Hiatal hernia symptoms fatigue. Hiatal Hernia: Symptoms, Diagnosis, and Treatment Options
What are the common symptoms of hiatal hernia. How is hiatal hernia diagnosed. What are the available treatment options for hiatal hernia. Can lifestyle changes help manage hiatal hernia symptoms. When should you seek medical attention for hiatal hernia.
Understanding Hiatal Hernia: Causes and Prevalence
A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm, the muscular wall separating the chest cavity from the abdominal cavity. This condition primarily affects the area where the esophagus passes through the diaphragm, known as the hiatus. Weakening of the muscles surrounding the hiatus can allow the upper part of the stomach to push upward into the chest area.
How common is hiatal hernia. Studies suggest that hiatal hernias affect up to 60% of adults by the age of 60, with the prevalence increasing with age. However, many individuals with hiatal hernias may not experience noticeable symptoms, making it challenging to determine the exact prevalence in the general population.
Risk Factors for Developing Hiatal Hernia
- Age (more common in people over 50)
- Obesity
- Pregnancy
- Smoking
- Chronic coughing or vomiting
- Straining during bowel movements
- Lifting heavy objects
Recognizing Hiatal Hernia Symptoms: When to Be Concerned
While many hiatal hernias are asymptomatic, some individuals may experience a range of symptoms that can impact their quality of life. What are the most common symptoms of hiatal hernia. The primary symptoms include:
- Heartburn, especially after meals or when lying down
- Difficulty swallowing (dysphagia)
- Regurgitation of food or sour liquid
- Chest pain or pressure
- Bloating and belching
- Shortness of breath
- Fatigue or exhaustion
When should you seek medical attention for hiatal hernia symptoms. It’s crucial to consult a healthcare professional if you experience persistent or severe symptoms, particularly if they interfere with your daily activities or if you notice chest pain, which could indicate a more serious condition.
Diagnostic Approaches for Hiatal Hernia
Accurate diagnosis of hiatal hernia is essential for appropriate treatment planning. How do doctors diagnose hiatal hernia. The diagnostic process typically involves a combination of physical examination, patient history, and specialized tests:
1. Physical Examination and Medical History
Your doctor will begin by discussing your symptoms and medical history. They may perform a physical examination, focusing on your abdomen and chest area.
2. Endoscopy
An endoscopy involves inserting a thin, flexible tube with a camera (endoscope) down your throat to examine your esophagus and stomach. This procedure can reveal the presence of a hiatal hernia and any associated complications, such as inflammation or ulcers.
3. Barium Swallow Study
During this test, you’ll drink a contrast solution containing barium, which coats your upper digestive tract. X-rays are then taken, allowing the doctor to visualize the outline of your esophagus and stomach, potentially revealing a hiatal hernia.
4. Esophageal Manometry
This test measures the strength and coordination of your esophageal muscles. A thin, pressure-sensitive tube is passed through your nose and into your esophagus to assess muscle function and detect any abnormalities.
5. pH Monitoring
To evaluate the extent of acid reflux associated with a hiatal hernia, your doctor may recommend 24-hour pH monitoring. This involves placing a small sensor in your esophagus to measure acid levels over an extended period.
Conservative Management: Lifestyle Changes and Dietary Modifications
For many individuals with hiatal hernia, conservative management through lifestyle changes and dietary modifications can significantly alleviate symptoms. What lifestyle adjustments can help manage hiatal hernia symptoms.
- Eating smaller, more frequent meals throughout the day
- Avoiding lying down immediately after meals
- Elevating the head of the bed by 6-8 inches
- Maintaining a healthy weight
- Quitting smoking
- Wearing loose-fitting clothing around the abdomen
- Practicing stress-reduction techniques, such as meditation or yoga
Which dietary changes can help reduce hiatal hernia symptoms. Consider the following dietary recommendations:
- Avoiding trigger foods such as spicy, acidic, or fatty foods
- Limiting caffeine and alcohol consumption
- Avoiding large meals before bedtime
- Incorporating more fiber-rich foods to prevent constipation
- Staying hydrated with water and non-acidic beverages
Pharmacological Interventions for Hiatal Hernia
When lifestyle changes alone are insufficient to manage hiatal hernia symptoms, various medications may be prescribed. What are the most common medications used to treat hiatal hernia symptoms.
1. Antacids
Over-the-counter antacids can provide quick relief from heartburn and acid reflux symptoms by neutralizing stomach acid. These include products containing calcium carbonate, magnesium hydroxide, or aluminum hydroxide.
2. H2 Receptor Blockers
These medications reduce acid production in the stomach. Examples include ranitidine, famotidine, and cimetidine. H2 blockers can provide longer-lasting relief compared to antacids.
3. Proton Pump Inhibitors (PPIs)
PPIs are potent acid-suppressing medications that can significantly reduce acid production and allow the esophagus to heal. Common PPIs include omeprazole, esomeprazole, and pantoprazole.
4. Prokinetics
These medications help strengthen the lower esophageal sphincter and promote faster stomach emptying. Examples include metoclopramide and domperidone.
How long should medications be taken for hiatal hernia. The duration of medication use varies depending on the severity of symptoms and individual response. Always follow your healthcare provider’s recommendations and discuss any concerns about long-term medication use.
Surgical Interventions: When Conservative Treatments Fall Short
In some cases, surgical intervention may be necessary to address persistent or severe hiatal hernia symptoms. When is surgery considered for hiatal hernia. Surgery is typically recommended in the following situations:
- Failure of conservative treatments to adequately control symptoms
- Large hiatal hernias causing significant symptoms or complications
- Presence of severe gastroesophageal reflux disease (GERD) associated with the hernia
- Risk of strangulation or incarceration of the hernia
Laparoscopic Nissen Fundoplication
This minimally invasive procedure is the most common surgical approach for treating hiatal hernia. During the surgery, the stomach is repositioned below the diaphragm, and the upper part of the stomach is wrapped around the lower esophagus to reinforce the lower esophageal sphincter.
Other Surgical Techniques
Depending on the specific characteristics of the hernia and the patient’s overall health, alternative surgical approaches may be considered, such as:
- Toupet fundoplication
- Dor fundoplication
- Collis gastroplasty (for very large hernias)
What is the recovery time after hiatal hernia surgery. Most patients can expect to return to normal activities within 2-4 weeks following laparoscopic surgery. However, full recovery may take up to 6-8 weeks, and dietary restrictions may be necessary during the initial recovery period.
Managing Complications and Long-Term Outlook
While hiatal hernias are generally manageable, complications can occur in some cases. What are the potential complications of untreated hiatal hernia.
- Gastroesophageal reflux disease (GERD)
- Esophagitis (inflammation of the esophagus)
- Barrett’s esophagus (precancerous changes in the esophageal lining)
- Esophageal stricture (narrowing of the esophagus)
- Strangulation or incarceration of the hernia (rare but serious)
How can these complications be prevented. Regular follow-up with your healthcare provider, adherence to prescribed treatments, and lifestyle modifications can significantly reduce the risk of complications. In some cases, periodic endoscopic monitoring may be recommended to detect any changes in the esophagus or stomach.
Long-Term Prognosis
With appropriate management, most individuals with hiatal hernia can lead normal, symptom-free lives. However, ongoing monitoring and adherence to treatment plans are essential for long-term success. What is the recurrence rate after hiatal hernia treatment. While conservative treatments can effectively manage symptoms, they do not correct the underlying anatomical defect. Surgical repair has a success rate of 80-90%, with a recurrence rate of about 10-20% over time.
Emerging Treatments and Future Directions
Research in the field of hiatal hernia management continues to evolve, with new techniques and approaches being explored. What are some promising areas of research for hiatal hernia treatment.
- Endoscopic techniques for hernia repair
- Novel pharmacological agents targeting esophageal motility
- Personalized treatment approaches based on genetic and molecular markers
- Improved surgical materials and techniques to reduce recurrence rates
- Non-invasive diagnostic tools for early detection and monitoring
As our understanding of hiatal hernia pathophysiology deepens, we can expect more targeted and effective treatment options to emerge in the coming years.
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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.
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Hiatal Hernia | Johns Hopkins Medicine
What is a hiatal hernia?
Unlike ventral hernias, which protrude through the abdominal wall, a hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the abdomen from the chest. A hiatal hernia results in retention of acid and other contents since the stomach tends to get squeezed by this opening in the diaphragm. These acids and other substances can easily back up — reflux or regurgitate — into the esophagus.
There are four types of hiatal hernias. The vast majority of hiatal hernias are called type I, or sliding hiatal hernias. In this type, the stomach intermittently slides up into the chest through a small opening in the diaphragm. Type II, III and IV hiatal hernias are called paraesophageal hernias. They occur when a portion of the stomach pushes up into the chest adjacent to the esophagus.
Hiatal Hernia Causes
Hiatal hernias can occur for a number of reasons, including:
Being born with an unusually large hiatus
Injury or trauma to the area such as force from a seatbelt during an accident
Obesity
Persistent and intense pressure on the surrounding muscles caused by:
Hiatal Hernia Diagnosis
To identify a hiatal hernia, a health care provider may use multiple diagnostic techniques but will begin with a medical history and physical examination. The provider will inquire about and/or look for:
Additional diagnostics may include:
Barium X-ray or CT of the upper digestive tract to identify the location and positioning of the gastric organs
Endoscopy exam, during which your doctor passes a thin, flexible tube equipped with a light and video camera (endoscope) down the throat and into the esophagus and stomach to check for inflammation
Hiatal Hernia Treatments
The symptoms associated with hiatal hernia, such as acid reflux, can be treated with lifestyle changes and medication. Surgery may be necessary to repair the hiatal hernia.
Specific treatment for a hiatal hernia will be determined by your doctor based on multiple factors, including your general health, anatomy, extent and location of the hernia, and severity of symptoms such as acid reflux. Any instance in which the stomach or abdominal organs rotate or twist, causing severe pain, blockage and possible strangulation in which blood supply is lost, is always treated with emergency surgery.
Hiatal Hernia Lifestyle and Medication Treatments
Many people do not experience any symptoms related to their hiatal hernia, or their symptoms, like heartburn, are mild. Generally, the symptoms of hiatal hernias can be controlled with lifestyle changes and medication such as:
Eating meals at least three to four hours before lying down
Eating moderate to small portions of foods
Limiting fatty foods, acidic foods (citrus fruits or juices), foods containing caffeine and alcoholic beverages
Losing weight or maintaining a healthy weight
Over-the-counter antacids or antihistamines; your physician may prescribe a stronger medication to manage your symptoms
Sleeping in a slightly elevated position
Smoking cessation
Hiatal Hernia Surgical Treatments
Surgery to repair a hiatal hernia is usually performed through small incisions during which the stomach and any other surrounding tissue are pulled down from the chest cavity and back into the abdomen. The surgeon will also make the opening in your diaphragm smaller and may reconstruct an esophageal valve to treat reflux.
Alternatively, hiatal hernia can be repaired through the chest.
Hiatus hernia: symptoms, causes, diagnosis, treatment
Content
- 1 Hiatus hernia: symptoms, causes and treatment
- 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 Surgical treatment of hiatal hernia
- 1.6.1 Indications for surgery
9000 5 1.6.2 Types of surgery
- 1.6.3 Operation
- 1.6.4 Postoperative period
- 1.1 Description of hiatal hernia
- 1. 7 Recovery after hiatal hernia surgery
- 1.7.1 Recommendations after surgery
- 1.7.2 Exercise for recovery
- 1.7.3 Recovery time after surgery
900 11
- 1.8 Complications of hiatal hernia
- 1.8.1 1. Erosion and ulcer of the esophagus
- 1.8.2 2. Stricture (stenosis) of the esophagus
- 1.8.3 3. Bleeding
- 1.8.4 4. Esophageal dystrophy
- 1.9 Prevention of hiatal hernia
- 1.9.1 Maintaining a healthy lifestyle
- 1.9.2 Foods that reduce the risk of hernia
90 005 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.
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, stretching of the 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.
The diagnosis of hiatal hernia includes examination by a physician, 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 effectively affect a person’s quality of life, 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 changing the diet or not eating before bed, as well as drugs or surgery, depending on the severity and duration of the disease.
Causes of hiatal hernia
The 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 can lead 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
Hiatus 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:
- Feeling of heartburn 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
Hiatal hernia can present with a variety of symptoms that may be related to digestion, breathing, or the cardiovascular system. Some of the symptoms:
- Chest pain and discomfort
- Acidity and heartburn
- Heaviness after eating or at night
- Difficulty swallowing
- Cough or difficulty breathing
- Palpitations and feeling of impotence 90 010
Diagnosis
Esophagogastroduodenoscopy (EGD) is the main diagnostic method for hiatal hernia. During this examination, the doctor can see the hernia and evaluate its size and shape.
In addition, an abdominal ultrasound (ultrasound) may be ordered to assess the condition of the 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 an even more detailed assessment of the condition and size of the hernia, as well as identifying possible complications.
Treatment of hiatal hernia 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 surgery
There are several types of surgery to treat hiatal hernia: laparoscopic Nissen-von-Rheingoldt surgery, fundoplication, thoracotomy, etc.
Laparoscopic Nissen von Rheingoldt is the most common type of surgical 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.
Surgery
Before surgery, the patient is given a complete blood count, urine test, 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 observe the regimen of 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 hiatal hernia surgery
Advice after surgery
After surgery, it is important to take care of your health by 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 supervising physician. 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.
Length of recovery after surgery
The length of recovery after surgery is always individual and depends on many factors such as age, comorbidities, 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
Hiatus hernia can lead to 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 can 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, this may also indicate a problem with your digestive system.
- If you often experience sudden reflux of stomach contents while eating, you should immediately seek medical attention.
It is important to remember that a 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. Surgical treatment may be necessary for patients in whom conservative treatment does not lead to a positive result or in case of complications of a hernia.
What precautions can be taken to prevent hiatal hernia?
Hernia can be prevented by: maintaining a healthy lifestyle, avoiding overeating, eating at least 3 hours before bedtime, not smoking, regular exercise, and weight control.
What are the consequences of delayed treatment of hiatal hernia?
Untimely treatment of a hernia can lead to various complications, such as congestion in the lungs, development of bronchitis, perforation of the stomach, etc. In some cases, a hernia can lead to the development of cancer of the esophagus.
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Hiatal hernia – HH symptoms and treatment
Table of contents
Hiatal hernia affects several organs in combination. 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.
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 for 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 traumatization of 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 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 meal 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 the 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.