Hernia is a condition in which any internal organ of the body pushes itself exceeding its original area. Hiatus is a small muscular portion of opening through which the food tube or esophagus opens up to the stomach. Hiatal hernia or hiatus hernia is the condition in which the part of the stomach pushes itself into the chest area through the hiatus. Mild to moderate cases of hiatal hernia does not cause any problem.
There are many people who may not even know that they have hiatus hernia unless they are tested for other causes. However a large hiatal hernia is problematic since it will allow food particles and stomach acids into the esophagus causing heartburn affecting the quality of life.
Many people may not have any symptoms of hiatal hernia and may not even know about it until it was diagnosed later. Some of them may have symptoms like heartburn, acid reflux and other symptoms of GERD. It is not necessary that every person having GERD will develop hiatal hernia. These two are not connected in any way. The signs of heartburn may produce sharp chest pain and can be confused for heart attack. It is the large hiatal hernias that cause symptoms like heartburn and belching. Some people may have difficulty in swallowing food.
Exact reason for the entry of part of stomach through the hiatus is not known. Some believe it is due to the weakening of muscles of the diaphragm which allows the bulging stomach through the tiny opening into the chest.
• Extreme pressure on the stomach may force its way into the hiatal opening.
• Any trauma or accidental injury to the hiatus area can weaken it causing hiatal hernia.
• When there is continuous pressure on the surrounding muscles due to repeated coughing or vomiting it would weaken the hiatus causing hiatal hernia.
• Some people are born with large sized hiatus which can easy give way for bulging of stomach region into the esophagus.
• If the attachment muscle is abnormally loose then it would give entry for the stomach to exert upwards.
There are two types of hiatal hernia namely sliding hiatal hernia and para-esophageal hiatal hernia. Sliding hernia is one in which part of the stomach slides up to the chest through the hiatus of the diaphragm. This type of hernia is the commonly found hernia. The points of junction in which the stomach and the esophagus fuse together are pushed back into the chest.
Very often this area resides well inside the chest portion permanently but gives trouble only when the person swallows something. Whenever the person swallows food the esophageal muscle contracts it shrinks the area making it easy for the stomach to be pulled up. Once the person finished swallowing, the herniated stomach falls back to its original position.
Para-esophageal hernia is one in which the hernia is large and the esophagus stays in its original position but allows the stomach to bulge through it to enter into the chest region beside it. This type of hernia will remain in the same position irrespective of the fact that a person completes swallowing or not. In rare cases, the stomach becomes trapped in this area and the blood supply may be cut off causing life threatening situations.
Who are at risk?
Hiatal hernias can occur on old age people above 55 years and those who are obese.
Tests and Diagnoses :
Imaging tests like X-ray and endoscopy of the stomach and esophagus can help the doctor to detect hiatal hernia. Hernia can be identified as separate sac between the portion of the stomach and the esophagus (food pipe). Most of the time, hernias are recognized while checking for reasons of heartburn.
Barium X-ray is also widely used for testing the presence of hernia. The person will be asked to drink barium liquid which will make a coated layer on the upper digestive tract. This will provide a clear image of the esophagus and stomach to the doctor.
Hiatal hernia will not cause any specific symptoms and hence need no treatment. People with acid reflux and heartburn due to hiatal hernia may require treatment. Medications are prescribed for managing heartburn. Over the counter antacids like Mylanta, Gelusil and Rolaids will provide immediate relief from the symptoms of heartburn. Your doctor may prescribe H2 receptor blockers like Tagmaet HB, Pepcid AC or Axid AR for decreasing the amount of acid production from the stomach. Proton pump inhibitors an also be used for healing the scar in the esophagus due to recurrent acid reflux.
Most of the times you can get relief from the symptoms by over the counter medications like lansoprazole, omeprazole or the like. Only some people will need strong doses of drugs to control acid reflux.
In rare cases surgery is done for repairing hiatal hernia. People who undergo surgery for GERD will get treatment simultaneously for hernia. The surgeon will make incision on the stomach and pulls your stomach gently down into the abdomen. He will close the opening of the diaphragm to a short narrow one and removes the hernia sac. He would reconstruct the weakened sphincter muscles of the esophagus to strengthen it. Treatment options are almost the same for hiatal hernia and GERD.
Pictures of Hiatal Hernia :
Images, Pics, Pictures and Photos of Hiatal Hernia
Lifestyle Changes :
You can manage the symptoms like heartburn and acid reflux by making small changes in your daily life. Instead of having full course meal you should eat several times in small quantities. This will give time for the stomach for easy digestion. Foods that would trigger heartburn and acid production should be restricted or completely avoided. Do not go to bed with full stomach. Finish your dinner at least 3 hours before you sleep. If you are obese consult your doctor to reduce weight.