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.
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:
Only large-sized Hiatal hernias are known to cause symptoms as listed below:
It is advisable to see a doctor if there are signs of the above symptoms to avoid complications in the future.
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.
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:
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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