Hiatal Hernia

When the upper portion of the stomach penetrates into the chest cavity through a hole in the opening of the diaphragm, Hiatal Hernia is caused.

Description of Hiatal Hernia

This type of hernia is very common and is mostly seen among the people who are overweight. In most cases, a hiatal hernia does not cause any symptoms and is of no importance. Thus, there is no chance of predicting hiatal hernia in advance unless a doctor discovers it in a routine x-ray check up.

In addition to this, you may be very much aware of its most common symptoms:

Gastresophageal Reflux – is a burning feeling that spreads out upwards from the lower part of the chest or upper abdomen. Alternatively, this can also make an unpleasant regurgitation that occurs when one lies down or bend over the body.

Many Doctors believe that a hiatal hernia adds to backward flow of the contents in the stomach. The stomach and esophagus in our body are separated by a sphincter, which is a ring-like muscle. This is like a muscle that acts like a rubber band preventing the contents of stomach from backward flow. This acts like a one-way valve. Sometimes, as the pressure in the stomach increases, the pressure at the muscle also increases and thus reflux occurs.

The severity of the symptoms of the hiatal hernia determines whether to consult a doctor or not. Infrequent reflux of stomach contents generally occurs in most people, though, a hiatal hernia increases this amount or occurrence of refluxes, thus making it more possible for the person to have a heartburn.

If the person is a smoker or an over weighed person or a consumer of certain types of foods that add to the acid backup then the symptoms for that person can be worse. Repeated refluxes of stomach content leads to esophagitis, which is an inflammation of the coating of the esophagus. When this goes rigorous, esophagitis can cause a constriction (reduction) of the esophagus. A stricture makes swallowing of food difficult or painful. This also leads to digestion problems.

Causes and Risk Factors of Hiatal Hernia

Coughing, vomiting or sudden physical exertion causes Hiatal hernia. These are the most common resons to be mentioned that causes this hiatal hernia because these increase the pressure in the abdominal cavity. Pregnancy and excess fluid in the abdomen also results in the occurance of the hiatal hernia.

Hiatal Hernia

Hiatal Hernia

Treatment of Hiatal Hernia

There are tree approaches to be followed to cure the hiatal hernia. And doctor suggests any one of these to follow.

No treatment – almost certainly, you need not do anything if no symptoms are found. And in most people there occurs no sysmtoms of hiatal hernia and thus there is no need of any treatment.

A blend of lifestyle transformations and medications – Stop smoking and reduce consumption of coffee and alcohol. This gets into great deal in reduction of over weight and also the burning sensation. This has to be followed with stricter lifestyle. Especially if one has frequent gastroesophical reflux, this style of restricted consumption of food can cure Hiatal Hernia.

Most of the patients can be dealt with a conventional program. Refluxes mostly occur during night and every step has to be taken inorder to enlist the aid of severity in preventing these refluxes. Do not lie down immediately after meals and also avoid late meals or meals just before going to bed. The head of the patient should be above the body level but just by increasing the number of pillows does not get succeded because, the pillows may slip down during sleep. So, the height of the head level has to be increased by adjusting the level blocks by atleast six blocks under the bed.

The stomach acid can be neutralised by consuming antacids or antacid combinations which contains alginic acid. And if even this doesn’t increase the chances of healing, then doctor may sometimes prescribe drugs like cimetidine, omeprazole or ranitidine which reduces production of the stomach acid.
Sometimes, when there happens to be severe symptoms or when there is bleeding or when an obstacle develops and when eating becomes painful, a surgery is required to cure hiatal hernia. The surgeon’s plan is to “rebuild” the esophageal sphincter and fix the hernia.
Paraesophageal and sliding are the two types of hiatal hernia. Symptoms of a simple paraesophageal hernia, typically develop in adult life and sometimes consists of a sense of stress in the lower chest immediately after eating and occasionally palpitations, due to cardiac arrhythmias. These occur due to the swelling of the herniated gastric pouch when food displaces the stomach’s air bubble.

Since complications are frequent in paraesophageal hiatal hernias, even in the absence of symptoms, operative repair is indicated in most cases. The usual method is to return the herniated stomach to the abdomen and affix it with sutures to the posterior rectus sheath (anterior gastroplexy). The enlarged hiatus is closed snugly around the gastroesophageal junction with interrupted sutures. It is unnecessary to excise (cut out) the hernia sac. The results of surgical management are generally excellent.

More than 80% of the patients with clinically noteworthy reflux have a sliding hiatal hernia. In these patients with sliding hiatal hernia, the cardioesophageal junction and the fundus of the stomach are shifted upward into the posterior mediastinum, revealing the lower esophageal sphincter to intrathoracic pressure. More than half of these pressure built hernias require no treatment as these are asymptomatic.

Questions To Ask Your Doctor about Hiatal Hernia

  • How to diagnose the problem? Any tests to be performed?
  • What is the severity of the problem?
  • What type of treatment is required?
  • What results can i expect from this treatment?
  • If a “wait and see” decision is made, will the hiatal hernia become worse?
  • Is surgery required?
  • What can i suppose from the surgery?