Hiatal hernia is a condition where the upper part of your stomach bulges through an opening in the large muscle that separates your abdomen and chest (the diaphragm). The diaphragm is a dome-shaped muscle located right below the lungs and the heart.
Your diaphragm contracts and flattens when you inhale. This creates a vacuum that pulls air into your lungs. The diaphragm also increases abdominal pressure to help the body get rid of vomit, urine, and feces. It also puts pressure on the esophagus to prevent acid reflux (the backflow of your stomach contents).
Your diaphragm has an opening called the hiatus, through which the food pipe, or esophagus, passes. A hiatal hernia occurs when your stomach pushes through this opening into your chest. It can affect individuals of any age and gender. However, it is more common in those who are 50 or older.
Hiatal hernias are generally divided into two types:
The exact cause of hiatal hernias is unknown. However, it is believed to occur due to the following:
Risk Factors
Hiatal hernias that are small generally do not exhibit any signs or symptoms. Hiatal hernias that are bigger may cause symptoms that are similar to GERD (gastroesophageal reflux disease). It is a condition where your stomach contents or acids travel backward into the esophagus. The symptoms of GERD include
Though there seems to be a link between hiatal hernia and GERD, one doesn’t seem to cause the other.
For diagnosing hiatal hernias, your healthcare provider would first record your medical history and perform a physical examination. Other methods that are used to diagnose hiatal hernias are:
Treatment measures for hiatus hernias include lifestyle changes, medications to treat the symptoms, and surgery.
Lifestyle Changes
Medications
Surgical Treatment Options
Cases that do not subside with lifestyle changes or medications, or individuals who have severe inflammation or narrowing of the esophagus, will require surgery. The goal of the surgery is to correct gastroesophageal reflux by improving the valve mechanism at the bottom of the esophagus. This valve controls the movement of food through the esophagus into the stomach and prevents its backflow.
During surgery, the stomach and the surrounding tissues are pulled down from the chest cavity into the abdomen. The opening in the diaphragm is made smaller, and the esophageal sphincter (the valve at the junction of the esophagus and the stomach) is reconstructed in order to prevent the stomach contents from moving backward.
This surgery is referred to as “Fundoplication”. It can be performed as either an open surgery or a laparoscopic procedure. There are three types of surgeries to repair a hiatal hernia:
1. Open Surgery: Here the surgeon makes one large incision in the abdomen. The upper part of the stomach called the fundus is wrapped around the lower part of the food pipe or the esophagus. This helps tighten the sphincter which stops the stomach acid from leaking up into the food pipe.
2. Nissen Fundoplication: Here the surgeon makes multiple small incisions in the abdomen. A laparoscope or a thin flexible tube with a light and camera is inserted through an incision to view and repair the hernia. It is also known as keyhole surgery.
3. Endoluminal Fundoplication (ELF): This procedure does not require any incisions. Here the doctor would place an endoscope through your throat into your esophagus. The surgeon then tightens the area where the esophagus joins the stomach.
Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler (MUSE) is another procedure that is used in the treatment of hiatal hernias. Here, surgical staples are used to attach the fundus (upper part of the stomach) to the lower portion of the esophagus.
Open Fundoplication Surgery | Laparoscopic Surgery |
Involves one larger incision | Involves multiple small incisions |
Longer procedure | Short Procedure |
Requires a hospital stay (2 to 3 days) | Requires no hospital stay |
Recovery can take longer (5-6 weeks) | Shorter recovery period (2-3 weeks) |
Though rare, in some cases hiatal hernias can get strangulated. Here the protruding portion of the stomach can get obstructed, and the blood flow to it is cut off. This can lead to tissue death, increasing the chances of infection. This can be a life-threatening situation and will require immediate medical attention.
Hiatal hernias that are asymptomatic will not require any form of treatment. Severe cases will require a combination of lifestyle changes, medications, and surgery. The treatment plan will differ from person to person. After surgery, most patients no longer require long-term treatment with prescription or over-the-counter antacid medications. However, it is important that you lead a healthy lifestyle where you eat healthily and stay active in order to prevent the recurrence of the hernia.
Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!
The cost of hiatal hernia treatment in Indore can range between ₹70000 to ₹120000. However, the cost of hiatal hernia treatment can vary depending on several factors such as the surgeon's experience and expertise, the complexity of the procedure, the type of anesthesia used, the facility fees, any additional tests or medications required, and insurance coverage. To know more, please contact a Medfin expert.
A hiatal hernia occurs when a part of the stomach pushes the diaphragm (a sheet-like respiratory muscle in the chest area).
Several factors can promote the formation of a hiatal hernia like injury or strain in the abdominal area due to chronic coughing, constipation, and other underlying conditions. People who are obese, smokers and older are more susceptible to develop hiatal hernias.
Symptoms related to it such as acid reflux can be managed through medications like antacids. If the symptoms do not subside or if they aggravate, surgery (open surgery and laparoscopy) may be advised by the doctor.
Hiatal hernia symptoms at times include acid reflux, which may be confused to those that occur during a heart attack. Hence one must visit a doctor immediately to avoid misdiagnosis of the condition.
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When an organ passes into an opening in the muscle or tissue that keeps it in place, a hernia occurs. In the abdominal wall, for instance, the intestines can split through a weakened area. Most hernias occur between the shoulders and hips in the belly, but they may also develop in the regions of the upper thigh and groin. Most hernias are not life-threatening right away, but they do not go away on their own.
Often to avoid serious complications shortly, they may require surgery. Many types of hernias can be caused such as inguinal hernia, femoral hernia, hiatal hernia, spigelian hernia, epigastric hernia, diaphragmatic hernia, incisional hernia, and umbilical hernia. The hernia is mostly free from pain and normally harmless. But this is not the case every time.
There may be times when hernia can cause pain and discomfort. Hernias are very easy to diagnose as it can be identified by just the bulge. Chiropractors and Osteopaths are consulted for hernias as they are the ones responsible for treating the discomfort and pain caused due to hernia through changes in diet or lifestyle and surgery or medications, respectively.
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Dr. Jayasimha Nagella
There are many causes of hiatal hernia. Out of all, the most common and known cause of hiatal hernia is applying pressure on your abdomen. The pressure can be from anything like lifting a heavy object or simply just lying down on your stomach with your stomach full.
Lying on your stomach may increase the risk of refluxing the stuff from your stomach to your oesophagus thus, naming this condition as hiatal hernia. There are pretty much high chances of causing hiatal hernia if you are lying on your stomach, but it also does depend upon various factors such as: Pregnant women lying on your stomach have high chances of applying pressure to the diaphragm.
The people who are obese and tend to lay down more on stomach have higher chances of causing hiatal hernia. The people who always tend to lay on their stomach particularly when their stomach is full are more likely to suffer from hiatal hernia. Thus, it is not always true that lying on the stomach can lead to causing hiatal hernia but yes, it can be a possibility when there is a lot of intolerable pressure applied on your diaphragm resulting in discomfort and pain.
Causing hiatal hernia is dependent on various other factors which are not mentioned above. Hence, if you are pregnant or are overweight and lying on your stomach, there is a very high possibility of you developing a hiatal hernia over time.
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Dr. Jayasimha Nagella
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