What is Hiatal Hernia?
A hiatal hernia is formed when the stomach pushes through the abdominal muscles (diaphragm) which separate the chest from the abdomen.
A small opening in the diaphragm called the hiatus allows the passage of the food tube (oesophagus) which connects to the stomach.
The stomach pushes up into the chest through this opening. The population of people above the age of 50 are more prone to the formation of this condition.
A small hiatal hernia may never cause symptoms until the doctor diagnoses it while evaluating for another condition.
A large hiatal hernia can cause stomach acid reflux into the oesophagus, resulting in heartburn.
The symptoms of this can be resolved by medication and precautions. However, in case of a very large hiatal hernia the doctor may recommend surgery.
What are the Causes of Hiatal Hernia?
It is not clear why Hiatal hernias form. Though, it seems to be a result of weakened muscle tissue of the diaphragm which allows the stomach to push up into the chest cavity.
Certain causes that lead to its formation are:
- An injury in that area, a result of surgery or trauma.
- A large-sized hiatus at birth.
- The age-associated weakening of muscles surrounding the hiatus.
- Consistent and extreme pressure on the muscles around the hiatus, a consequence of vomiting, coughing, strained bowel movements, heavy weight-lifting, or rigorous exercising.
- Smoking and obesity can increase the risk of its occurrence.
What are the Symptoms of Hiatal Hernia?
Only large-sized Hiatal hernias are known to cause symptoms as listed below:
- Difficulty in swallowing.
- Regurgitation of food or liquid consumed back into the mouth.
- Shortness of breath.
- Reflux of stomach acid into the oesophagus.
- Heartburn which worsens on leaning or lying down.
- Abdominal or chest pain.
- Vomiting blood or passing black stools (an indicator of gastrointestinal bleeding).
It is advisable to see a doctor if there are signs of the above symptoms to avoid complications in the future.
How to Diagnose Hiatal Hernia?
The following diagnostic procedures could be recommended for the evaluation of a hiatal hernia:
X-ray of your upper digestive system: The patient is made to drink a chalky liquid, which coats and fills the inner lining of the digestive tract.
X-ray images of the coating now allow the doctor to see a silhouette of your oesophagus, stomach, and upper intestine and determine anomalies indicative of hiatal hernia.
Upper Endoscopy: A thin, flexible tube attached with a light and camera (endoscope) is introduced down the throat, to inspect the inside of the oesophagus and stomach to evaluate inflammation.
Esophageal Manometry: This test is used to measure the rhythmic contractions of the esophageal muscles while swallowing. This technique also measures the coordination and force exerted by the esophageal muscles.
What is the Treatment options for Hiatal Hernia?
Depending on the severity of the symptoms demonstrated the doctor may prescribe medications or surgery.
Medications for heartburn and acid reflux, the doctor may recommend:
- Antacids that neutralize stomach acid.
- Medications to lessen acid production.
- Medications deter acid production and allow the oesophagus to heal.
In addition to medication, the doctor may suggest several lifestyle changes that could lessen the severity of the symptoms or do away with the symptoms.
Although once diagnosed, checkups as per the periodicity of the doctor should be to avoid future complications.
If the medication fails to alleviate or resolve the symptoms of hiatal hernia or have complications like severe inflammation or narrowing of the oesophagus, surgery is recommended.
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