A hernia is when an internal body part pushes into a different part than where it normally belongs. The hiatus is the opening in the diaphragm, the large muscle that lies between your abdomen and chest. So, a hiatus hernia (more commonly known as hiatal hernia) occurs when part of your stomach moves up into your diaphragm to the chest region. For you to breath comfortably, your body uses the diaphragm.
A hiatal hernia mostly contains a variable portion of the stomach. It may also contain a transverse colon, omentum, small bowel, spleen or some combination of all the organs. A sac of peritoneum contains all the herniated contents.
Ideally, your stomach should be below the diaphragm. However, if you are suffering from hiatus hernia, then a portion of the stomach pushes up through an opening known as hiatus. People who are over 50 years are more venerable to this condition and it affects up to 60 percent of people by the time they reach 60 years old. People who are overweight and women are also at risk of having this condition as well. This is according to the Esophageal Cancer Awareness Association.
The hiatal hernia is in two types known as sliding and paraesophageal.
Sliding hiatal hernia
The sliding hiatus hernia is the most common type and it occurs when the stomach and the section of the esophagus slides up into the chest through the hiatus. It tends to be small and may not require any form of treatment. This is because they don’t cause any symptoms and that means your life continues as usual.
However, if you are experiencing the symptoms of reflux, your doctor gives you a portion of a pump inhibitor to reduce acid production. You should also eliminate or better still limit the intake of beverages that contain acids such as orange juice, alcohol, coffee and certain foods such as fatty, acidic and spiced food.
Paraesophageal hiatal hernia
It is also known as rolling hiatus hernia. Although paraesophageal hernia is not very common, it may be a cause for alarm. This is because when the esophagus, a hollow tube leading to the throat, and the stomach stay in their normal locations, a part of the stomach squeezes through the hiatus and it ends up landing next to esophagus. You can stay with this type of hernia without even having any symptoms but the problem comes in if the blood flowing into your stomach is blocked. That is quite serious and can warrant a medical emergency.
Symptoms of hiatal hernia
Mostly, there are people with hiatal hernia and they don’t know about it because it doesn’t cause them any problem or discomfort. In fact, your hiatus hernia may be discovered by chance when you are having a test for something else. However, if you are the unlucky one, then you may be affected. You should plan for a doctor’s visit if you experience a painful burning feeling in your chest especially after having your meals. This feeling is also known as heartburn. Other factors to warrant a doctor’s visit include bringing up small amounts of food or fluids that are bitter, having a bad breath, bloated or burp feeling, feeling sickly, mouth filling with saliva, belching often, a nighttime cough or having pains and difficulties when swallowing.
Don’t hesitate to seek medical advice if the symptoms persist even after three weeks if the symptoms of hiatal hernia getting worse or the over-the-counter drugs are not helping you at all. Moreover, there are symptoms that need urgent doctor’s appointment especially when you are already having indigestion or acid reflux and you are unable to swallow at ease, you are losing weight for no apparent reason, if you are experiencing pains in your upper tummy or you are feeling sickly and even vomiting often.
Remember if you are having heartburns frequently, you may experience chest pain which can be confused with the pain of the heart attack and maybe it’s hiatal hernia pain. You can also be having heart problems or peptic ulcers. To clarify this, it is advisable to undergo a doctor’s check for proper diagnosis.
Hiatal hernia causes
Mostly, the causes of hiatal hernia are not known although it may be caused by stretching of the bands of tissue. These bands are attached between the esophagus and diaphragm in the hiatus. There are also other diaphragmatic types of a hernia that are as a result of a birth defect. To some people, it can be caused by an injury or any other damage that is capable of weakening the muscle tissue making it possible for your stomach to push through the diaphragm.
Coughing, vomiting, straining during bowel movements and lifting heavy objects are some of the reasons that can repeatedly put a lot of pressure on the muscles around the stomach and increase the risk of getting hiatus hernia. If you are among those people who were born with an abnormally large hiatus, then this can make it easy for the stomach to move through the diaphragm. Factors such as obesity, aging, pregnancy and smoking can increase your risk of having a hiatus hernia.
Hiatal hernia diagnosis
There are several tests that can be used to diagnose the hiatus hernia condition and they include:
a) Barium x-ray
Your doctor will recommend you have a drink containing barium before taking an x-ray so as to provide a clear silhouette of the upper digestive tract. The image will allow your doctor to see the exact location of your stomach. If the doctor’s results say that it is protruding through your diaphragm, then that means you are having a hiatus hernia.
An endoscopy can also be performed by your doctor to see if you are suffering from hiatal hernia. This test is done by sliding a thin tube in your throat and passes it down to the esophagus and the stomach. Your doctor will be able to tell what is going on down there and if you are suffering from hiatal hernia if the stomach is pushing through the diaphragm. Also, any obstruction whatsoever will clearly be visible.
Hiatal hernia treatment
Hiatal hernia is mostly not a cause for concern especially if there are no symptoms experienced. In other words, if you are having a hiatus hernia and you are not aware it is because you are not experiencing any symptoms at all and the condition doesn’t require any form of treatment at all.
When a part of the stomach squeezes through the hiatus, a condition known as pares hernia, then this can cause problems and doctors may at times recommend hiatal hernia surgery. Mostly, a surgery is recommended if the drugs don’t work. When it is done, the aim is to rebuild or repair weak esophageal muscles, put back the stomach in its rightful place and reduce the size of the hiatus.
You might also be given advice to follow a hiatal hernia diet changing your feeding program from three large meals to small frequent meals throughout the day. If you are a smoker, giving up is the only option you are left with because tobacco smoke can irritate your digestive system. If this happens, then the symptoms will only become worse and for sure this is not what you want.
You should seek medical advice if the medicines you purchase from the pharmacy are not helpful with the hiatal hernia pain relief. This is because your doctor is in a good position to prescribe stronger medicines that can relieve you from the pain and discomfort caused by a hiatus hernia.
Indigestion medicines are normally available and they are good at easing the symptoms of heartburn. You can get them in your nearby pharmacy but remember to ask your pharmacist for advice. It would also be advisable to consult your doctor so that he/she can tell you the best drug that will work for you depending with your symptoms and let you know when to take your medicines in terms of if it is for all times or only when you have the hiatus hernia symptoms.
If the stronger medication is still not working, then your doctor may send you for further tests to find out what exactly is ailing you and its cause so that he/she will know if you need a hiatus hernia repair surgery or should be done. A recommendation of surgery mostly comes in when you don’t respond to other drugs and you keep on having quite bad symptoms.
The surgery is performed by either making a standard incision in the chest or the abdomen. They can also use laparoscopic surgery and this is good because it shortens the hiatal hernia surgery recovery time. Although hernia can recur after surgery, you can reduce that risk by having a healthy weight, avoid lifting heavy objects and avoid straining on your abdominal muscles.
Your doctor may also prescribe over the counter antacids for neutralizing the acid in the stomach. Alginates are also prescribed because they are good since they make a barrier between the food and the stomach by forming a floating raft that floats on top of your food. This will give enough time for the esophagus to heal.
When is hiatus hernia surgery recommended?
Surgery may be necessary if the hiatus hernia is in danger of becoming constricted and in return cut off the supply of the blood. Surgery may come in to assist in putting back the hernia to where it is rightfully supposed to be reducing it. This minimally invasive procedure is referred to as laparoscopic. To perform this type of surgery, a few small incisions are made in the abdomen and using a laparoscopic the surgeon is able to see inside the abdomen.
The incisions made in the abdomen are used to insert the surgical instruments and the surgeon is guided by the laparoscope which transmits the picture of the internal organs to a monitor and the surgery is performed. Laparoscopic surgery is advantageous because it has less risk of infection, less pain, less scarring and rapid recovery to the patients.
The patient is not necessarily restricted to a certain diet. Within a week, most patients are able to go back to their daily activities without much struggle. It is also important to know that complete recovery will take about two to three weeks and hard labor and lifting of heavy objects should be avoided for at least three months after the surgery. Even after a successful surgery, the hernia may return and so a surgery is not a guarantee to full recovery whatsoever.
Changes you can have to avoid or manage hiatus hernias
Making lifestyle changes especially your diet can reduce any symptoms of hiatus hernias. You can also consider having your meals in small bits throughout the day instead of the common three large meals during the day. Another thing to avoid is having your meals or snacks some hours before you go to bed. Also avoid foods that are known to increase heartburn such as spicy foods, chocolate, caffeine, onions, citrus fruits, alcohol and any food made with tomatoes.
Other ways of reducing hiatus hernia symptoms are to stop smoking, ensuring you raise your bed at least 6 inches and avoid bending over or lying down after having your meals. It may be hard to avoid hiatus hernia entirely and so by getting ways to manage is equally helpful. Among the things you can do include maintaining a healthy weight, avoid straining during bowel, seeking help while lifting heavy objects and avoid tight belts and certain abdominal exercises.
Complications of hiatus hernia
While there are some people who have hiatus hernia and do not experience any problem, there are the less fortunate ones and they have to maintain a controlled lifestyle and medication just to keep the condition at bay.
When your stomach produces acid and it ends up in your esophagus, you are likely to get a number of complications the first one being inflammation of your esophagus. You can end up getting ulcers that acid from your stomach may damage the esophagus. Anemia is another cause and this is brought about by bleeding from ulcers. If you have repeated inflammation, your esophagus will be scarred and in return, it will end up being narrow and thus, make the food to be stuck or come back up.
This article was written by Paul Verbiton, blogger at Verbiton.com and content writer by profession. Leave him a comment below if you liked his article or visit his blog and contact him if you want to hire him for content writing services.