ENDOSCOPIC SURGERY TREATS PERSISTENT HICCUPS LASTING OVER 10 YEARS IN A 68-YEAR-OLD MAN

A 68-year-old Cambodian man visited Nam Sai Gon International General Hospital in a state of fatigue and had difficulty eating due to severe gastroesophageal reflux disease (GERD) and persistent hiccups that had lasted for more than 10 years.

Endoscopic Surgery Treats Persistent Hiccups Lasting Over 10 Years In A 68-Year-Old Man

According to Nam Sai Gon International General Hospital, the patient, Mr. H.V. (68 years old), arrived with complaints of fatigue, loss of appetite, and vomiting. His medical history included long-standing diabetes and essential hypertension. For over a decade, he had experienced chronic hiccups and acid reflux but did not seek medical attention due to underestimating the symptoms. Only when the condition significantly worsened did he come to the hospital for treatment.

Upon initial examination, the doctors diagnosed him with a hiatal hernia, a common gastrointestinal condition with a high risk of complications. In simple terms, a hernia occurs when an internal organ pushes out of its normal position. Typically, the stomach lies below the diaphragm — a thin, dome-shaped muscle separating the chest and abdominal cavities. The esophagus passes through a small opening in the diaphragm called the hiatus to connect with the stomach. In hiatal hernia, part of the stomach pushes up through this opening into the chest cavity.

Dr. Nguyen Trung Duong, MMed, Specialist Level II, Deputy Head of the General Surgery Department at Nam Sai Gon International General Hospital, explained:

“Sliding hiatal hernia is a common condition in older adults, occurring when the muscles and tissues around the hiatus become weakened, allowing abdominal organs to slip into the chest cavity.” This is the most common type of diaphragmatic hernia and is often associated with acid reflux, significantly affecting the patient’s health. If not detected and treated early, it may lead to serious complications such as bowel obstruction, intestinal necrosis, volvulus, pneumonia, or respiratory failure.

Based on the esophagogastroduodenoscopy (EGD) results, Dr. Duong diagnosed the patient with atrophic gastritis, hiatal hernia, and GERD. The hernia was compressing the diaphragm and the phrenic nerve — the nerve responsible for controlling breathing — leading to spasms and prolonged hiccups. In addition, acid reflux further irritated the phrenic nerve, exacerbating the condition. Dr. Duong emphasized: “The goal of treating a hiatal hernia is not only to control the symptoms but also to minimize the risk of dangerous complications”.

Given the severity of the condition, the surgical team opted for laparoscopic surgery to correct the hernia. After more than two hours, the General Surgery team at Nam Sai Gon International General Hospital successfully closed the diaphragmatic opening and performed a Nissen fundoplication — a procedure that helps prevent acid reflux and strengthens the lower esophageal sphincter (LES). This approach reduces reflux-related discomfort and lowers the risk of long-term complications.

According to Dr. Duong, this condition is relatively common, especially in elderly or overweight individuals. To reduce the risk of developing a hiatal hernia, it is essential to manage body weight, maintain healthy lifestyle habits, and follow a balanced diet. Recommendations include eating slowly, avoiding spicy foods and those that trigger acid reflux, and limiting overeating.

Following surgery, Mr. V’s condition stabilized, his digestive function improved significantly, and his overall health recovered well. He has been discharged and continues to follow outpatient care as prescribed by his doctors.

Hiatal hernia can lead to dangerous complications if left untreated. If symptoms such as epigastric pain (below the ribs and above the navel), early satiety, nausea, hematemesis (vomiting blood), reflux, chest pain, or shortness of breath occur, patients should promptly visit a medical facility for timely diagnosis and treatment to avoid serious health consequences.

Nam Sai Gon International General Hospital accepts both public health insurance and private health insurance.

We would like to thank Tiep Thi Gia Dinh newspaper for sharing this information with its readers.

Nam Sai Gon International General Hospital

No. 88, Street No. 8, Trung Son Residential Area, Binh Hung Commune, Ho Chi Minh City.

Hotline: 18006767

info@nih.com.vn

BRC: No. 0312088602, issued on December 14th, 2012 by the Department of Planning and Investment of Ho Chi Minh City. Medical Examination and Treatment License No. 230/BYT-GPHĐ, issued by the Ministry of Health.