What is a hiatal hernia. How is it diagnosed. What are the risk factors for developing a hiatal hernia. What are the common symptoms of hiatal hernia. How is a hiatal hernia treated. When is surgery necessary for hiatal hernia. What are the different types of hiatal hernia.

Understanding Hiatal Hernia: Types and Manifestations

A hiatal hernia occurs when a portion of the stomach protrudes through the hiatus, an opening in the diaphragm that allows the esophagus to connect with the stomach. This condition can manifest in different forms, each with its own set of characteristics and potential complications.

Sliding Hiatal Hernia

The most common type is the sliding hiatal hernia. In this case, the lower esophageal sphincter and a small part of the stomach slide upward into the chest cavity. Patients with this type may experience heartburn and gastroesophageal reflux (GERD).

Paraesophageal Hernia and Intrathoracic Stomach

A more severe form is the paraesophageal hernia, where the upper portion of the stomach (fundus) moves into the chest cavity. In extreme cases, known as giant esophageal hernia, the entire stomach and even parts of the intestines may migrate through the hiatus.

Risk Factors Contributing to Hiatal Hernia Development

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

• Heavy lifting
• Intense coughing or sneezing
• Violent vomiting
• Pregnancy and childbirth
• Obesity
• Genetic predisposition
• Smoking
• Chronic stress
• Short esophagus (in cases of paraesophageal hernia)

Can obesity cause hiatal hernia? Yes, excess weight can exert pressure on the abdomen, potentially leading to the development of a hiatal hernia.

Recognizing Hiatal Hernia Symptoms: From Mild to Severe

The symptoms of hiatal hernia can vary widely, ranging from nonexistent to severe. While small hiatal hernias often cause no symptoms, larger ones can lead to significant discomfort and health issues.

Common Symptoms

• Heartburn and regurgitation
• Difficulty swallowing (dysphagia)
• Chest pain, especially after eating
• Vomiting after meals
• Fatigue
• Shortness of breath

Is fatigue a symptom of hiatal hernia? While not a direct symptom, fatigue can be associated with hiatal hernia, especially in cases where the condition disrupts sleep or leads to nutritional deficiencies due to eating difficulties.

Symptoms Specific to Paraesophageal Hernias

Paraesophageal hernias may cause additional symptoms such as:

• Fainting
• Anemia
• Aspiration (inhaling stomach contents into the lungs)

Diagnostic Procedures for Hiatal Hernia

Accurate diagnosis of hiatal hernia is crucial for appropriate treatment. Two main diagnostic procedures are commonly used:

Upper GI Series (Barium Swallow)

This procedure involves the patient swallowing a barium solution, which allows the physician to observe the movement of fluid through the esophagus and the appearance of the stomach via X-ray imaging.

Esophagoscopy/Endoscopy

In this procedure, a thin, flexible tube with a camera is inserted through the mouth into the esophagus. This allows the physician to directly view the interior of the esophagus and obtain tissue samples if necessary.

How is a hiatal hernia diagnosed? Primarily through an upper GI series or endoscopy, which provide detailed images of the esophagus and stomach.

Treatment Approaches: From Conservative Management to Surgery

The treatment of hiatal hernia depends on the severity of symptoms and the type of hernia. Options range from lifestyle modifications and medications to surgical interventions.

Conservative Management

For mild cases, especially sliding hiatal hernias, treatment may include:

• Lifestyle modifications (e.g., elevating the upper body during sleep)
• Medications to manage GERD symptoms
• Weight loss for obese patients

Surgical Interventions

Surgery becomes necessary when:

1. GERD symptoms are not controlled with medication
2. The patient has a giant esophageal hernia

When is surgery required for hiatal hernia? Surgery is typically recommended when conservative treatments fail to control symptoms or in cases of large hernias that pose risks of complications.

Surgical Techniques for Hiatal Hernia Repair

Various surgical techniques are employed to repair hiatal hernias, with minimally invasive approaches being preferred when possible.

Repairing the Hiatus

For early-stage hiatal hernias, the enlarged hiatus is reduced in size using sutures and a prosthetic mesh to reinforce the diaphragm tissue.

Nissen Fundoplication

This procedure involves wrapping the upper part of the stomach (fundus) around the lower esophagus. It helps prevent sliding hiatal hernias and reinforces the lower esophageal sphincter, alleviating reflux symptoms.

Collis-Nissen Gastroplasty

This technique is used for paraesophageal hernias and intrathoracic stomach, especially when complicated by a short esophagus. It involves using the upper portion of the stomach to extend the esophagus, reducing tension.

What is Nissen fundoplication? It’s a surgical procedure that wraps the upper part of the stomach around the lower esophagus to prevent reflux and sliding hiatal hernias.

Post-Treatment Outcomes and Long-Term Management

After successful treatment, most patients experience significant improvement in their symptoms. However, long-term management may be necessary to prevent recurrence and maintain overall digestive health.

Post-Surgical Care

• Gradual return to normal diet
• Follow-up appointments to monitor healing
• Potential lifestyle modifications to prevent recurrence

Long-Term Management

Long-term strategies may include:

• Maintaining a healthy weight
• Avoiding triggers that may exacerbate symptoms
• Regular check-ups to monitor the condition

Do patients need GERD medications after hiatal hernia surgery? In most cases, GERD medications are not necessary after successful surgical repair of a hiatal hernia.

Hiatal Hernia and Its Impact on Quality of Life

While many hiatal hernias are asymptomatic, those that do cause symptoms can significantly impact a person’s quality of life. Understanding the condition and seeking appropriate treatment is crucial for managing symptoms and preventing complications.

Psychological Impact

Living with chronic symptoms like heartburn or difficulty swallowing can lead to:

• Anxiety about eating
• Social isolation due to dietary restrictions
• Sleep disturbances affecting overall well-being

Physical Limitations

Severe cases may result in:

• Restricted physical activities
• Nutritional deficiencies due to eating difficulties
• Chronic pain affecting daily functioning

How does a hiatal hernia affect daily life? It can impact eating habits, sleep patterns, and physical activities, potentially leading to a decreased quality of life if left untreated.

Preventive Measures and Lifestyle Modifications

While not all hiatal hernias can be prevented, certain lifestyle changes may reduce the risk or alleviate symptoms:

• Maintaining a healthy weight
• Avoiding heavy lifting or straining
• Quitting smoking
• Managing stress through relaxation techniques
• Eating smaller, more frequent meals
• Avoiding lying down immediately after eating

Can lifestyle changes prevent hiatal hernia? While they may not prevent all cases, lifestyle modifications can reduce the risk and help manage symptoms of existing hernias.

Emerging Research and Future Directions in Hiatal Hernia Management

The field of hiatal hernia management is continually evolving, with ongoing research aimed at improving diagnostic techniques and treatment options.

Advanced Imaging Techniques

Researchers are exploring more sophisticated imaging methods to enhance the accuracy of hiatal hernia diagnosis and to better guide treatment decisions.

Minimally Invasive Surgical Innovations

Advancements in laparoscopic and robotic-assisted surgical techniques are making hiatal hernia repair less invasive, potentially leading to faster recovery times and reduced complications.

Novel Therapeutic Approaches

Investigations into new medications and non-surgical interventions are ongoing, aiming to provide additional options for patients who may not be suitable candidates for surgery.

What are the latest advancements in hiatal hernia treatment? Current research focuses on improving minimally invasive surgical techniques and exploring novel non-surgical interventions to enhance treatment outcomes.

In conclusion, hiatal hernia is a complex condition that can significantly impact a person’s health and quality of life. From understanding its various types and manifestations to exploring diverse treatment options, managing this condition requires a comprehensive approach. As research continues to advance, patients and healthcare providers can look forward to more effective and less invasive treatment options in the future. Whether through conservative management, surgical intervention, or emerging therapies, the goal remains to alleviate symptoms, prevent complications, and improve overall well-being for those affected by hiatal hernia.

Hiatal Hernia | Columbia Surgery

In a hiatal hernia (also called hiatus or diaphragmatic hernia), a portion of the stomach penetrates (herniates) through a weakness or tear in the hiatus of the diaphragm, the small opening that allows the esophagus to pass from the neck and chest to its connection with the stomach. Often there are no symptoms, and the condition may not cause any problems. The patient may not be aware they have a hiatal hernia.

Sliding Hiatal Hernia

The term sliding is employed when hiatal hernia involves the lower esophageal sphincter where the esophagus attaches to the stomach. It can also involve a small portion of the stomach. The patient may experience heartburn and gastroesophageal reflux. Because reflux may damage the lining of the esophagus, treatment is essential. Symptoms can usually be managed with medications and behavior modification such as elevating the upper body on a pillow during sleep. Surgery may sometimes be required to correct a sliding esophageal hernia.

Paraesophageal Hernia and Intrathoracic Stomach

In more severe cases of hiatal hernia, the fundus, or upper portion of the stomach, may slide upward into the chest cavity through the hiatus. The condition occurs as an intensifying of a sliding hiatal hernia. In rare cases, the entire stomach and even some of intestines may migrate through the hiatus and rest on top of the diaphragm next to the esophagus, a condition known as giant esophageal hernia.

Giant Hiatal Hernias: Podcast by Lyall A. Gorenstein, MD »  

Risk Factors

Hiatal hernia is initiated by pressure in the abdomen occurring through:

• Heavy lifting
• Hard coughing or sneezing
• Violent vomiting
• Pregnancy and delivery
• Obesity may also cause hiatal hernia because of pressure on the abdomen caused by extra weight.
• Heredity
• Smoking
• Stress
• Short esophagus (paraseophageal hernia)

Signs and Symptoms

Most small hiatal hernias do not cause symptoms. The most common symptom of hiatal hernia is gastroesophageal reflux (GERD).

Giant hiatal hernias may cause symptoms including heartburn/regurgitation, anemia, aspiration, chest pain associated with eating, vomiting after meals, difficulty swallowing, fatigue, and shortness of breath.

Symptoms of parasophageal hernia may include problems swallowing, fainting, and vomiting.

Diagnosis

Hiatal hernia is diagnosed with an upper GI series or endoscopy.

In an upper GI series, or a barium swallow, also called barium contrast X-ray, the patient swallows a solution of barium, a compound that will appear inside the body during X-ray so the physician may observe how fluid moves through the esophagus as well as the appearance of the stomach.

In esophagoscopy/endoscopy of the esophagus, a thin, flexible tube with a camera is inserted through the mouth into the esophagus, allowing the physician to view the interior of the esophagus and obtain small tissue samples for biopsy, if necessary.

Treatments

Hiatal hernias require repair for two main reasons:

1. The patient’s reflux symptoms are not successfully controlled with GERD medication therapy.
2. The patient has a giant esophageal hernia (also known as intrathoracic stomach.)

If surgical treatment is required, our surgeons nearly always use minimally invasive anti-reflux techniques, including laparoscopy and endoscopy, with the type of procedure used depending upon the amount of stomach that has migrated through the diaphragm into the chest. GERD medications are not necessary after surgery.

Repairing the Hiatus

An early-stage hiatal hernia may be repaired by decreasing the size of the enlarged hiatus (the opening in the diaphragm through which the esophagus travels on its way to the stomach). This is accomplished by means of sutures and a prosthetic mesh to reinforce the diaphragm tissue.

Nissen Fundoplication

To repair and prevent a sliding hiatal hernia, Nissen fundoplication involves wrapping of the fundus (upper part) of the stomach around the bottom portion of the esophagus to create a bulge of tissue that holds the stomach in place below the diaphragmatic hiatus. Nissen fundoplication also reinforces the lower esophageal sphincter and alleviates reflux when it is present.

Collis-Nissen Gastroplasty

Paraesophageal hernia and intrathoracic stomach may be complicated when a short esophagus pulls upward on the stomach. In Collis-Nissen gastroplasty, the surgeon uses the upper portion of the stomach to extend the esophagus and ease this tension. Our team routinely uses minimally invasive laparoscopy to perform this procedure, which was traditionally performed through a major chest incision.

Next Steps

If you are in need of help for an esophageal condition, we’re here for you. Call us now at (212) 305-1909 or fill out our online form to get started today.

Related Topics 

• Achalasia
• Barrett’s esophagus
• Esophageal atresia
• Esophageal cancer
• Esophageal dilation
• Esophagectomy
• Gastroesophageal reflux disorder (GERD)
• Hiatal hernia
• Swallowing disorders/dysphagia

Hiatal Hernia Symptoms & Treatment

1. Home
3. Services & Specialties
5. Gastroenterology & colorectal surgery
7. Hiatal hernia symptoms & treatment

Gastroenterology colorectal surgery

• Abdominal & stomach pain causes & treatment
• Anal sphincter electromyography testing
• Anorectal manometry testing
• Barrett’s esophagus symptoms & treatment
• Caffeine side effects
• Celiac disease symptoms & treatment
• Capsule endoscopy procedure
• Cholecystectomy surgery
• Colorectal cancer screening
• Constipation symptoms, causes & treatment
• Crohn’s disease symptoms & treatment
• Cyclic vomiting syndrome
• Diarrhea treatment
• Diverticular diseases
• Electrohydraulic lithotripsy procedure
• Endoscopic mucosal resection procedure
• Endoscopic retrograde cholangiopancreatography
• Endoscopic ultrasound
• Esophageal motility disorders
  • Esophageal stricture
  • Tracheoesophageal fistula

• Esophagogastro-duodenoscopy testing
• Esophageal manometry testing
• Fecal transplantation therapy
• Fiducial markers
• Gallstones symptoms & treatment
• Chronic acid reflux (Gastroesophageal reflux disease)
• Halo procedure
• Heartburn treatment
• Hemorrhoid symptoms & treatment
• Hepatitis A symptoms & treatment
• Hepatitis B symptoms & treatment
• Hepatitis C symptoms & treatment
• Hiatal hernia symptoms & treatment
• Non-viral hepatitis symptoms & treatment
• Pancreatic cancer screening
• Paracentesis procedure
• Pancreatitis symptoms & treatment
• pH monitoring of stomach acid
• Stomachache trouble
• Sphincter of Oddi manometry testing
• Spyglass endoscopic camera probe
• Welcome our new GI doctors
• Whipple procedure
• Irritable bowel syndrome (IBS) symptoms & treatment
• Peptic (stomach) ulcers
• Inflammatory bowel disease (IBD)
• Total parenteral nutrition
• Ulcerative colitis symptoms & treatment

Find a GI specialist

A hiatal or hiatus hernia happens when part of your stomach comes up through the diaphragm, the muscle that separates your chest area from your stomach area (abdomen). The tube that leads from your mouth to your stomach (esophagus) goes through a part of the diaphragm called the hiatus. If the muscle around the hiatus is weak, the top part of your stomach can press up through the diaphragm into the chest area and you may need hiatal hernia treatments.

Symptoms of a hiatal hernia

With most instances of hiatal hernia, symptoms are not present and need no treatment. More serious hiatal hernia symptoms may include trouble swallowing, heartburn, belching, tiredness and chest pain. Schedule an appointment with your doctor if you have these possible hiatal hernia symptoms and they are causing you concern. If you’re feeling chest pain, call your doctor immediately, as this may be a sign of a more serious condition.

Getting a hiatal hernia diagnosis

To diagnose a hiatal or hiatus hernia, your doctor will perform a physical exam. They’ll talk to you about your symptoms of hiatal hernia and may order tests, including:

• Endoscopy: A flexible tube equipped with a light and tiny camera (endoscope) is inserted down your throat to see inside the esophagus and stomach. If needed, a tissue sample (biopsy) can be done during an endoscopy. These samples are examined in a lab to check for problems.
• pH monitoring: This test checks for stomach acid in your esophagus.
• Motility testing: This measures if the esophagus is working properly. A thin, flexible tube (catheter) is inserted into your nose, down the esophagus and into the stomach.

Hiatal hernia services & treatment

Hiatal hernia treatments may include these dietary and lifestyle recommendations:

• Eat smaller more frequent meals
• Avoid fatty foods, alcohol, chocolate, caffeine and peppermint
• Don’t smoke
• Maintain normal weight
• Do not lie down after eating
• Do not eat for three to four hours before bedtime
• Elevate your head by six inches with a pillow wedge

Over-the-counter or prescriptions medicines may be used for hiatal hernia treatments, such as:

• Antacids. These will address symptoms of hiatal hernia but won’t fix any damage stomach acid has caused in your esophagus.
• H-2 receptor blockers. These heartburn medications reduce the amount of acid the body makes. They can help relieve symptoms of hiatal hernia for longer periods of time.
• Proton pump inhibitors. These block the acid the body makes, which allows the esophagus to heal.

Sometimes your doctor’s suggestion for hiatal hernia treatment may include surgery.

Get care

We help you live well. And we’re here for you in person and online. 

Find a GI specialist

Find a location

Get a second opinion

Sign in to LiveWell

Hiatus hernia – HH symptoms and treatment

Table of contents

Hiatus hernia affects several organs in aggregate. The esophagus passes into the epigastrium through the hiatal opening in the diaphragm, and hiatal hernia occurs when part of the stomach is forced into the chest cavity. The most vulnerable are considered to be pregnant women, people over 50 and obese. Also, a hernia of the esophageal opening of the diaphragm can be caused by excessive strength exercises, lifting heavy loads, excessive stress during bowel movements, etc. Hiatal hernia of the diaphragm is predominantly an acquired disease, but hereditary cases are also observed. With the manifestation of relevant symptoms and the identification of HH, a decision is made to perform an operation to remove the hernia. In some cases, you can try to do conservative treatment without surgery, but this method is not applicable to all types of HH and only temporarily relieves the symptoms of the disease.

Varieties of HH

Hiatal hernia is classified based on the specifics of displacement and two key types are distinguished in its typology: treatment in a hospital.

paraesophageal hiatal hernia is the most dangerous case for health, causing serious complications and disrupting blood flow to vital organs.

In addition, there are several stages of severity of the course of the disease (stages I, II, III and IV) based on the degree of transition of the stomach into the sternal region.

Factors affecting the development of HH

HH develops due to a pathological change in the size of the esophageal opening. With minor deviations from the permissible values, a hernia of the esophageal opening of the diaphragm does not show symptoms until a targeted diagnosis, and the signs of HH are easily confused with manifestations of other diseases of the gastrointestinal tract or from the cardiovascular system.

Hernia of the alimentary opening of the diaphragm can manifest itself due to many circumstances and is currently increasingly common in medical practice.

Main factors in the development of HH:

• muscle hypotension due to age;
• chronic diseases of the gastrointestinal tract;
• intra-abdominal hypertension;
• weight fluctuation;
• complications from operations on the esophagus;
• a consequence of trauma to the abdomen.

As for the complications that hiatal hernia can provoke, the most common is reflux esophagitis. The obvious symptoms of reflux esophagitis include regular bouts of heartburn after eating. Usually this complication is inherent if the patient has a sliding (axial) hiatal hernia, and as a treatment, the patient is prescribed therapy that normalizes acidity. Erosions of the esophagus and stomach are also quite often manifested, which in turn, if not detected and treated in time, can lead to a precancerous state of latent gastrointestinal bleeding and, as a result, cause anemia. Moreover, hiatal hernia can lead to peritonitis and sepsis due to compression of the hernia. With obvious symptoms of intoxication, vomiting, acute persistent pain, hospitalization is indicated as soon as possible.

Hiatal hernia is more often asymptomatic, but at the same time has a number of symptoms that may indicate the presence of the disease.

Symptoms of HH

Often HH is so small that it is hidden, but in more severe cases the following symptoms occur:

• frequent heartburn;
• belching;
• hiccups;
• difficulty and discomfort in swallowing;
• extremely fast satiety;
• sharp pains in chest;
• sore tongue;
• attacks of dry cough.

As practice shows, a patient with a confirmed diagnosis of hiatal hernia usually suffers immediately from a number of symptoms and needs treatment based on the diagnosed type of HH.

For correct treatment it is necessary to carry out a complete diagnosis, taking into account the most detailed questioning of the patient for the presence of symptoms, data on acidity and indicators of hernia. Hiatus hernia is detected by contrast radiography, esophageal motility studies, gastroscopy with biopsy, and daily pH-metry.

Outpatient treatment of HH

Treatment of HH begins with conservative methods, if the severity of the symptoms and the severity of the course of the disease allow. Since a hernia of the esophageal opening of the diaphragm can proceed in a latent form for a long time and with a high degree of probability the patient has already taken certain actions to alleviate his condition, first of all, they conduct detailed consultations with a gastroenterologist to determine the correct treatment tactics. There are general rules, following which you can significantly improve the quality of life:

• adhere to the fractional diet plan;
• limit the consumption of certain foods that cause heartburn and adversely affect the digestive tract;
• do not lie down for 3 hours after eating;
• stop drinking alcohol and smoking.

It should be added that conservative treatment implies only relief of symptoms of reflux esophagitis and is effective only at the initial stage of HH.

Surgical treatment of HH

If negative dynamics persist, doctors may decide that surgery is necessary. This is a more radical way of treatment, but also more effective, especially in case of acute exacerbations of the disease and if the hiatal hernia has developed into stages III and IV. Often, a hernia of the esophageal opening of the diaphragm can be accompanied by a number of other diseases of the gastrointestinal tract, therefore, in such cases, complex treatment is performed. Today, surgeons prefer laparoscopic operations due to their low trauma and reduced time for postoperative recovery.

Since a hernia of the esophageal opening of the diaphragm significantly disrupts the normal arrangement and functioning of several organs of the abdominal and sternal regions, the operation to eliminate it consists in performing a number of established manipulations:

Fundoplication, as a rule, is performed by the following methods:

• the author’s method of Academician A.F. Chernousov, the founder of antireflux surgery in Russia; This is a laparoscopic fundoplication, due to which a lasting effect is achieved with a recurrence probability of only 2% within a year from the moment of operation.
• Nissen fundoplication involves the formation of a cuff around the esophagus to maintain the correct functioning of its lower sphincter. This is a classic operation used to treat HH, but it has several disadvantages. For example, the lower esophageal sphincter is blocked not only for gastric juice, but also for the release of gases, which provokes bloating. In some cases, there is a relapse of the disease.
• The Tope fundoplication differs from the Nissen method in the degree of fundus turnover (270 degrees) and, most importantly, in the complete preservation of the function of the lower esophageal sphincter.

Dietary restriction and rest for about three weeks is the key to a successful and quick recovery. In most cases, if the hernia of the esophageal opening of the diaphragm is removed in a timely manner and the treatment was carried out taking into account all the recommendations, the patient will be guaranteed to be able to return to his usual way of life.

Branches and departments that treat hiatal hernia

hiatal hernia: symptoms, causes, diagnosis, treatment

content

• 1 hiatal hernia: symptoms, causes and treatment
  900 09 1. 1 Description of hiatal hernia
  • 1.1.1 What is it?
  • 1.2 Causes of hiatal hernia
  • 1.3 Symptoms of hiatal hernia
  • 1.4 Diagnosis of hiatal hernia
    • 1.4.1 Symptoms
    • 1.4.2 Diagnosis
  • 1.5 Treatment of hiatal hernia without surgery
    • 1.5.1 Medical treatment
    • 1.5.2 Diet
    • 1.5.3 Physical activity
    • 1.5.4 Acupuncture
  • 1.6 Hiatal hernia surgery 9000 8
  • 1.6.1 Operation indications
  • 1.6.2 Types of operation
  • 1.6.3 Operation
  • 1.6.4 Postoperative period
• 1.7 Recovery after surgery for hiatal hernia
  • 1.7.1 Postoperative recommendations
  • 1.7 .2 Physical exercise for recovery
  • 1.7.3 Duration of recovery after surgery
• 1.8 Complications of hiatal hernia
  • 1.8.1 1. Erosion and ulcer of the esophagus
  • 1.8.2 2. Strictures (stenosis) of the esophagus
  • 1. 8.3 3. Bleeding
  • 1.8.4 4. Dystrophy of the esophagus
• 1.9 Prevention of hiatal hernia 900 08
• 1.9.1 Maintaining a healthy lifestyle
• 1.9.2 Foods that reduce the risk of hernia
• 1.9.3 Correct posture while eating
• 1.9.4 Reducing stress

Hiatal hernia is a serious disorder of the digestive system that can lead to dangerous complications. In the article we will talk about the causes, symptoms, diagnosis and treatment of this disease. Learn how to prevent hernia and restore health.

A hiatal hernia is a disease in which part of the stomach protrudes from the abdominal cavity through a hole in the diaphragm into the chest cavity. This leads to disruption of the esophagus, which passes through the diaphragm on its way from the throat to the stomach. Hiatus hernia is a serious problem that can cause various complications if not treated on time.

The causes of hiatal hernia may be a violation of the muscle tone of the diaphragm, excess weight, pressure on the abdominal cavity, stretched ligaments, etc. Signs of the disease may include reflux (leakage of acidic fluid from the stomach into the esophagus), difficulty swallowing, rapid heart rate, chest pain, and difficulty breathing.

Diagnosing a hiatal hernia includes a doctor’s examination, endoscopy, and X-ray. Treatment may include removing the cause of the disease (eg, weight bearing), exercises to strengthen the muscles of the diaphragm, drug therapy, and, in severe cases, surgery.

Description of hiatal hernia

What is it?

Hiatus hernia is a common condition where the upper abdomen pulls through the diaphragm and moves into the chest cavity.

This will have a dramatic effect on the quality of life of a person, causing symptoms such as heartburn, difficulty swallowing, vomiting, a burning sensation in the chest cavity and pain in the chest.

A hiatal hernia can be confirmed through an examination such as X-ray, endoscopy, or magnetic resonance imaging.

Further treatment may include simple lifestyle changes such as dietary changes or not eating before bed, as well as drugs or surgery, depending on the severity and duration of the disease.

Causes of hiatal hernia

Consequences of stretching of muscles and ligaments in the area of ​​the diaphragm can lead to hiatal hernia. This is due to the rapid repetition of the same movements, as well as the features of professional activity.

Chronic diseases , such as heartburn, stomach ulcers, diseases of the esophagus, can also cause hiatal hernia.

Obesity is one of the main risk factors for hiatal hernia. Excess weight puts extra stress on the diaphragm and causes it to stretch.

Smoking may cause tissue damage in the area of ​​the diaphragm, which may contribute to hiatal hernia. Nicotine constricts blood vessels, which disrupts blood circulation in tissues.

Genetic predisposition can also cause hiatal hernia. Hereditary factors can affect the initially weak structure of the diaphragm.

Aging of the body is a natural process that can also affect the occurrence of hiatal hernia. As we age, body tissues lose elasticity and can be more easily damaged.

Symptoms of hiatal hernia

Hiatal hernia is a serious condition caused by extrusion of part of the stomach into the chest cavity through the diaphragm. A characteristic manifestation of the disease is reflux esophagitis, or inflammation of the esophagus. It occurs as a result of a stable reflux of gastric contents into the esophagus, which causes irritation and inflammation of the walls of the esophagus. Among the main symptoms of hiatal hernia are the following:

• Heartburn sensation is the most common symptom of hiatal hernia. It is manifested by an unpleasant burning sensation in the chest, which extends to the throat. The sensation can be heavy and often occurs after eating or light exercise.
• Chest pains – pains are caused by irritation of the walls of the esophagus, they can be severe and prolonged. To diagnose a hernia of the esophageal opening of the diaphragm, an accurate differentiation from heart pain is necessary.
• Nausea and vomiting – these symptoms often occur after eating and may be associated with backflow of stomach contents.
• Severe constipation – occurs as a result of impaired bowel function and may be caused by changes in the location of the digestive organs.
• Iron deficiency – occurs due to bleeding as a result of the disease. It can manifest itself in the form of anemia, weakness and increased fatigue.

If you experience these symptoms, you should see a doctor for diagnosis and treatment.

Diagnosis of hiatal hernia

Symptoms

Hiatus hernia can present with a variety of symptoms that may be related to digestion, breathing, or the cardiovascular system. Some of the symptoms:

1. Chest pain and discomfort
2. Acidity and heartburn
3. Heaviness after eating or at night
4. Difficulty swallowing
5. Cough or difficulty breathing
6. Palpitations and feeling of impotence

Diagnosis

Esophagogastroduodenoscopy is the main method for diagnosing hiatal hernia ( EGDS). During this examination, the doctor can see the hernia and evaluate its size and shape.

An abdominal ultrasound (ultrasound) may also be ordered to assess the condition of internal organs that may be affected by the hernia.

An X-ray of the chest and abdomen with contrast can also be prescribed, which allows for an even more detailed assessment of the condition and size of the hernia, as well as to identify possible complications.

Hiatal hernia treatment without surgery

Medical treatment

If a patient has a small hiatal hernia, the doctor may prescribe medication. Medications can help reduce stomach acid and protect the esophagus from damage. It is important to follow the dosage and doctor’s recommendations to avoid side effects.

Diet

In case of hiatal hernia, it is not recommended to consume spicy, acidic and fatty foods, as well as drinks containing caffeine. To reduce pressure in the stomach, you should eat food little by little, but more often – 5-6 times a day in small portions. Patients are also advised to observe certain rules for eating – do not eat before bed and do not bend over after eating.

Physical activity

Regular exercise can help strengthen the muscles of the diaphragm and abdomen, which will reduce the risk of a hernia recurring. But at the same time, you should not engage in too intense sports, which can cause increased pressure in the abdomen.

Acupuncture

Acupuncture is an alternative medicine that can help with hiatal hernia. This method is based on the impact on active points on the human body with the help of needles. Acupuncture can help reduce symptoms associated with a hernia, such as heartburn and belching.

Surgical treatment of hiatal hernia

Indications for surgery

Surgical treatment of hiatal hernia is performed when conservative methods fail and the patient continues to experience pain, difficulty in swallowing, heartburn, recurrent pneumonia or asthma.

Types of operation

There are several types of operations for the treatment of herbal hernia of the diaphragm: laparoscopic nissen-porus-rangold-operation, pundication, thoracotomy, etc.

Laparoscopic nissen-rainhold-operation-the most common type of hier gytous treatment. This is a minimally invasive method that avoids large scars on the abdominal wall.

Fundoplication is a method in which the upper part of the stomach is wrapped around the lower esophagus and fixed. This type of operation is used most often for recurrence of hernia of the esophageal opening of the diaphragm.

Operation

Before the operation, the patient undergoes a complete blood count, urine test, and bacteriological tests to detect the presence of infection. Two hours before the operation you need to stop eating and drinking. The surgeon performs the operation under anesthesia. The duration of the operation depends on the complexity of the pathological process and the chosen method of treatment. After the operation, the patient is in intensive care under the supervision of doctors.

Postoperative period

The patient must comply with the postoperative period: limit physical activity, use of fatty, spicy, spicy foods, stop smoking and alcohol. Take your medications as prescribed by your doctor. After removing the sutures and increasing physical activity, patients should see a specialist to adjust their exercise regimen.

Recovery after surgery for hiatal hernia

Recommendations after surgery

After surgery, it is important to take care of your health, following the recommendations of specialists. In the first days after the operation, it is necessary to limit physical activity, not to make sudden movements.

The diet should be light and digestible without intimidating the digestive system. It is worth giving up fatty, spicy and sour foods, as well as smoking and alcohol. Multiple meals in small portions are recommended.

It is also important to take anti-inflammatory drugs and antibiotics, if prescribed by the supervisor. If pain symptoms or other abnormalities appear, you should immediately consult a doctor.

Exercise for recovery

Exercise can speed up the recovery process after surgery. But during the period of leveling the condition, it is necessary to avoid physical exercises that can be detrimental to health.

Examples of exercises that can be done after a period of rehabilitation are yoga exercises, swimming and Pilates. You can also do exercises to strengthen the abdominal muscles, which will help reduce the risk of a hernia recurring.

The length of recovery after surgery

The length of recovery after surgery is always individual and depends on many factors such as age, presence of concomitant diseases, general health, etc.

A full recovery usually takes 2 to 6 months, although in some cases a longer recovery period may be required. During this period, it is important to follow all the recommendations of doctors and monitor your well-being.

Complications of hiatal hernia

1. Erosion and ulcer of the esophagus

Hiatal hernia can lead to the development of erosions and ulcers in the wall of the esophagus. This is due to the fact that the acidic contents of the stomach are poured into the esophagus and irritate its walls. Over time, this can lead to the formation of ulcers, which can be dangerous if not treated promptly.

2. Strictures (stenoses) of the esophagus

In some cases, hiatal hernia can lead to the formation of strictures (stenoses) of the esophagus. Strictures are narrow places in the esophagus where food can be obstructed. This can cause pain and discomfort when eating, and lead to complications if not treated promptly.

3. Bleeding

If hiatal hernia is complicated by erosions and ulcers of the esophagus, there may be a risk of bleeding. This disorder can be life-threatening and requires immediate medical attention.

4. Dystrophy of the esophagus

In hiatal hernia, the walls of the esophagus may become less elastic and thin, which can lead to the development of dystrophy of the esophagus. This allows food to linger in the esophagus, which creates favorable conditions for the development of infection and other complications.

Prevention of hiatal hernia

Maintaining a healthy lifestyle

Non-observance of a healthy lifestyle is one of the main causes of hiatal hernia. To prevent the development of this disease, it is necessary to eat right and control weight. It is important to stop smoking and drink alcohol in moderation. Regular exercise can also help prevent hernia.

Products that reduce the risk of hernia

Nutrition is one of the factors that can influence the development of hiatal hernia. For prevention, it is recommended to consume natural products, including vegetables and fruits. Dark chocolate and olive oil may also help reduce the risk of hernia.

Correct body position during meals

After eating, it is not recommended to lie down immediately, it is better to keep the body upright for several hours. In this case, it is important not to burden the stomach, to observe the measure in food intake. Don’t put off eating until late in the evening, as this can lead to indigestion.

Stress reduction

Emotional stress can contribute to hernia. To prevent the development of the disease, it is recommended to engage in meditation, yoga, and any other ways of relaxation. It is also helpful to take more time to rest and sleep.

When to see a doctor for hiatal hernia

Hiatal hernia is a serious disease that can lead to various complications in the human body. Therefore, at the first signs of the disease, you should seek help from a doctor.

• If you frequently experience vomiting, nausea, and a stuffy throat, this could be a sign of a hiatal hernia.
• If you have persistent chest pain that gets worse with exercise, it could also indicate a problem with your digestive system.
• If you often experience sudden reflux of stomach contents while eating, you should immediately contact your doctor for help.

It is important to remember that hiatal hernia will not go away on its own without treatment and can lead to serious consequences. Therefore, if you have suspicions of this ailment, immediately seek the advice of a specialist.

Q&A:

What are the causes of hiatal hernia?

One of the main causes is weakness of the muscles of the diaphragm, which can occur as a result of various factors such as age, obesity, pregnancy, smoking, frequent weight lifting, etc.

What symptoms can accompany hiatal hernia?

The most striking symptom is heartburn, which can occur after eating, especially when lying on your back. There may also be a feeling of heaviness in the abdomen, vomiting, respiratory problems, chest pain, etc.

How is hiatal hernia diagnosed?

Various methods are used for diagnosis, including esophagogastroduodenoscopy, barium fluoroscopy, computed tomography, magnetic resonance imaging, etc.

How is hiatal hernia treated?

Treatment may be conservative or surgical. Conservative treatment includes medications that reduce stomach acid production and lifestyle changes such as quitting smoking, exercising regularly, and losing weight.