What are the symptoms of a hiatal hernia. How is a hiatal hernia diagnosed. What treatment options are available for hiatal hernias. Who is at risk for developing a hiatal hernia. Can hiatal hernias be prevented.

Understanding Hiatal Hernias: Types and Anatomy

A hiatal hernia occurs when the upper part of the stomach protrudes through the diaphragm into the chest cavity. This happens through an opening called the hiatus, which normally allows the esophagus to pass through the diaphragm. There are different types of hiatal hernias:

• Type I (Sliding hiatal hernia): The most common type, where the stomach slides up into the chest
• Types II, III, and IV (Paraesophageal hernias): Less common but potentially more dangerous, where part of the stomach is trapped above the diaphragm

Understanding the anatomy involved in hiatal hernias is crucial for proper diagnosis and treatment. The diaphragm plays a vital role in separating the abdominal cavity from the chest cavity, and any disruption to this barrier can lead to complications.

Recognizing the Symptoms of Hiatal Hernias

Hiatal hernias can present with a variety of symptoms, although some people may not experience any discomfort at all. Common symptoms include:

• Heartburn
• Chest pain
• Difficulty swallowing
• Regurgitation of food or liquids
• Shortness of breath
• Abdominal pain

Are all hiatal hernias symptomatic? No, many small hiatal hernias, especially Type I hernias, may not cause any noticeable symptoms. However, larger hernias or paraesophageal hernias (Types II, III, and IV) are more likely to cause discomfort and potentially serious complications.

Gastroesophageal Reflux Disease (GERD) and Hiatal Hernias

Hiatal hernias are closely associated with GERD. The hernia can weaken the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus. This reflux can lead to symptoms such as heartburn, chest pain, and difficulty swallowing. Managing GERD is often a crucial part of treating hiatal hernias.

Risk Factors and Causes of Hiatal Hernias

Several factors can increase the likelihood of developing a hiatal hernia:

• Age (over 50 years old)
• Obesity
• Pregnancy
• Chronic coughing or vomiting
• Straining during bowel movements
• Lifting heavy objects
• Excessive physical exertion

Can hiatal hernias be prevented? While not all hiatal hernias can be prevented, maintaining a healthy weight, avoiding heavy lifting, and managing conditions that cause chronic coughing can help reduce the risk. Additionally, practicing good posture and avoiding tight clothing around the abdomen may be beneficial.

Diagnostic Procedures for Hiatal Hernias

Diagnosing a hiatal hernia typically involves a combination of physical examination, medical history review, and diagnostic tests. Common diagnostic procedures include:

1. Barium swallow (Upper GI study)
2. Chest X-rays
3. CT scans
4. Upper endoscopy (EGD)

How does a barium swallow help diagnose hiatal hernias? During this procedure, the patient swallows a contrast material (liquid barium) that coats the lining of the esophagus and stomach. This allows X-ray images to clearly show the structure of the upper digestive tract, revealing any abnormalities such as hernias or strictures.

The Role of Endoscopy in Hiatal Hernia Diagnosis

Upper endoscopy, also known as esophagogastroduodenoscopy (EGD), is a valuable tool in diagnosing hiatal hernias. During this procedure, a thin, flexible tube with a camera is inserted through the mouth and into the esophagus and stomach. This allows the doctor to directly visualize the upper digestive tract and identify any abnormalities.

What are the advantages of endoscopy over other diagnostic methods? Endoscopy provides a detailed, real-time view of the esophagus and stomach, allowing for the identification of even small hernias. It also enables the doctor to take tissue samples (biopsies) if necessary, which can be crucial in ruling out other conditions or complications.

Treatment Options for Hiatal Hernias

The treatment approach for hiatal hernias depends on the severity of symptoms and the type of hernia. Options include:

• Lifestyle modifications
• Medications
• Minimally invasive surgery
• Open surgery (in rare cases)

When is surgery necessary for a hiatal hernia? Surgery is typically recommended when conservative treatments fail to provide relief or when complications arise. These complications may include chronic anemia, severe pain, recurrent pneumonia, or strangulation of the hernia.

Minimally Invasive Surgical Techniques

Minimally invasive surgery, such as laparoscopic repair, has become the preferred method for treating hiatal hernias that require surgical intervention. This approach offers several advantages:

• Smaller incisions
• Reduced postoperative pain
• Shorter hospital stays
• Faster recovery times

How is laparoscopic hiatal hernia repair performed? The surgeon makes several small incisions in the abdomen and inserts a camera and specialized instruments. The hernia is then reduced, and the diaphragmatic opening is repaired. In some cases, mesh may be used to reinforce the repair.

Managing Symptoms and Complications of Hiatal Hernias

For many patients with hiatal hernias, symptom management is the primary focus of treatment. This may involve:

• Dietary changes (avoiding trigger foods, eating smaller meals)
• Elevating the head of the bed
• Avoiding lying down shortly after meals
• Quitting smoking
• Maintaining a healthy weight

What medications are commonly used to manage hiatal hernia symptoms? Antacids, H2 receptor blockers, and proton pump inhibitors are often prescribed to reduce stomach acid and alleviate symptoms such as heartburn and regurgitation.

Potential Complications of Untreated Hiatal Hernias

While many hiatal hernias do not cause serious problems, some can lead to complications if left untreated:

• Chronic GERD
• Esophagitis
• Barrett’s esophagus
• Esophageal strictures
• Strangulation of the hernia (a medical emergency)

How can strangulation of a hiatal hernia be recognized? Symptoms of strangulation include severe chest or abdominal pain, difficulty swallowing, vomiting, and inability to pass gas or have bowel movements. This condition requires immediate medical attention.

Living with a Hiatal Hernia: Lifestyle Adjustments and Long-term Outlook

For many individuals, living with a hiatal hernia involves making certain lifestyle adjustments to manage symptoms and prevent complications. These may include:

• Adopting an anti-reflux diet
• Practicing stress-reduction techniques
• Wearing loose-fitting clothing
• Avoiding activities that increase abdominal pressure

What is the long-term outlook for patients with hiatal hernias? With proper management and treatment, most people with hiatal hernias can lead normal, symptom-free lives. Regular follow-ups with a healthcare provider are important to monitor the condition and adjust treatment as needed.

The Importance of Regular Monitoring

Even if a hiatal hernia is not causing significant symptoms, regular monitoring is crucial. This may involve periodic endoscopies or imaging studies to assess the size of the hernia and check for any complications. Early detection of changes can lead to more effective treatment and better outcomes.

How often should patients with hiatal hernias be monitored? The frequency of follow-up appointments and tests depends on the individual case. Factors such as the size of the hernia, presence of symptoms, and any associated conditions like GERD will influence the monitoring schedule.

Emerging Research and Future Treatments for Hiatal Hernias

The field of hiatal hernia treatment is continuously evolving, with ongoing research into new techniques and therapies. Some areas of current interest include:

• Improved minimally invasive surgical techniques
• Novel mesh materials for hernia repair
• Endoscopic approaches to hernia treatment
• Advances in acid-suppression medications

What promising new treatments are on the horizon for hiatal hernias? Researchers are exploring endoscopic techniques that could potentially repair small hiatal hernias without the need for external incisions. Additionally, there is ongoing work to develop more effective and longer-lasting medications for managing GERD associated with hiatal hernias.

The Role of Robotic Surgery in Hiatal Hernia Repair

Robotic-assisted surgery is gaining traction in the treatment of hiatal hernias. This advanced approach offers several potential benefits:

• Enhanced precision and dexterity for surgeons
• Improved visualization of the surgical site
• Potential for even smaller incisions
• Reduced postoperative pain and faster recovery

How does robotic surgery compare to traditional laparoscopic techniques for hiatal hernia repair? While both approaches are minimally invasive, robotic surgery may offer advantages in complex cases or when performing additional procedures such as fundoplication. However, the choice between robotic and laparoscopic surgery depends on factors such as surgeon expertise, patient characteristics, and hospital resources.

As research continues and technology advances, the management of hiatal hernias is likely to become even more effective and personalized. Patients and healthcare providers can look forward to improved diagnostic tools, more targeted treatments, and better long-term outcomes for those affected by this common condition.

Hiatal Hernias | Michigan Medicine

A hernia occurs when an organ protrudes through the wall of muscle that encircles it. A hiatal hernia means that the upper part of your stomach has protruded up into your chest, pushing through the little opening (or hiatus) in your diaphragm (which separates your abdomen from your chest).

Most of the time, hiatal hernias are so small they might not be felt at all. But if the hernia is a bit larger, it could force the opening in your diaphragm to become larger, too. At that point, the entire stomach and other organs are in danger of sliding up into your chest.

A hiatal hernia can also put undue pressure on your stomach, by squeezing or twisting it. This pressure can make your stomach retain acid, which can then flow up into your esophagus. You could develop chest pain, gastroesophageal reflux disease, and/or heartburn, and have trouble swallowing or even breathing.  The acid may also cause ulcers within the stomach that can bleed and lead to acute or chronic anemia (low blood counts).

There are a few different kinds of hiatal hernias. Type I hernias, or sliding hiatal hernias, are the smallest and most common variety. These hernias cause your stomach to slide through a small opening in the diaphragm, and up into your chest. These often do not require an operation or treatment.

Much less common than these are Types II, III, and IV hernias, or paraesophageal hernias. These occur when a part of the stomach protrude into the chest adjacent to the esophagus. That part of the stomach is “trapped” above the diaphragm and can’t slide back down again. While these hernias are far less common, they can be more dangerous, since they cause more serious symptoms, and because the blood flow to your stomach can be compromised.

Risk Factors

Those over the age of 50, pregnant women, and the obese are at higher risk. A hiatal hernia can also be triggered by insistent pressure on the hiatus muscles. That pressure can be caused by coughing, vomiting, immoderate straining during bowel movements, lifting heavy objects, and/or excessive physical exertion.

Symptoms

Hiatal hernias, especially Type I hernias, do not usually cause symptoms. They may, however, be associated with the following: burping, heartburn, nausea, vomiting, and/or regurgitation into the esophagus.

A paraesophageal hernia, or Type II, III, or IV hernia, may cause more severe symptoms. These can include:

• Abdominal/chest pain
• Abdominal bleeding (which can be indicated by blood in vomit, red or black stool, anemia, blood test indicating loss of blood)
• Change in voice
• Early satiety (or becoming full after only eating a small amount of food)
• Occasional trouble swallowing (especially solid food)
• Shortness of breath or trouble breathing after eating
• Acid reflux
• Regurgitation or a sensation of food “sticking”

Diagnosis

Along with a complete exam and detailed medical history, your surgeon may use one or more diagnostic tests to determine the best course of treatment.

Barium Swallow / Upper GI study requires that you swallow a small amount of contrast material, or liquid barium, which coats the lining of your esophagus so that X-ray images may be obtained. If you have experienced trouble swallowing, this procedure can help to locate any areas in your esophagus that may have narrowed. These areas are called strictures.

Chest X-rays: Electromagnetic energy produces images of internal tissues, bones and organs.

CT-Scans: These scans make up a series of images of the inside of your body, all taken from different angles, to reveal a high level of detail. To ensure that your veins and organs show up clearly in these scans, you may need to swallow a dye used for that purpose, or have it injected into your vein.

Upper Endoscopy (EGD): A procedure in which an endoscope is threaded through your mouth and then into your esophagus. This procedure allows your surgeon to actually see your upper digestive tract, which includes your esophagus, stomach, and duodenum, or the first part of your small intestine. Your surgeon can then remove a tissue sample as well.

Treatments

Hiatal hernias don’t always require treatment beyond regular monitoring and medications. Under certain conditions, however, treatment will be necessary. Those conditions include: chronic anemia; chronic pain; complications by gastroesophageal reflux disease; complications by esophagitis; danger of strangulation; inability to vomit; recurrent pneumonia or other infections. The following treatments are available for those with hiatal hernias.

Minimally Invasive Hernia Repair

Minimally invasive surgery can effectively diminish the size of a hernia, as well as reduce the opening in the diaphragm, thereby preventing strangulation. During this procedure, surgeons will insert a tiny video camera into your abdomen. They’ll be able to view images projected onto a monitor, which will allow them to complete the procedure with greater control and finesse. The purpose of this surgery is to restore the stomach into your abdomen and close down the hole in the diaphragm. Minimally invasive surgery is associated with a quicker recovery and faster return to function than traditional open repair. Your doctor will determine if you are a candidate for this approach. (Video)

Fundoplication

Your surgeons may also perform a fundoplication, which will help to prevent acid from rising through the stomach.

Make an Appointment

To discuss a potential hernia treatment or surgery, contact the Surgery Call Center at (734) 936-5738.

Hiatal Hernia | Cedars-Sinai

ABOUT

CAUSES
DIAGNOSIS

TREATMENT

NEXT STEPS

What is a hiatal hernia?

A
hernia is when part of an organ goes through an opening in the muscle wall around
it.

In a
hiatal hernia, part of your stomach pushes up into an opening (the hiatus) in your
diaphragm. The diaphragm is the muscle between your belly (abdomen) and your chest.

In most cases, your food pipe (esophagus) goes through the hiatus and joins your stomach.
But with a hiatal hernia, the top part of your stomach moves up through that opening
into your chest.

The top part of your stomach gets pinched. Stomach acid can back up (reflux) through
the opening. This may cause heartburn and other symptoms.

There are two types of hiatal hernias: sliding and paraesophageal.

Sliding hiatal hernia

This type of hernia:

• Is
  most common
• Happens when part of the stomach and the place where the stomach and esophagus
  meet slide up into your chest through the opening (hiatus)

Paraesophageal hernia

This type of hernia:

• Is
  less common but can be more serious
• Happens when part of your stomach pushes up through the opening (hiatus) into
  your chest and is next to your esophagus

What causes a hiatal hernia?

Experts don’t know what causes hiatal hernias. Some causes may include:

• Coughing
• Vomiting
• Straining while having a bowel movement
• Sudden physical effort
• Pregnancy
• Obesity

Who is at risk for a hiatal hernia?

You may be at greater risk for a hiatal hernia if you:

• Are age
  50 or older
• Are overweight or obese
• Are pregnant
• Smoke

What are the symptoms of a hiatal hernia?

In
many cases, a hiatal hernia has no symptoms.

Some people do have symptoms. These may include:

• Burping
• Feeling nauseous
• Vomiting
• Backflow (reflux) of acid or stomach contents into the esophagus or throat
• Heartburn
• Regurgitation
• Trouble swallowing

Paraesophageal hernias may have more severe symptoms. These can include:

• Having trouble swallowing sometimes, most often with solid foods
• Feeling full after eating only a small amount of food
• Belly (abdominal) or chest pain
• Abdominal bleeding
• Blood loss (anemia)

In
some cases, a paraesophageal hernia can lead to a medical emergency. The stomach or
abdominal organs may turn or twist, causing very bad pain. There is a danger that
the
stomach’s blood supply may be cut off (strangulation). This is an emergency. You will
likely need surgery right away.

The symptoms of a hiatal hernia may look like other health problems. Always see your
healthcare provider to be sure.

How is a hiatal hernia diagnosed?

Your
healthcare provider will give you a physical exam. They will look at your past
health.

You
may also have tests, including:

• Chest
  X-ray.
  This may show that you have a hiatal hernia.
• Upper
  endoscopy, also called EGD (esophagogastroduodenoscopy).
  This test looks at
  the lining of your food pipe (esophagus), stomach, and the first part of your small
  intestine (the duodenum). It uses a thin, lighted tube called an endoscope. The tube
  has a camera at one end. The tube is put into your mouth and throat while you are
  sedated. Then it goes into your esophagus, stomach, and duodenum. Your healthcare
  provider can see the inside of these organs.
• Upper GI
  (gastrointestinal) series or barium swallow.
  This test looks at the organs of
  the top part of your digestive system. It checks your food pipe (esophagus), stomach,
  and the first part of your small intestine (the duodenum). You will swallow a
  metallic fluid called barium. Barium coats the inside of the esophagus, stomach, and
  intestines so that they can be seen on an X-ray. 
• Esophageal
  manometry.
  This test checks the strength of your esophagus muscles. It can
  see if you have any problems with reflux or swallowing. A small tube is put into your
  nostril, then down your throat into your esophagus. This measures the pressure that
  your esophagus muscles make at rest and during swallowing.

How is a hiatal hernia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend
on
how severe the condition is.

In
most cases, you won’t need treatment. But you may need medical care if your hernia:

• Is at
  risk of being twisted so much that blood supply is cut off to your stomach
  (strangulation)
• Is more
  difficult because of severe GERD (gastroesophageal reflux disease)
• Is more
  difficult because of redness and swelling (inflammation) of your esophagus
  (esophagitis)

Your
healthcare provider may suggest medicines to:

• Weaken
  or neutralize stomach acid (antacids)
• Reduce
  the amount of acid your stomach makes (H-2 blockers or proton pump inhibitors)
• Strengthen your lower esophageal sphincter (LES), the muscle that stops stomach acid
  from backing up into your esophagus

In
severe cases, surgery may also be needed to:

• Make
  your hernia smaller
• Stop
  loss of blood flow to your stomach (strangulation) by closing the opening in your
  diaphragm

What are possible complications of
a hiatal hernia?

In
most cases, a hiatal hernia won’t lead to other health problems.

In
some cases, it can cause other problems such as:

• Severe GERD (gastroesophageal reflux disease)
• Lung
  problems or pneumonia because stomach contents have moved up into your esophagus and
  into one or both lungs
• Strangulation of the hernia, cutting off blood flow to your stomach (medical
  emergency)

What can I do to prevent a hiatal hernia?

Health experts don’t know what causes hiatal hernias. They don’t know how to stop
them from happening.

Living with a hiatal hernia

Follow your healthcare provider’s advice for treating and managing your hiatal hernia.
You may need to make some lifestyle changes, such as:

• Losing
  weight if you are overweight or obese
• Not
  eating for 3 to 4 hours before going to bed
• Not
  bending over right after eating
• Quitting
  smoking
• Elevating the head of your bed while you sleep

When should I call my healthcare provider?

Call your healthcare provider if your
symptoms come back after treatment has stopped them. Let your healthcare provider
know
if symptoms get worse or you have new symptoms.

Key points about hiatal
hernia

• A hiatal hernia is when part of your stomach pushes up into an opening (the hiatus)
  in your diaphragm.
• There
  are two types of hiatal hernias: sliding and paraesophageal.
• Paraesophageal hernias are less common but can be more serious. You may need surgery.
• Experts don’t know what causes hiatal hernias.
• In most
  cases, there are no symptoms.
• In most
  cases, no medical care is needed.

Next steps

Tips to help you get the most from a visit to your health care
provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember
  what your provider tells you.
• At the visit, write down the name of a new diagnosis and any new
  medicines, treatments, or tests. Also write down any new instructions your provider
  gives you.
• Know why a new medicine or treatment is prescribed and how it
  will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results
  could mean.
• Know what to expect if you do not take the medicine or have the
  test or procedure.
• If you have a follow-up appointment, write down the date, time,
  and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Jen Lehrer MD

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Hernia, symptoms, diagnosis and treatment | Alpha

Esophageal hernia: symptoms and treatment

A hiatal hernia (hiatal hernia) is a condition in which the upper portions of the stomach and part of the esophagus enter the chest area through an opening in the diaphragm. Diaphragmatic hernia of the esophagus causes significant discomfort and interferes with a person in everyday life. Over time, the disease can provoke dangerous complications, therefore, it requires serious treatment.

Causes of disease

In childhood, a hernia of the diaphragm of the esophagus occurs due to anatomical pathologies of the formation of the fetus. The child has a displacement of the cardial part of the stomach into the chest cavity.

Possible causes of hernia of the esophagus in adults:

• weakness of the ligamentous apparatus of the digestive system;
• inflammatory diseases of the stomach: ulcer, chronic gastroduodenitis, pancreatitis, etc.;
• pathology of the esophagus: burns of the mucosa, esophagitis, varicose veins, etc.;
• injuries of the gastrointestinal tract;
• damage caused by a prolonged increase in pressure in the abdominal cavity, for example, during heavy physical exertion;
• obesity, constipation, flatulence;
• tumors.

Diaphragmatic hernia classification

• Sliding (axial) . The fundus of the stomach and part of the esophagus slide freely into the chest cavity. Axial hernias are the most commonly diagnosed. The risk of infringement is minimal.
• Perioesophageal (paraesophageal) . Less common is a pathology in which the esophagus remains in place, and the fundus of the stomach and other abdominal organs protrude through the opening of the diaphragm. Paraesophageal hernias are often infringed, therefore, as a rule, they require surgical treatment.
• Mixed . Hernia of the esophagus of the stomach has signs of both types described above.
• Acquired short esophagus . Pathology occurs as a result of trauma and inflammatory diseases. The stomach is drawn into the mediastinum through the diaphragmatic opening.

Esophageal hernia stages

• I – the abdominal esophagus is displaced into the mediastinum, the fundus of the stomach is located close to the diaphragm.
• II – the bottom and cardia of the stomach are located in the esophagus.
• III – the stomach and part of the esophagus are displaced into the mediastinum.

Hernia symptoms

The disease can proceed for many years without severe symptoms. Most often, pathology is diagnosed during a routine examination or medical examination.

There are several non-specific symptoms of a hernia of the esophagus, in the event of which it is necessary to consult a gastroenterologist:

• Heartburn, which is aggravated by physical exertion, bending over.
• Pain behind the sternum, the cause of which is the compression of displaced organs.
• Belching with a sour or bitter taste.
• Dysphagia after swallowing food quickly or eating fried food.
• Hiccups, which may increase to vomiting.

Signs of a hernia of the esophagus are often confused with cardiac symptoms. The patient may experience persistent cough, shortness of breath, tachycardia, blanching of the skin after eating. Pain with a hernia of the esophagus can be localized in the region of the heart.

Disease diagnosis

The most informative are instrumental diagnostic methods:

• Barium X-ray . Pictures are taken in several projections. Radiography allows you to detect the protrusion of organs in the esophageal opening of the diaphragm and assess the severity of the disease.
• Computed tomography . According to the pictures, the doctor determines the size, localization of the defect. The CT image clearly shows the blood vessels and contents of the hernia.
• Fibroesogastroscopy . A thin tube with a video camera is pushed into the esophagus. The doctor on the screen sees the mucous membrane of the internal organs, can detect inflamed areas, ulcers, scars and other defects.
• ultrasound . The examination determines the degree of displacement of the boundaries of the mediastinum, heart, measure the defect of the diaphragm.
• Esophageal manometry . An examination is prescribed to assess the performance of the esophageal sphincters. Esophageal manometry helps not only in diagnosis, but also in evaluating the effectiveness of prescribed therapy.

Treatment

At stages 1 and 2, conservative treatment of esophageal hernia is indicated. To reduce heartburn, drugs are prescribed that reduce the level of acidity in the stomach, antacids. It is possible to take medications that stimulate the peristalsis of the stomach.

Proper nutrition plays an important role in treatment. The patient should divide the daily norm into 5-6 small portions, have dinner no later than 2 hours before bedtime. Fried, spicy, fatty foods, alcoholic and carbonated drinks are excluded from the diet. The menu is based on vegetable soups, boiled fish, meat, kissels, cereals, fruits. Normalization of nutrition with a hernia of the esophagus allows you to almost completely get rid of unpleasant symptoms.

In severe clinical cases, surgery is indicated. The task of the surgeon is to eliminate reflux and reduce the esophageal opening in the diaphragm. Rehabilitation after surgery takes several days. To prevent relapse, patients are advised to follow a diet, give up bad habits and avoid physical activity.

What is dangerous hernia of the esophagus without treatment:

• infringement of internal organs;
• increased reflux to vomiting;
• development of ulcers, erosion in the digestive tract;
• occurrence of internal bleeding.

Diagnosis and treatment of esophageal hernia in Nizhny Novgorod

The clinic “Alfa Health Center” invites you to undergo a comprehensive examination of the gastrointestinal tract. Our specialists will make a diagnosis, prescribe competent treatment, and help get rid of the uncomfortable manifestations of the disease. The phone number for registration is listed on the website.

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Hiatal hernia and REB: symptoms, treatment, prevention

Hiatal hernia and reflux gastroesophageal disease: causes, symptoms, diagnosis and treatment. Find out how to prevent these diseases and what to do if you already have them.

Hiatal hernias are one of the most common disorders of the digestive system. This disease is characterized by prolapse of the upper part of the stomach through the diaphragm into the chest cavity, which can cause a number of unpleasant symptoms.

One of the most common manifestations of hiatal hernia is reflux gastroesophageal disease (GERD). This disease is characterized by unpleasant symptoms such as heartburn, belching, bitterness in the mouth, chest pain and others.

GERD is a symptom associated with the backflow of acid from the stomach into the esophagus. This is due to a malfunction in the sphincter that separates the stomach from the esophagus. If such disorders are not treated promptly, they can lead to various complications such as ulcers, esophageal stenosis, and even cancer.

Hiatus hernia

Hiatus hernia is a violation of the position of the hiatus of the diaphragm, as a result of which part of the stomach is displaced into the chest cavity. Such a violation occurs due to weakening of the muscles of the diaphragm or increased pressure in the abdominal cavity. A hernia causes reflux of acid and stomach contents into the esophagus, which can lead to reflux gastroesophageal disease.

Symptoms of hiatal hernia can range from mild to severe. Typically, patients complain of chest pain, heartburn, dysphagia, that is, difficulty swallowing, and belching. If a herniated diaphragm remains unnoticed and not symptomatic, then it may not require treatment.

• However, if you have symptoms of hiatal hernia, it is advisable to see a doctor.
• In some cases, surgery may be required.

To prevent hiatal hernia, you need to monitor your weight, avoid spices and alcohol, and eat right – eat small meals and not go to bed immediately after eating.

The main symptoms of a hiatal hernia

A hiatal hernia may be asymptomatic, but in some cases certain signs of the disease may appear.

One of the main symptoms is heartburn , which can be both light and strong. Heartburn occurs when stomach contents back up into the esophagus.

Also characteristic is a violation of the process of swallowing and belching . A person may feel pressure in the chest and pain, worsening of the general condition, perhaps even vomiting after eating.

With hiatal hernia, some patients may experience bleeding from the esophagus . This occurs as a result of the fact that the mucous membrane of the esophagus is irritated at the outlet of the stomach and loses its integrity.

Other symptoms of hiatal hernia may include nausea, constipation, loose stools, fatigue . Often these symptoms are explained by the body not being able to digest food as a result of the proper functioning of the digestive system.

Causes of hiatal hernia

Obesity. Being overweight increases pressure in the abdomen, which can cause diaphragmatic distension and a hernia.

Increased pressure in the abdominal cavity. Often occurs in pregnant women, as well as in people engaged in heavy physical labor.

Diaphragm rupture. May be caused by trauma such as a car accident or a fall from a height.

Chronic cough. Constant tension of the diaphragm when coughing can lead to its stretching and the appearance of a hernia.

Great straining during urination and defecation. May occur in people with constipation or an enlarged prostate. Under these conditions, the diaphragm can also stretch and form a hernia.

Genetic predisposition. In some people, the diaphragm may be the weakest point, which can lead to a hernia.

Diagnostic methods for hiatal hernia

Esophagogastroduodenoscopy

One of the most accurate research methods is esophagogastroduodenoscopy. It allows you to assess the condition of the walls of the esophagus, stomach and duodenum, as well as to identify a hernia and its stage of development. During the procedure, the doctor, using a special tube with a camera light source, examines the digestive organs, and if necessary, can take a biopsy to confirm the diagnosis.

Functional tests

Functional tests are used to evaluate the muscles of the diaphragm and esophagus, as well as the movement of the stomach. These include fluoroscopy, manometry, and impedance-pH-metry. Thanks to these methods, it is possible to determine the causes of reflux, clarify the diagnosis and choose the most effective treatment.

Computed tomography

Computed tomography (CT) can be used to identify hiatal hernia and evaluate its size. In this case, an x-ray of the digestive organs takes place after the introduction of a contrast agent for greater accuracy. CT can be an important effective diagnostic method in cases where esophagogastroduodenoscopy is not available or unsuitable (for example, in cardiac hernia).

Ultrasound

Ultrasound is a safe and inexpensive test that can help determine the size of a hiatal hernia. In this case, an image of the pathological part of the digestive organ is created using ultrasonic waves. Ultrasound examinations are not accurate and cannot confirm the diagnosis; however, they can serve as an aid in the diagnosis of hiatal hernia.

Principles for the treatment of hiatal hernia

Basic principles of treatment:

1. Avoid factors that aggravate hiatal hernia. These include: smoking, weight gain, intake of fatty and spicy foods, alcohol, treatment with certain medications.

3. The use of drug therapy. The goal of medical treatment is to reduce symptoms and prevent complications of a hernia. Drugs are used that reduce the acidity of gastric juice and improve the function of the esophageal-gastric sphincter.

4. Surgical treatment. It is used if conservative treatment fails or complications occur (eg, bleeding from an esophageal ulcer, esophageal stricture). The operation consists in reducing the hernia and strengthening the opening of the esophageal part of the diaphragm.

Individual approach

Treatment of hiatal hernia requires an individual approach, which depends on the severity of clinical manifestations, the presence of concomitant diseases, age and other factors. Treatment should be comprehensive and include lifestyle changes, drug therapy and surgical treatment, if necessary.

Understanding gastroesophageal reflux disease

Reflux gastroesophageal disease (GERD) is a chronic condition characterized by the regular leakage of acid from the stomach into the esophagus. Reflux is the result of a weakening of the sphincter that normally separates the esophagus from the stomach.

GERD can lead to serious complications such as esophageal ulcers, changes in the structure of the esophagus, and pharyngeal candidiasis. Therefore, it is important to see a doctor if you have symptoms of ADHD and monitor your health.

Although EBRD cannot be completely cured, there are many treatments available to help reduce symptoms and avoid complications. These methods may include lifestyle changes, diet, medications, and surgery. Treatment should be prescribed only after a thorough diagnosis and consultation with a doctor.

1. Lifestyle changes include stress reduction and avoidance of smoking, alcohol and coffee.
2. Diet avoids fatty, spicy and acidic foods, as well as foods containing caffeine and chocolate.
3. Medications for may include drugs that reduce stomach acid and strengthen the sphincter. Some patients may need a course of antibiotics to clear the infection.
4. Surgical treatment of may only be recommended in cases of severe complications and failure of other treatments.

Main symptoms of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERB) is a chronic disease characterized by backflow of stomach acid into the esophagus. As a result, irritation and inflammation of the walls of the esophagus occurs, which causes unpleasant symptoms.

Main signs of GERB:

• Burning sensation in the chest is the most common symptom of reflux disease. Burning can occur at any time of the day, but is most often felt after eating.
• Feeling of fullness and fullness in the abdomen – occurs as a result of a violation of the digestive process. May be accompanied by belching and nausea.
• Dysphagia Difficulty swallowing food. It can happen gradually and end with a complete rejection of food.
• Acid regurgitation – a bad smell and taste in the mouth that occurs after eating or even during a night’s sleep.
• Dry and irritable cough – occurs as a result of the reverse release of gastric contents into the lungs. This symptom can lead to the development of bronchitis and other respiratory diseases.

The presence of one or more of these symptoms may indicate the presence of GERB. Only a qualified doctor can make a correct diagnosis and prescribe the necessary treatment.

Causes of reflux gastroesophageal disease

Reflux gastroesophageal disease (GERD) is the most common disease of the esophagus. It occurs when the lower esophageal sphincter malfunctions, which leads to a violation of the movement of food mass from the stomach to the esophagus.

There are several risk factors that contribute to the development of ECDE:

• Obesity. Excess weight puts additional pressure on the stomach, which leads to a decrease in the tone of the lower cardiac sphincter.
• Smoking. Nicotine irritates the mucosa of the esophagus and increases the secretion of gastric juice, which contributes to the development of GERD.
• Taking certain medications. For example, some antidepressants and asthma medications can cause a decrease in the tone of the lower esophageal sphincter and an increase in gastric acid secretion.
• Food environment. The use of spicy, fatty, acidic foods, as well as frequent overeating can lead to the development of RGEB.

Poor diet, alcohol consumption, hiatal hernia, and pregnancy may also contribute to the development of EDGE.

To reduce the risk of GERD, you need to watch your weight, do not smoke, avoid eating spicy and fatty foods, and also do not abuse alcoholic beverages.

Methods for diagnosing reflux gastroesophageal disease

Reflux gastroesophageal disease (GERD) is a pathological condition in which the contents of the stomach back up into the esophagus. There are several ways to diagnose this disease.

• FGDS — fibrogastroscopy is one of the most common diagnostic methods for ADHD. The doctor examines the esophagus, stomach and the beginning of the intestine. Using this method, you can detect a hernia of the esophageal opening of the diaphragm and other disorders.
• Manometry is a test that measures the pressure of the muscles of the esophagus and detects abnormalities in the motor abilities of the esophagus.
• PH-metry – allows you to measure the level of acidity of gastric juice that has returned to the esophagus. This helps to diagnose RGEB and determine the causes of its occurrence.

Some patients may experience chest pain and discomfort, which may be caused by EBRD. With such symptoms, it is necessary to consult a doctor for diagnostic tests and appropriate treatment.

Principles of treatment of gastroesophageal reflux disease

Lifestyle changes

Lifestyle changes are an important part of the treatment of gastroesophageal reflux disease. Patients are advised to reduce weight, avoid smoking, drinking alcohol, and reduce the amount of fatty, spicy and acidic foods consumed. It is also important to ensure that the patient is not taking medications that can cause reflux.

Drug therapy

For reflux gastroesophageal disease, drugs can reduce stomach acid levels and reduce irritation of the esophagus. The doctor may prescribe drugs with proton pumps, antacids, as well as H2-histamine receptor inhibitors.

Surgical treatment

In severe cases, when drug therapy fails, surgery may be necessary. The main treatment is fundoplication, which involves wrapping the top of the stomach around the lower esophagus. This helps prevent regurgitation of stomach contents into the esophagus and reduces symptoms of reflux.

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Q&A:

What are hiatal hernias?

A hiatal hernia is a condition where the upper part of the stomach is forced out through the diaphragm and moved into the chest cavity. This can cause various symptoms such as increased heart rate, difficulty breathing, and heartburn.

What are the causes of hiatal hernia?

Hiatal hernias can be caused by a variety of causes, including being overweight, pregnancy, constant stress on animal muscles, hernias, and heredity. Also high risk of infections and other factors that can affect the normal functioning of the stomach.

What are the symptoms of hiatal hernia?

Symptoms of a hiatal hernia may include heartburn, difficulty swallowing, palpitations, difficulty breathing, chest pain, and abdominal discomfort.

How can a hiatal hernia be diagnosed?

To diagnose hiatal hernia, your doctor may do a number of tests, including a chest x-ray, esophagogastroduodenoscopy, and gastric manometry.

What is reflux gastroesophageal disease?

Gastroesophageal reflux disease is a condition where the acidic contents of the stomach move back up the esophagus, causing various symptoms such as heartburn, regurgitation, heaviness and discomfort in the stomach area.