Dr. Lakshmi Murthy

Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small Hiatal hernia doesn't cause problems and you may never know you have a Hiatal hernia unless your doctor discovers it when checking for another condition.

But a large Hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large Hiatal hernia sometimes requires surgery.

Causes

Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughing, vomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting Hiatal hernia is more.

The two common types of Hiatal hernia are:

1. Sliding Hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of Hiatal hernia is less intense and has no symptoms.
2. Fixed Hiatal hernia or Paraoesophageal Hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.

Symptoms

Usually, no symptoms are experienced during Hiatal Hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:

1. Heartburns which become worse when a person lies down
2. Chest pain, better called epigastric pain
3. Problem in swallowing food
4. Belching

Tests for Diagnosis

Several tests can be carried out for the diagnosis of Hiatal hernia. They include:

1. Barium X-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, Hiatal hernia is signified.
2. Endoscopy is another test for detection of Hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.

Treatment

Medicines, which are used to cure a Hiatal hernia may include antacids for neutralizing stomach acid, H2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of Hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:

1. Exercise regularly and maintain a healthy weight
2. Avoid lifting heavy objects and ask for help
3. Avoid any kind of strain on the abdominal muscles

Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of Hiatal hernia.