A hiatal hernia is a condition developed when the upper part of the stomach bulges through an opening in the diaphragm. The diaphragm is a muscle that separates the abdomen and chest. It has a small opening through which the food tube passes and connecting to the stomach. In a hiatal hernia, the stomach pushes up through the opening in the diaphragm and bulges into the chest. The bulging of stomach to the chest can cause food and acid back up into the esophagus causing heartburn.
Symptoms of hiatal hernia
- Backflow of food and liquids into the mouth
- Backflow of stomach acid into the esophagus
- Difficulty swallowing
- Chest or abdominal pain
- Shortness of breath
- Vomiting of blood
- Passing of black stools
A hiatal may be caused by:
- Age-related changes in the wearing the muscles of the diaphragm
- Injury to the area after trauma or surgery
- Birth defects with an unusually large hiatus
- Persistent and intense pressure on the surrounding muscles of the diaphragm
Diagnosing Hiatal Hernia
The doctor performs an endoscopy to diagnose the condition. The procedure involves inserting a thin flexible tube with a camera attached to inside of the esophagus and stomach and check for inflammation. Other test includes x-ray of the upper digestive system and esophageal manometry to measure the rhythmic muscle contractions and coordination and force exerted by the muscles of the esophagus when food is swallowed.
Medications are prescribed to ease the symptoms including recurrent heartburn and acid refluxes and production. Medication along with little lifestyle modification is advised by the doctor and these changes include:
- Consume several smaller meals rather than a few large meals
- Avoid fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine that trigger heartburn
- Avoid lying down right after a meal
- Have the dinner at least two to three hours before bedtime.
- Maintain a healthy weight or reduce the excess weight
- Stop smoking and alcohol consumption
- Elevate the head while lying
- Perform any kind of physical activity or exercises at least 5 days a week
Surgical treatment options include pulling back the bulged abdomen into the stomach and reconstructing an esophageal sphincter. In laparoscopic surgery a laparoscope is used, which is a thin long tube that has a camera attached to its end to view the irregularities inside the abdominal cavity. The surgeon makes a small incision and inserts the laparoscope to investigate the abnormality and later few more small incisions are made to insert the surgical tools and perform repair of the required organs and muscles. The surgeon pulls back the bulged stomach from the diaphragm and closes the incision. If necessary, the surgery is also performed by making a single incision in the chest wall and the procedure is termed as thoracotomy.