Hiatus Hernia?

[Tolley]

I would further add that there are quite significant dangers with some of the commonest treatments for GERD by conventional medical treatments.

PPI's have come under close scrutiny in a few studies of late for their potential problems when taken long term.

In fact they might actually contribute to cancer according to this researcher.

The problem being that PPIs mask the symptoms of severe GERD and so damage is being done to the sufferer but they are unaware of it.

http://www.sciencedaily.com/releases/2011/07/110718161333.htm

Totally misleading post.

First of all, please do not post excerpts from the popular press as if they were scientific articles, even if they purport to be reporting on same. Post the original, actual article from the actual scientific journal. Popular press extracts are often inaccurate.

Secondly, the article referenced most definitely does not say or imply that PPIs "contribute to cancer". What they do say is that patients who obtain symptomatic relief with PPIs may be less likely to have endoscopic tests and thus some cases of Barrett's esophagus may not be detected. The researcher's conclusion is not that PPIs should be avoided, but rather than all cases of GERD, even those which get adequate symptomatic from conservative measures, would benefit from periodic endoscopy to screen for pre-cancerous conditions. Same would logically apply to cases of GERD which get symptomatic relief from herbal/alternartive ones.

Herbal products dont mask anything they alleviate the conditions so if you dont have any pain or discomfort when you are taking the herbal supplements then you wont be doing any damage unlike continual use of PPIs which mask the damage and only lead to more problems down the track.

[OldChinaHam]

Since this is a serious topic I will make no remarks that immediately come to mind.

Other than to say, I believe you meant Hiatal Hernia

One of which I have had the great pleasure to have inflicted on myself while trying to smack the pill

300 yards down the fairway.

This is better than an inguinal hernia, I will say,

Which I have not had.

Good luck to anyone with one.

There is NO good cure but surgery

And if you are in America you will pay plenty for 1/2 hour of surgery

So hope you are in Thailand.

Good luck, the surgery is not really that painful

I was up and reading a magazine upside down after the general anesthesia while I was still loopy ion the gurney of the recovery room. But you should be right as rain, in a few days, and need to abstain from driving because you do not want to make any sudden emergency braking maneuvers which could split you open again before you are healed.

Hope this helps.

Very easy

The surgery

Like falling off a log.

(Sorry, did not realize that there is another way of pronouncing/spelling this condition. But, please do not worry. If you get the surgery, it is relatively painless afterwards, and you just need to really take it easy, and do not make any sudden movements, and follow the doctor's recovery instructions, so that you have a good outcome, as did I. This surgery, for me anyway, is certainly nothing to fear, and I prefer it to something like a dental root canal therapy.)

Edited July 25, 2013 by OldChinaHam

[WitawatWatawit]

"Herbal products dont mask anything they alleviate the conditions so if you dont have any pain or discomfort when you are taking the herbal supplements then you wont be doing any damage ..."

Tolley, I know you are referring to the OP's condition with this statement, but some people might read this as blanket general advice. I hope not. For example, it has been said by some researchers that turmeric can affect the efficacy of beta blockers. From personal experience - and therefore purely anecdotal - I have found this to be true. If anyone wants to discuss this, I will open a separate thread. I was taking turmeric pills (kamin chan in Thai) because I firmly believe it works against prostate cancer - but don't take my word for it - do your own research.

On HH, I had one 20 years ago, but can't remember the treatment (might have been tagamet, but I can't be sure). Condition cleared up and has never returned. I did have some problems later which a doc in HK said was likely to be a stomach ulcer. No tests as I was heading back to Bkk. About then I read about NZ manuka honey, which even intrigued US health authorities. So I bought some, and after taking it 3 times a day for 2 weeks, my condition cleared.Should have gone for tests, but did not. No problem since. This is NOT ADVICE. Do not take it until you have researched it (there was not much in the way of internet in those days, so I took a chance - you DO NOT have to).

Cheers,

Wit

[haybilly]

Where do most of the medical experts on here recommend one should go for a good, safe, reasonably priced internal examination? Some years ago, when I could afford it, I had one at Bumrungrad BKK, but if there is an equally good but somewhat cheaper alternative, preferably without having to fly to India, could someone recommend?

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[negreanu]

Nexium the new omeprazole...works a treat 20mg a day for me was a life changer. Now find i only need 20mg every 2-3 days.

[Sheryl]

Where do most of the medical experts on here recommend one should go for a good, safe, reasonably priced internal examination? Some years ago, when I could afford it, I had one at Bumrungrad BKK, but if there is an equally good but somewhat cheaper alternative, preferably without having to fly to India, could someone recommend?

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By "internal examination" do you mean a genera check-up, or are you referring to endoscopy?

All of the large hospitals offer check up packages and you can compare their prices on the web.

They also all do endoscopy (gastroscopy being the one you would have for upper GI symptoms) and again, should be able to check prices on the web. Last time I priced it, Saint Louis was the l;east expensive of the private hospitals in Bkk for both gastroscopy and colonoscopy (endoscopy of the other end -- unlike gastroscopy, which is doen only for people with specific problems, colonoscopy is recommended about every 10 years for people over age 50 as a genera screening).

[haybilly]

Thanks Sheryl, your advice is always welcome.

Do you recommend going down to Bangkok, if one was living in Chiang Mai, or is the gastroscopy process something that any reasonable Thai hospital can safely undertake? I had my last one at Bumrungrad, but I am not in BKK and don't have access to the same level of finance these days.

[Sheryl]

You can certainly get a gastroscopy done safely in CM. I would suggest SriPat.

[haybilly]

Preferable to Rajavej? I have an irrational dislike of Maharaja, or Sripat, due to it's woeful parking-yes, I am being frivolous, actually. I really just meant that I am registered at Rajavej already.

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[Sheryl]

You an certainly get it done at Rajavej as well, just will cost more.

Doing the test is not complicated, any hospital will be OK. If abnormal findings then it becomes a matter of finding the best doctor to treat.

[haybilly]

You an certainly get it done at Rajavej as well, just will cost more.

Doing the test is not complicated, any hospital will be OK. If abnormal findings then it becomes a matter of finding the best doctor to treat.

Thanks again, Sheryl, and sorry to go on about this but--when you suggest Sripat, do you mean the standard Thai wing or floor 13 for foreigners--I didn't think that prices between the Foreign wing Floor 13 and Rajavej were so different--is this the case??

I have a couple of unrelated medical issues both of which may/may not require surgical intervention so I am trying to find my safest, cheapest and best option.

The other procedure is nasal, Rhinitis, nasal breathing, or lack of it, at night--just to let you know--although I am aware that this is not the Topic to discuss these matters and shall try to get info in another Post.

[Sheryl]

Sripat means the private wing but either is fine, same doctors, same standard of care, just more convenient in the private wing.

While Sri Pat costs more than the public channel at the same hospital, for something like endoscopy I think you will still find it less expensive than a private hospital, but by all means go ahead and price them both.

It is rare for results of a gastroscopy to require surgical treatment. Ditto rare to require surgery for rhinitis.

If you do go to Rajavej try to select doctors affiliated with CCU.

[haybilly]

Many thanks for your great help-you always give good advice.

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[haybilly]

Hi again, Sheryl,

can you just clarify what you mean by "affiliated to CCU"--is it a typo for CMU?

I fear I have given up with Sripat--I went down today, Monday, and after spending 40 minutes trying to park, walked a fair way from the city centre [ in the rain] only to find most of Chiang Mai were waiting at the bottom of the lifts to go up to all floors including 13--there were so many that there was a queue with attendants and a chain allowing a few through at a time--I even considered walking up the stairs but thought better of it--I am sorry to say that I gave up.

So, it's off to Rajavej now--hence the query about CCU or CMU?

[Sheryl]

Sorry, typo. Meant CMU.

[paul66667]

i just bought prevacid lansoprazole in government hospital 2400bt for 30mg 30 days supply, i need to take it with plavix as omeprazole and nexium have fda warning not to be taking with plavix, does anyone know if i can get shipped from india phillpines etc iknow 30 day supply in india cost about 10 us dollars for 30 tabs, anyone know how i can get them sent to thailand?

[jrtmedic]

Have you attempted to obtain the prevacid (lansoprazole) from an outside pharmacy. If you can locate an outside supplier it may be cheaper than the price charged at the hospital.

Sorry I cannot answer your import question.

[Sheryl]

i just bought prevacid lansoprazole in government hospital 2400bt for 30mg 30 days supply, i need to take it with plavix as omeprazole and nexium have fda warning not to be taking with plavix, does anyone know if i can get shipped from india phillpines etc iknow 30 day supply in india cost about 10 us dollars for 30 tabs, anyone know how i can get them sent to thailand?

Lansoprazole is available in Thai;land only under brand name Prevacid so the price you got is as low as it goes here.

A permit from the FDA (which you cannot get) is required for import of pharmaceuticals.

In any event the FDA warning you refer to applies equally to lansoprazole (and all PPIs) so is not a good reason for using that as opposed to a locally made brand of omeprazole which are extremely inexpensive.

In addition, the warning did not advise against taking the drugs, only advised that persons taking them who develop severe diarrhea should seek medical help quickly and have c. difficle ruled out. here is the full text of the warning:

http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm290838.htm

Omeprazole remains not only approved for use in the US but approved for OTC sale there. The incidence of c. difficile diarrhea is not at all high, though it is greater tyhan in similiar patients not on PPIs. Biggest risk would come if you were also on antibiotics.

[jrtmedic]

With respect

The FDA has issued a specific warning which relates to the use of Omeprazol + Plavix

Here is the detail

http://www.fda.gov/Drugs/DrugSafety/ucm231161.htm

The OP may care to discuss with his/her doctor the use of Zantac which does not interfere with Plavix

Edited August 21, 2013 by jrtmedic

[Sheryl]

You're right, I missed the reference to plavix and thought he meant the more generic warning.

There are some indications lansaprazole may also interfere with plavix though the data is less certain. Nexium seems like a better bet among the PPIs.

http://www.clotcare.com/clopidogrelprotonpumpinhibitors.aspx

[jrtmedic]

I believe the OP's original query related to cost.

It is unlikely (although I have not checked) that any of the "new" generation of PPI's is available in Thailand except as an expensive import.

It is for this reason I suggest that the OP discuss with his/her Doctor the possibility of using one of the older histamine H2-blockers such as Zantac as a possible alternative to expensive PPI's.