hiatal hernia

A hiatus hernia is a condition where part of the stomach pushes up into the chest through an opening in the diaphragm, which is the muscle tissue that separates the chest from the abdomen. This opening is called the hiatus, hence the name hiatus hernia.

There are two main types of hiatus hernias: sliding hiatus hernia and paraesophageal hiatus hernia.

A sliding hiatus hernia is the most common type, where the part of the stomach and the section of the esophagus that joins the stomach slide up into the chest.

Paraesophageal hiatus hernia, while less common, is more cause for concern. The esophagus and stomach stay in their normal locations, but part of the stomach squeezes through the hiatus, landing it next to the esophagus. The danger is that the stomach can become “strangled,” or its blood supply can be shut off.

Hiatus hernia

Common symptoms of a hiatus hernia include heartburn, difficulty swallowing, and chest pain. However, many people with a hiatus hernia don’t have any symptoms. In most cases, treatment involves medication to manage symptoms and lifestyle changes to help reduce the frequency of acid reflux. In severe cases, surgery may be required.

Causes of Hiatus hernia

A hiatus hernia, also known as hiatal hernia, is a condition where part of your stomach pushes upward through your diaphragm. The diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. In a hiatus hernia, the stomach bulges up through that opening into your chest.

The exact cause of many hiatus hernias isn’t known. In some people, the diaphragm may have a natural weakness; in others, there might be a lot of pressure on the abdominal cavity. The most common known causes include:

1. Ageing: As we grow older, changes can cause the hiatus to enlarge and thus could enable part of the stomach to herniate through the diaphragm.

2. Weight: Excessive weight can put additional pressure on the abdomen of a person, pushing stomach contents up into the chest cavity.

3. Injuries or Trauma: An injury to the area could potentially weaken the opening, allowing a hernia to form.

4. Persistent and heavy coughing: This can increase the pressure in the abdominal cavity, pushing part of the stomach through the hiatus.

5. Excessive straining during bowel movements or urination: Constant, heavy pressure can weaken the muscles over time, leading to a hernia.

6. Pregnancy and delivery: Pressure increases on the woman’s abdomen during these times which can cause this issue.

7. Certain surgeries or procedures in the abdomen or chest: Surgery can sometimes damage or weaken the areas around the diaphragm, making it easier for a hiatus hernia to form.

8. Genetic or congenital factors: Some people may be born with an abnormally large hiatus.

Remember, it’s possible to have a hiatus hernia without knowing, as they often don’t cause problems and you may not have any symptoms. However, if you experience persistent heartburn, acid reflux or other gastrointestinal problems, visit your doctor who can diagnose and recommend effective treatments.

Risk Factors of Hiatus hernia

Hiatus hernia is a condition in which a part of your stomach pushes upward into your chest. It occurs when the opening in the diaphragm, through which the esophagus passes, weakens and enlarges. Risk factors associated with hiatus (hiatal) hernia include:

1. Age: A hiatal hernia can happen at any age but it’s primarily common in people who are above the age of 50.

2. Obesity: Being overweight can put extra pressure on your abdomen, increasing your risk of a hiatal hernia.

3. Smoking: The habit of smoking can weaken your muscles, including the diaphragm, thus increasing risk of developing a hernia.

4. Genetics: It’s noticed that some people have a naturally larger hiatal opening. Others are born with an abnormally large hiatus.

5. Constant heavy lifting or coughing: Constant strain or pressure on your stomach and esophagus can cause hiatus hernia.

6. Persistent or severe vomiting: This can lead to increased pressure in the abdomen, increasing your risk.

7. Injuries or surgery: Any surgery or injury to your chest or abdomen can increase the risk.

8. Previous hernia: If you’ve had one hiatus hernia, there is a chance you may have another.

Remember, having a risk factor does not mean you will develop a disease, it merely increases the likelihood of developing it. Regular check-ups, a balanced diet, maintaining a healthy weight, and good lifestyle choices can help in preventing such conditions.

Signs and Symptoms of Hiatus hernia

A hiatus hernia, also known as a hiatal hernia, is a condition where part of your stomach pushes up through your diaphragm into your chest. Here are some of the signs and symptoms:

1. Heartburn: This is the most common sign and occurs due to stomach acid coming back up the esophagus, causing a burning sensation. Heartburn can worsen after meals or when you’re lying down.

2. Regurgitation: You might experience regurgitation of food or sour liquid into the mouth, especially when bending over or lying down.

3. Difficulty swallowing: Some people may experience a sensation of food getting stuck in their middle chest or throat, known as dysphagia.

4. Chest or abdominal pain: Pain can occur in the chest or upper abdomen, typically after eating.

5. Shortness of breath: In severe cases, a hiatal hernia might cause difficulty breathing.

6. Feeling overly full soon after meals: Some individuals with a hiatal hernia might feel overly full soon after eating.

7. Unexplained weight loss: While this is less common, some people might experience unexplained weight loss.

8. Vomiting blood or passing black stools: These are signs of gastrointestinal bleeding, which require immediate medical attention.

It’s worth noting that a hiatal hernia can be present without causing any symptoms. In fact, many people discover they have a hiatal hernia when they get a chest X-ray or endoscopy for other reasons.

Diagnosis Hiatus hernia

A Hiatus hernia is a condition in which part of the stomach pushes up through the diaphragm muscle. The diaphragm, which is a large muscle that helps with breathing, has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach.

In a Hiatus hernia, the stomach bulges up into your chest through that opening. This can lead to Gastroesophageal Reflux Disease (GERD), where the stomach acid is regurgitated back into the esophagus, causing heartburn and acid reflux.

There are two main types of Hiatus hernias: sliding and paraesophageal. Sliding hernia is when part of your stomach and the gastroesophageal junction slip up into your chest. Paraesophageal hernia is less common but is more cause for concern. It happens when part of your stomach pushes through the diaphragm and stays there.

Common symptoms of Hiatus hernia include heartburn, belching, difficulty swallowing, chest or abdominal pain, feeling especially full after meals, vomiting blood or having black stools (signs of gastrointestinal bleeding).

It’s most common in people over 50 years old. Obesity and smoking are known risk factors. For most small Hiatus hernias, treatment is typically only necessary when it’s causing noticeable symptoms. In critical conditions, surgery may be recommended to correct the hernia.

Treatment of Hiatus hernia

Treatment of a hiatus hernia depends on the patient’s condition, the severity of the symptoms, and the size and type of the hernia.

1. Lifestyle Changes: For minor or asymptomatic hiatus hernias, lifestyle changes might be recommended. These could include eating smaller, more frequent meals, avoiding late-night meals or meals two to three hours before bedtime, reducing the intake of fatty foods, caffeine, chocolate, acidic foods that may increase stomach acid production, and elevate the head of the bed while sleeping to prevent acid reflux. Quitting smoking, losing weight (if overweight), and avoiding stress can also help.

2. Medications: Over-the-counter antacids, H-2-receptor blockers, and proton pump inhibitors may be used to alleviate symptoms by reducing stomach acid, thus helping to relieve heartburn and reflux. These medications can typically lessen or alleviate symptoms.

3. Surgery: Surgical intervention is considered if the hernia is large, or if symptoms persist despite medication and lifestyle changes. Laparoscopic surgery is commonly performed for a hiatal hernia. Through small incisions in the abdomen, the stomach is pulled down into the abdomen, the hiatus is tightened, and sometimes a supportive prosthetic mesh is implanted. Another common surgical procedure is fundoplication, wherein the upper part of the stomach is wrapped around the lower part of the esophagus to reinforce the closing function of the lower esophagus.

Note: All treatments should be under the guidance of a doctor. It’s important to discuss all possible treatment options with the healthcare provider, considering potential benefits and risks.

Also, Mayo Clinic and other trustworthy medical sites offer more detailed and easy-to-understand info about this topic for everyone to educate themselves.

Medications commonly used for Hiatus hernia

Hiatal hernia refers to a condition where part of the stomach bulges up into the chest through an opening in the diaphragm, called the hiatus. The medication used in the treatment of hiatal hernia primarily aims to reduce stomach acid, healing the esophagus, and relieve symptoms like heartburn and indigestion. Here are some commonly used drugs:

1. Antacids: These over-the-counter drugs like Tums, Rolaids, and Maalox neutralize stomach acid and can provide quick relief.

2. H2 blockers: These medications reduce acid production. They include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac), with some of them available over-the-counter without a need for prescription.

3. Proton pump inhibitors (PPIs): These drugs also block the production of acid. They are usually used if the conditions aren’t improving with the use of antacids or H2 blockers. Examples include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), and pantoprazole (Protonix).

4. Prokinetic agents: These might be used in combination with other medications if a hiatal hernia is causing severe symptoms. They help your stomach empty faster, which can prevent reflux of stomach acid. Examples are metoclopramide (Reglan) and bethanechol (Urecholine).

It is advisable to take these medications under the advice of a healthcare professional, and the dosage should be strictly followed as prescribed. These medications might have side effects and should be taken cautiously if you have other medical conditions.

Prevention of Hiatus hernia

Prevention of Hiatus Hernia includes several lifestyle changes and tips:

1. Maintain a healthy weight: Excess weight can put pressure on your abdomen, increasing the risk of a hiatus hernia. Striving to stay in a healthy weight range can help to reduce this risk.

2. Avoid heavy lifting: Heavy lifting or straining during bowel movements can also increase abdominal pressure, contributing to the development of a hiatus hernia.

3. Eat smaller meals: Large meals can put pressure on the stomach and potentially worsen the symptoms of a hiatus hernia. Eating smaller, more frequent meals throughout the day can help to alleviate this.

Hiatus hernia

4. Avoid lying down or going to bed immediately after meals: To minimize the risk of stomach acid backing up into the esophagus (a condition which can be aggravated by a hiatus hernia), try to wait several hours after eating before lying down or going to bed.

5. Limit foods that trigger heartburn: Certain foods and drinks can increase your risk of heartburn, which can put extra pressure on the hiatus and potentially lead to a hernia. These include alcohol, chocolate, spicy foods, fatty foods, citrus fruits, and caffeinated beverages.

6. Stop smoking: Smoking can damage your lower esophageal sphincter, making it less effective at preventing acid from refluxing from your stomach into your esophagus.

Lastly, it’s crucial to have regular check-ups with your healthcare provider. If you experience symptoms such as heartburn, abdominal pain, difficulty swallowing, or unintentional weight loss, seek medical attention. Early diagnosis and treatment can help prevent complications of a hiatus hernia.

FAQ’s about Hiatus hernia

Sure, here are some Frequently Asked Questions (FAQs) about Hiatus Hernia:

1. What is a Hiatus Hernia?
A hiatus hernia is a condition in which part of the stomach pushes up into the chest through an opening in the diaphragm (a thin sheath of muscle separating the chest from the abdomen).

2. What are the symptoms of a Hiatus Hernia?
Symptoms can often be non-existent (especially in sliding hiatus hernias). When symptoms do occur, they may include heartburn, acid reflux, chest pain, difficulty swallowing, belching, feeling full quickly, and shortness of breath.

3. What causes a Hiatus Hernia?
The exact cause is unknown, but it may be related to weakness in the diaphragm due to aging or direct trauma. Conditions that increase the pressure in the abdomen like obesity, pregnancy, and constipation can also contribute to the formation of a hiatus hernia.

4. How is a Hiatus Hernia diagnosed?
A doctor usually diagnoses a hiatus hernia during tests for other conditions. Such tests may include an endoscopy (where a thin, lighted tube is used to examine your esophagus and stomach), a barium X-ray, or a manometry test to measure the pressure in the esophagus.

5. How is a Hiatus Hernia treated?
Treatment for a hiatus hernia depends on the severity of symptoms. Mild symptoms can often be managed with diet changes, lifestyle modifications, like losing weight and quitting smoking, and medications to reduce acid. If the hiatus hernia is large, or if symptoms persist despite self-care measures, your doctor may suggest surgery.

6. Is surgery always necessary for a Hiatus Hernia?
No, surgery is not always necessary for a hiatus hernia. If the hernia is not causing discomfort or complications and is small, your doctor could recommend monitoring it but not treating it.

7. Can a Hiatus Hernia heal itself?
No, a hernia won’t heal by itself. They may not cause problems if they are small and don’t cause any symptoms, but they usually don’t go away without treatment.

8. What kind of diet should be followed by someone with a Hiatus Hernia?
A diet low in acidic and fatty foods can help manage hiatus hernia symptoms. Spicy foods, peppermint, citrus, and tomato-based foods may exacerbate symptoms. Eating small frequent meals instead of large meals can also take pressure off the stomach.

9. Can a Hiatus Hernia cause serious complications?
A large, untreated hiatus hernia can potentially lead to complications, like a strangulated hernia (where blood supply to the herniated tissue is cut off) or Gastro-Esophageal Reflux Disease (GERD), which can potentially cause ulcers, esophagitis, and Barrett’s esophagus – a pre-malignant condition.

10. Can a Hiatus Hernia recur after treatment?
Yes, a hiatus hernia can recur after treatment, particularly after surgical repair. This is why it’s important to follow doctor’s orders regarding post-surgery care, diet, and lifestyle changes.

Please remember this information is general in context, it’s always important to consult directly with your healthcare provider to understand your specific circumstance and treatment choices.

Useful links

A hiatus hernia (also known as hiatal hernia) occurs when part of your stomach pushes upward through your diaphragm. The diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.

Here are some useful links from reputable journals for more information on hiatus hernia:

  1. https://pubmed.ncbi.nlm.nih.gov/28730506/
  2. https://pubmed.ncbi.nlm.nih.gov/30596364/

Please note that these articles are quite technical, so if you need help understanding certain medical terminologies, don’t hesitate to ask.

Complications of Hiatus hernia

A hiatus hernia is a condition in which part of the stomach pushes up into the chest through an opening in the diaphragm known as the hiatus. While many people with hiatus hernia may have no symptoms, some people may experience complications which include:

1. Gastroesophageal Reflux Disease (GERD): This is the most common complication and it occurs when stomach acid comes back up into the food pipe (esophagus), leading to heartburn, chest pain, and possibly damage to the lining of the esophagus.

2. Difficulty Swallowing: This can occur as a result of inflammation and scarring in the esophagus which narrows it.

3. Chest pain: This can occur when a large part of the stomach pushes through the hiatus causing chest pain similar to heart disease.

4. Anemia: If there is severe damage to the esophagus due to acid reflux it can lead to bleeding which can result in anemia if left untreated.

5. Strangulation: In rare cases, part of the stomach can become stuck in the chest cavity and be strangled, obstructing blood flow. This is a medical emergency and requires immediate attention.

6. Barrett’s esophagus: Chronic acid reflux can lead to changes in the cells lining the esophagus. This condition, known as Barrett’s esophagus, can increase the risk of esophageal cancer.

Remember, complications from a hiatus hernia can be serious. Therefore, it’s important to seek medical attention if you have symptoms of a hiatus hernia or if your symptoms worsen. Your healthcare provider can then determine the best course of treatment for your specific condition.

Home remedies of Hiatus hernia

Hiatus hernia is the condition in which a part of your stomach pushes up into your diaphragm, through an opening called the hiatus. While severe cases may require medical or surgical intervention, milder cases of a hiatus hernia can be managed at home with the following natural remedies:

1. Diet Modification: It’s recommended to eat smaller meals instead of heavy ones to avoid pressure on the stomach. Stay away from spicy food, carbonated beverages, citrus fruits, and other foods that can cause heartburn.

2. Weight Management: Maintaining a healthy weight can greatly reduce the symptoms of a hiatus hernia by decreasing abdominal pressure.

3. Avoid Constrictive Clothing: Clothes that are too tight can squeeze the stomach and force food up into the esophagus, worsening the symptoms of a hernia.

4. Elevation: After eating, try not to lie down right away. Raising the head of your bed can also lessen reflux symptoms at night.

5. Quit Smoking and Reduce Alcohol: Both smoking and drinking can aggravate the symptoms of a hiatus hernia.

6. Regular Exercise: Regular exercise, particularly movements that strengthen the abdomen, could help alleviate the symptoms.

7. Herbal Remedies: Herbs such as chamomile, licorice, or marshmallow might help ease the symptoms of GERD, which is often associated with hiatus hernia. However, you should consult a doctor or a herbalist before using these treatments.

8. Mindful Eating: Not only should you eat slower, but also pay attention to chewing your food thoroughly to reduce digestion burden.

9. Stay Hydrated: Water can help in neutralizing the stomach acid and thus relieving the symptoms to some extent.

Please ensure any new or ongoing symptoms are discussed with your healthcare provider. While these home remedies may alleviate symptoms, they should not replace a comprehensive treatment plan provided by a doctor.