What are the risk factors for hiatal hernias. How are hiatal hernias diagnosed. What treatments are available for hiatal hernias. Can hiatal hernias cause chest pressure and other symptoms. When does a hiatal hernia require surgical intervention.

Understanding Hiatal Hernias: Types and Mechanisms

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. There are several 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 becomes trapped above the diaphragm

Are all hiatal hernias symptomatic. No, many hiatal hernias, especially Type I, may not cause noticeable symptoms. However, larger hernias can lead to various complications and discomfort.

The Mechanism Behind Hiatal Hernias

How do hiatal hernias affect the digestive system. When a hiatal hernia occurs, it can cause several physiological changes:

1. Enlargement of the diaphragm opening
2. Pressure on the stomach
3. Acid retention in the stomach
4. Acid reflux into the esophagus

These changes can lead to symptoms such as chest pain, gastroesophageal reflux disease (GERD), heartburn, and difficulty swallowing or breathing.

Risk Factors and Causes of Hiatal Hernias

Who is most at risk for developing a hiatal hernia. Several factors can increase the likelihood of developing this condition:

• Age over 50
• Pregnancy
• Obesity
• Persistent pressure on the hiatus muscles

What activities can trigger a hiatal hernia. Certain actions that increase abdominal pressure may contribute to the development of hiatal hernias:

• Chronic coughing
• Frequent vomiting
• Straining during bowel movements
• Lifting heavy objects
• Excessive physical exertion

Recognizing Hiatal Hernia Symptoms

While Type I hiatal hernias often remain asymptomatic, they may be associated with various digestive issues. What are the common symptoms of a hiatal hernia. Symptoms can include:

• Burping
• Heartburn
• Nausea
• Vomiting
• Regurgitation

Symptoms Specific to Paraesophageal Hernias

Paraesophageal hernias (Types II, III, and IV) may present with more severe symptoms. What additional symptoms might indicate a paraesophageal hernia. These can include:

• Abdominal or chest pain
• Abdominal bleeding (indicated by blood in vomit or stool)
• Changes in voice
• Early satiety (feeling full quickly)
• Difficulty swallowing, especially solid foods
• Shortness of breath after eating
• Acid reflux
• Sensation of food “sticking”

Diagnostic Procedures for Hiatal Hernias

How do healthcare providers diagnose hiatal hernias. Diagnosis typically involves a combination of physical examination, medical history review, and various diagnostic tests:

Barium Swallow / Upper GI Study

What is a barium swallow test. This procedure involves swallowing a contrast material (barium) that coats the esophagus lining, allowing for clear X-ray images. It can help identify any narrowed areas (strictures) in the esophagus that may be causing swallowing difficulties.

Chest X-rays

How do chest X-rays aid in diagnosis. These images use electromagnetic energy to visualize internal tissues, bones, and organs, potentially revealing the presence of a hiatal hernia.

CT Scans

What advantages do CT scans offer in diagnosing hiatal hernias. CT scans provide detailed, cross-sectional images of the body from various angles. They can offer a more comprehensive view of the hernia and surrounding structures.

Upper Endoscopy (EGD)

How does an upper endoscopy help in diagnosing hiatal hernias. During this procedure, an endoscope is inserted through the mouth and into the esophagus, allowing direct visualization of the upper digestive tract. It also enables tissue sample collection if necessary.

Treatment Options for Hiatal Hernias

Do all hiatal hernias require treatment. Not necessarily. Many hiatal hernias can be managed with regular monitoring and medications. However, certain conditions may necessitate treatment:

• Chronic anemia
• Persistent pain
• Complications from GERD
• Esophagitis complications
• Risk of strangulation
• Inability to vomit
• Recurrent pneumonia or other infections

Minimally Invasive Hernia Repair

What does minimally invasive hernia repair involve. This surgical procedure aims to reduce the hernia size and narrow the diaphragm opening to prevent strangulation. Surgeons use a small video camera inserted into the abdomen to guide the repair process.

Living with a Hiatal Hernia: Lifestyle Modifications

Can lifestyle changes help manage hiatal hernia symptoms. Yes, several lifestyle modifications can potentially alleviate symptoms and improve quality of life for those with hiatal hernias:

• Maintaining a healthy weight
• Eating smaller, more frequent meals
• Avoiding lying down immediately after eating
• Elevating the head of the bed
• Quitting smoking
• Limiting alcohol consumption
• Avoiding tight-fitting clothing around the abdomen

Dietary Considerations

What dietary changes can help manage hiatal hernia symptoms. Consider the following dietary adjustments:

• Avoiding trigger foods (e.g., spicy, acidic, or fatty foods)
• Eating slowly and chewing thoroughly
• Staying upright for at least three hours after meals
• Limiting carbonated beverages
• Reducing caffeine intake

Complications and Long-term Outlook

What potential complications can arise from untreated hiatal hernias. While many hiatal hernias remain asymptomatic, some may lead to serious complications if left untreated:

• Chronic GERD
• Esophagitis
• Barrett’s esophagus
• Esophageal strictures
• Strangulation of the hernia
• Gastric volvulus (stomach twisting)

What is the long-term outlook for individuals with hiatal hernias. The prognosis for most people with hiatal hernias is generally good, especially with proper management and treatment when necessary. Many individuals can effectively control their symptoms through lifestyle modifications and medication. In cases requiring surgical intervention, modern techniques offer high success rates with minimal complications.

Emerging Research and Future Treatments

Are there new developments in hiatal hernia treatment. Ongoing research continues to improve our understanding and management of hiatal hernias. Some areas of focus include:

• Advanced imaging techniques for more accurate diagnosis
• Improved minimally invasive surgical procedures
• Novel medications for symptom management
• Exploration of regenerative medicine approaches

How might future treatments improve outcomes for hiatal hernia patients. Potential advancements could lead to:

• More personalized treatment plans based on individual patient factors
• Reduced recovery times following surgical interventions
• Better long-term symptom control
• Improved quality of life for those living with hiatal hernias

When to Seek Medical Attention

When should someone with a suspected hiatal hernia consult a healthcare provider. It’s advisable to seek medical attention if you experience:

• Persistent heartburn or acid reflux
• Difficulty swallowing
• Chest pain or pressure
• Shortness of breath, especially after eating
• Unexplained weight loss
• Vomiting blood or passing black stools

How can early detection improve outcomes for hiatal hernia patients. Prompt diagnosis and treatment can:

• Prevent the progression of symptoms
• Reduce the risk of complications
• Improve overall quality of life
• Potentially avoid the need for more invasive treatments in the future

The Importance of Regular Check-ups

Why are regular medical check-ups important for those with known hiatal hernias. Routine follow-ups allow healthcare providers to:

• Monitor the size and condition of the hernia
• Assess the effectiveness of current treatments
• Make necessary adjustments to management plans
• Catch any potential complications early

In conclusion, hiatal hernias are common digestive tract conditions that can significantly impact an individual’s quality of life. While many cases remain asymptomatic or can be managed conservatively, understanding the signs, symptoms, and available treatments is crucial for optimal health outcomes. By staying informed and working closely with healthcare providers, those affected by hiatal hernias can effectively manage their condition and minimize its impact on daily life.

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.

Treatment and when to seek help

People with a hiatal hernia can experience heartburn, often after eating. This can cause an individual to experience a painful, burning feeling in their chest. When the hernia is larger, it can also cause pain or pressure in the chest if it affects the heart and lungs.

A hiatal hernia is where the upper part of the stomach, or another internal organ, bulges through the opening in the diaphragm, called the hiatus.

The diaphragm is a thin muscle separating the abdomen and the chest. It helps stop acid from coming up into the esophagus, or food pipe. A hiatal hernia makes it easier for acid to reach the esophagus.

This article looks at what chest pain from a hiatal hernia feels like, whether chest pain signifies that a hernia is worsening, treatment options, and when to contact a doctor.

Hiatal hernia can cause chest pain and has associations with the following conditions.

Gastroesophageal reflux disease (GERD) and heartburn

In many cases, chest pain from a hiatal hernia has links to acid and the contents of the stomach traveling up to the esophagus.

This is called gastroesophageal reflux disease (GERD) and can cause a person to experience heartburn. Heartburn feels like a burning sensation in the middle of the chest and can cause a foul, acidic taste in the mouth.

According to a 2019 article, the chest pain related to GERD can feel similar to the pain associated with a heart attack. The pain can also occur without heartburn.

Additionally, GERD can cause the muscles in the esophagus to spasm. This can also cause a person to experience chest pain that they could mistake for a heart attack.

Heart and respiratory system

Hiatal hernias can affect the respiratory system, which may also cause pain or pressure in the chest.

As the hernia enlarges and takes up more space, it can compress the arteries in the heart and lungs. This may cause a part of the lung to collapse, which can lead to the following:

• trouble breathing
• an intense tightness in the chest
• shortness of breath

Hiatal hernias may also cause pressure on the heart, called tamponade. The hernia can compress the heart, causing shortness of breath and chest discomfort.

Chest pain can signify a strangulated or worsening hiatal hernia.

A hernia becomes strangled when the blood supply to the hernia is cut off.

A doctor may suspect that a hiatal hernia is strangulated if a person has severe chest or upper abdominal pain, usually after a meal. In this scenario, individuals may also experience retching and vomiting.

If people suspect their hernia is worsening, they should contact a doctor.

Depending on the severity of a hiatal hernia, a person may not require medical treatment.

A 2022 article notes that while hiatal hernias are common and affect up to 60% of individuals over 50 years of age, only 9% experience symptoms. People who do not experience symptoms do not require medical treatment.

Home treatment and management

The following can help manage the symptoms of a hiatal hernia:

• stopping smoking, if applicable
• eating small meals
• avoiding oily or fried foods
• avoiding caffeine
• avoiding alcohol
• maintaining a moderate weight
• taking over-the-counter (OTC) antacids
• being upright while eating
• eating at least 3 hours before going to bed

Medical treatment

If a person experiences symptoms of a hiatal hernia, such as GERD, they may require medical treatment.

This may involve using proton pump inhibitors, which are medications to treat heartburn, acid reflux, GERD, and stomach ulcers. Doctors may also recommend surgical procedures.

Procedures and surgeries include:

• Transoral incisionless fundoplication: This procedure does not involve incisions. A doctor places an endoscope down the throat and into the esophagus to tighten it. They then wrap parts of the stomach — the cardia and the fundus — around the esophagus.
• Endoluminal fundoplication: A doctor places an endoscope, a tube that attaches to a camera and light, down the throat. They then tighten the area where the esophagus joins the stomach to prevent acid from flowing into the esophagus.
• Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler: A doctor uses surgical staples to attach the fundus to the esophagus. This procedure stops acid reflux.
• Nissen fundoplication: Surgeons can perform this procedure laparoscopically, which means through tiny incisions. They insert a laparoscope, a tube with a camera and light attached, to repair the hernia and tighten the stomach opening.
• Open surgery: This involves the surgeon making a larger incision into the abdomen. The surgeon pulls the stomach up into the abdominal cavity and wraps the fundus around the lower part of the food pipe. This prevents acid from leaking up into the esophagus.

Someone should contact a doctor if they experience chest pain, whether they believe it is due to a hiatal hernia. Chest pain may indicate a serious medical condition, such as a heart attack.

Individuals should also contact a doctor if their symptoms:

• persist for longer than 3 weeks
• do not resolve from using OTC antacids
• worsen

A hiatal hernia can cause a person to experience chest pain. One of the most common presentations of a hiatal hernia is GERD. GERD can cause a person to experience heartburn, causing discomfort and pain in the chest.

It can also cause the esophageal muscles to spasm, resulting in chest pain that feels similar to chest pain relating to a heart attack.

Other causes of chest pain from a hiatal hernia are pressure on the lungs or chest due to the expansion of the hernia. These may cause shortness of breath and chest discomfort.

Severe chest pain, along with some other symptoms such as retching and fever, may indicate that a hiatal hernia is strangulated.

This is a medical emergency, and anyone with these symptoms should seek immediate emergency medical assistance.

People should also seek medical attention immediately if they experience chest pain. This is because chest pain can be a sign of a heart attack.

Hiatus 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.

Hiatal hernia

Hiatal hernia is a violation of the position of the esophageal opening 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.

Main symptoms of hiatal hernia

Hiatus 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 mild or severe. 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 abdominal cavity, 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.

Methods for diagnosing hiatal hernia

Esophagogastroduodenoscopy

Esophagogastroduodenoscopy is one of the most accurate research methods. 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 of 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 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, caffeinated foods 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 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 satiety 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 decrease the tone of the lower esophageal sphincter and increase 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 do not abuse alcoholic beverages.

Methods for diagnosing gastroesophageal reflux 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 where 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.

Related videos:

Q&A:

What are hiatal hernias?

A hiatal hernia is a condition where the upper part of the stomach is pushed 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 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.

How to treat reflux gastroesophageal disease?

Gastroesophageal reflux disease can be treated in many ways, including lifestyle changes, medications, and surgery. It is necessary to consult with a specialist to determine the most effective method of treatment, depending on the severity and nature of the disease.

Hiatal hernia – (Clinic Di Center)

Hiatus hernia

A hernia of the esophageal opening of the diaphragm is a displacement into the chest cavity through the esophageal opening of the diaphragm of the lower part of the esophagus, part of the stomach, and sometimes the intestinal loops. Normally, the ligamentous apparatus of the esophageal opening of the diaphragm, subphrenic adipose tissue and the natural anatomical arrangement of the abdominal organs prevent the movement of organs lying under the diaphragm into the chest cavity. The disease contributes to the throwing of the acidic contents of the stomach into the esophagus, so its main symptom is heartburn. A hernia exists in every twentieth adult, and over the age of 50 – in every second.

What are the causes of a hernia?

The cause of a hernia may be the weakening of the ligamentous apparatus. It is present in 5% of the total adult population and in about 50% of those over the age of 50 (age-related weakening of the ligamentous apparatus), it is more common in untrained, asthenic people. Another factor provoking the development of this disease is a significant increase in intra-abdominal pressure due to severe flatulence, pregnancy, trauma or large tumors of the abdominal cavity, bouts of uncontrollable vomiting or persistent cough (for example, in patients with chronic obstructive bronchitis). Dyskinesia (impaired peristalsis) of the digestive tract, in particular the esophagus, which is often observed against the background of chronic inflammatory diseases (gastric ulcer and 12-colon ulcer, gastroduodenitis, pancreatitis, cholecystitis), can also lead to the development of a hernia. In rare cases, the cause of its occurrence is malformations of embryonic development (short esophagus, chest stomach).

What are the symptoms?

Hiatus hernia leads to insufficiency of the locking mechanisms located on the border of the stomach and esophagus, which means it provokes the throwing of acidic stomach contents into the esophagus and the development of reflux esophagitis. A small hernia may not show any symptoms and is usually discovered during a diagnostic examination associated with another disease.

In cases where the hernia is large, but the locking mechanisms at the border of the esophagus and stomach still function adequately, the main manifestation of the disease is pain behind the sternum, in the heart or in the epigastric region. Pain occurs immediately after eating, when lifting weights or during stress, and can last from a few minutes to several days. Often there is dysphagia (impaired swallowing of food). If the hernial sac is compressed, then there are dull aching pains in the epigastric or epigastric region or behind the sternum.

With insufficiency of the locking mechanisms, the main symptom of a hernia of the esophageal opening of the diaphragm is heartburn. It occurs after eating, a sharp change in body position, more often at night, due to an increase in the tone of the vagus nerve. Starting as a burning heartburn, discomfort can turn into pain.

What complications can a hernia cause?

Hiatus hernia can actually cause coronary pain due to irritation of the vagus nerve and subsequent spasm of the coronary vessels of the heart, this situation is fraught with the development of serious cardiovascular complications up to myocardial infarction. Another extremely unpleasant symptom is belching of gastric contents or air. If a large amount of gastric contents is spit up, especially at night, this can lead to the development of aspiration pneumonia. Regurgitation is not preceded by nausea or stomach contractions, but occurs by contraction of the esophagus.

Diagnostic tests

Diagnosis of a hernia of the esophageal opening of the diaphragm is difficult, since its symptoms are very diverse, it is often combined with other diseases of the gastrointestinal tract and proceeds with complications. No wonder this disease is figuratively called the “masquerade of the upper abdomen.” To make a diagnosis, an x-ray of the esophagus is performed with contrasting with barium sulfate, the motility of the esophagus is examined using esophagomanometry, and daily pH-metry is performed.

Treatment and prevention of hernia

Since the clinical picture of the disease in the vast majority of cases is determined by the reflux of gastric contents, the treatment is the same as for reflux esophagitis.