Internal hernia complication

For me, my symptoms started several weeks ago and are basically the following: very stabby stabby under the rib cage on the right side; elevated liver enzymes; intermittent constipation and bloating; general feeling of ache in pouch area (worse when I eat but pretty constant); and swelling (of my lower body especially). I was quitting smoking at the time and had been taking Chantix which (per my Google searching) is known to cause stomach pain. At first I thought that was the problem so I called my cardiologist and asked to discontinue the Chantix. A week after I stopped that, the pain was still there and somewhat worse if anything. The swelling was getting very pronounced and I was feeling generally crappy. I started to worry that my smoking had caused an ulcer and so I followed up with both my heart doc and my RNY doc.

RNY doctor said the symptoms might not all be related to the internal hernia but the pain specifically is likely related. The diagnosis was made after I presented with the above mentioned symptoms and the RNY doctor ordered the following: CT with Contrast and referral to Gastroenterology. The gastro doctor ordered an MRI of the liver and an endoscopic exam. Cardiologist ordered heart echo with Definity Contrast.

Findings were: liver duct slightly dilated but not likely causing issues; on the CT a loop of bowel was seen above the diaphragm where it should not be; on the MRI for the liver this same loop was seen in the background; the scope found a small marginal ulcer and several esophageal ulcers. Heart was found to have unrelated issues that were known previously, nothing cardiac to explain the swelling found.

Treatment plan: Medication for the ulcers, Lasix for the swelling added to several other cardiac meds I was already on; and surgery to repair the internal hernia.

I am scheduled for the surgery next Wednesday. One week out of work, several weeks of lifting restrictions. Luckily I don't really 'do' much for my job as far as physically so I should be ok pretty quickly. It is all super frustrating but I am glad to get it done. If I have any episodes of extreme pain before then I must go to the ER right away. If the bowel becomes 'pinched' it could rupture or suffer tissue death leading to possible sepsis infection and lots of risky badness.

For those of you curious about the how and why of internal hernia stuffs...

My RNY doctor said basically that I have lost such a high percentage of my body fat that the mesentery has become too thin and fragile. It has now torn and a loop of bowel has slipped up and out of the proper area. This leaves me at risk for the blood supply to be compromised to that loop which could then become and life threatening problem very quickly.

Internal hernias are a fairly uncommon complication of laparoscopic RNY but certainly are known to happen. Since you may not have symptoms very long prior to having a seriously life threatening issue develop, keep in mind that pain is not normal. If you are hurting, go talk to your doctor. I almost chalked all of this up to being stressed out and quitting smoking. If I hadn't had the complete work up and great doctors I have this could have been missed and I could have been in real danger.

Internal hernias are most common 6 months to 3 years from surgery and more common with people who are very successful in losing weight. Here is a link to an article I found interesting as I researched to better understand what was what.

If you have had experiences with this type of complication, I would love to hear your story.

I'm glad you you paid attention to the pain and sought answers. Did they mention this to be a Peterson's hernia? My doc mentioned it to me as a possible complication- your description sounds a lot like like how he described how it could occur. (Successful fat/weight loss creates pockets the bowel can get caught in)

Yes, that is a type of internal hernia. He said it is similar but it looks (from the imaging) like my bowel might have slipped through a different area. I had a Peterson's hernia last year already so this is round two for me of hernia surgery :( Basically the same symptoms and treatment though.

Wow, I can't offer any advice, no experience with hernias...but wanted to say good luck next week.

I'm glad that you are scheduled for surgery and that you heal quickly.

Ugh..Sorry to hear that. Unfortunately I can relate.

I had so far 3 surgeries to fix internal hernias. They fix Peterson - another one popped out. Then 2 years later another small one with kinked bowels. When I was waiting for surgery - I ate lightly - mostly liquids and slider foods, small portions, very I low fiber, but enough fat to help "lubrication" of my insides.

Walking helped to move "food" when it got "stuck" in the part of the gut inside the hernia. Gut massage. Breathing exercises. Etc...

I hope things get better for you soon. Sometimes it sucks. Hugs.

That is a great idea! I think I need to do that. The doctor didn't really offer any diet/eating advice between now and then but I bet it will be more comfortable and less likely to end up in the ER if I go with liquid/squishy. I'm going to try for that. Thank you for your thoughts and sorry we are hernia buddies. :)

I don't have any experience with internal hernias. I'm glad that you will be getting surgery! I hope everything turns out well. Good thoughts headed your way!

I am getting ready to have my 3rd hiatal/sliding hernia repair done along with a revision due to gerd. I know our hernias are different but the symptoms can be very similar. The pain and swelling can be so uncomfortable. I'm sorry you're going through another surgery but very glad you followed through and caught it early. Best of luck to you next week!