, the one way that they can identify your pulmonary fibrosis is by doing a lung biopsy. I had a biopsy done. While you’re put out during the procedure, the recovery has been one of the most painful surgical recoveries I have had. That being said, it’s probably one of the best things I’ve done since it identified my fibrosis and I’m being treated for it.

Hang in there guys! 🙏🙏🙏

[Sis]

Thank you for reply Denise. For my HH I have been on Pantoprazole for many years. It used to work well but since my PF diagnosis it has rapidly gotten worse. I have had biopsies last year 2023 but doctors only told me I have PF. I’ll keep searching. Prayers for you.

[jap]

I was diagnosed with IPF in April 2022. Was told I had 2-4 yrs to live. Tried OFEV but had bad reaction and ended up in hospital. Was referred to Dignity Health/Norton Thoracic in Phoenix AZ for possible lung transplant. End result – pulmonary team there felt there was underlying cause for the fibrosis. After many tests and lung biopsies along w consult with Cleveland Clinic I was told I had Silent Aspiration along w hiatal hernia. After more testing it was decided to do Nissan Fundoplication where the stomach is wrapped around esophagus. The chronic gerd had caused all the lung scarring and that I was misdiagnosed by original pulmonologist. Will always have pulmonary fibrosis but the hope is it will not get worse. I need oxygen when exerting myself (like simple walking) and have Barrotts Esophagus but I can live with that.

[Sis]

Hello jap. Thanks for t reply. I have never heard of Silent Aspiration and HH. I need to go to that clinic in Phoenix you went to have my HH checked It is pretty close to where I live as I live in Las Vegas, NV Also I have never heard of Barotts Esophagus I’ll research it to learn more

Pray you will live many more years than you were told

[Pattye]

I’ve had GERD for years. After being diagnosed 2 years ago with ipf, I had a terrible time breathing if I bent over. My Gastro Dr. Didn’t think my hernia was very large & not bothering my lungs & said my lungs couldn’t handle surgery. I got a referral to UT Dell Medical in Austin & they wanted to do surgery immediately! I had it done in January & the quality of my life has greatly improved. No more tightness in my chest, my crackle & wheezing has stopped & I can bend over! I only spent one night in the hospital. The diet was the hardest part of the surgery & recovery!

[papa]

I have read all the responses and good information. I have had IPF for about 4yrs. I have had Gerd for many years and have been on Nexium for a long. cause This gerd at night when I am lying down causes me to spit up phlegm and interrupts my sleep. I have started taking reflux gourmet at bedtime. You can get it on Amazon. It coats the esophagus so you don’t have the backup in your throat. I use o2 at night.

During the day I walk and do chores around the house. Going up and down stairs can be a stretch. I now use a rescue inhaler for tasks that cause me to lose my breath. I can see that my breathing has gotten worse over time and causes some depression once in a while. It is good to share with this group.

[Sis]

Thank you Papa for the good information. I will definitely try the Reflux Gormet you mentioned. Good luck to you.

[Temple Mayo]

Hi everyone. I would like to weigh in on this conversation with my experience. In 2021, I, like many, was diagnosed with IPF after undergoing an xray in prep for bilateral inguinal hernia surgery. Unfortunately, my PCP sent me to a private practice pulmo. Big mistake.

After an HRCT, pulmo diagnosed me with ILD, which as you know, is the larger category of lung diseases that include IPF. For two years, pulmo treated me using a “wait and see” approach, which meant he did not prescribe antifibrotics. My PFT scores were decent except for diffusion, which continued to decrease over the two years I treated with pulmo. For an ancillary reason, I decided to go to the teaching hospital we have in my city. My new pulmo put me directly on Ofev. The question becomes, what did the loss of two years on antifibrotic therapy cost? I’ll never know. But, I tell you that story to suggest to everyone to get treatment frrom a pulmo at a treating hospital, if possible. Alternatively, treat only with pulmos who are part of a transplant program. I have completed transplant eval at another teaching hospital in my state. While I may never get a transplant due to age or other affliction, I am happy that I am a transplant candidate if that option becomes necessary.

During my transplant eval, I was diagnosed with GERD -which I knew- and a hiatal hernia. The transplant team suggested that I undergo surgical repair, which I did in March. There is no necessary correlation between GERD and IPF, but a significant contingent of IPF patients have GERD. It is thought that stomach acid is regurgitated during sleep and some of the acid trickles down the trachea into the lungs causing scarring. So, if you have a hiatal hernia, you may want to have it repaired if medically advisable.

Finally, someone asked recently about post-nasal drip and what to do about it. Like many of us, I have had PND for as long as I can remember. What my ENT has suggested is to use Nasacort and Astepro once a day. According to him, these two drugs can be used daily. In any event, it has help my PND greatly,

God bless all of you.

Temple