Dr. Naresh Pamnani

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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

An eardrum rupture or perforation is a little gap or tear in your eardrum and the tympanic membrane. The tympanic membrane is a thin tissue that partitions the canal of the middle ear and outer ear. This layer vibrates when sound waves enter your ear. The vibration proceeds through the bones of the center ear. Since this vibration allows you to listen, your hearing can be affected if your eardrum is harmed. A ruptured eardrum is additionally called a perforated eardrum. Permanent hearing loss could be an end result in some cases.

A ruptured eardrum, similar to thunder; can happen all of a sudden. You may feel a sharp pain in your ear, or an ear infection that you've had for some time all of a sudden leaves. In some cases, the person may not feel any signs of the rupture.

Some of the causes for such a perforation are:

1. Infection: Ear infections are a major reason for eardrum rupture, particularly in children. Liquids tend to deposit behind the eardrum in such cases.
2. Exercises: Exercising can bring about pressure changes in the ear and lead to a punctured eardrum. This is known as barotrauma, and takes place when the pressure outside the ear is not the same as the pressure inside the ear. Activities that can bring about barotrauma include scuba diving or flying on plane.
3. Other activities: Wounds can likewise burst your eardrum. Any injury to the ear or side of the head can bring about a crack.

Diagnosis: Your specialist can use a few approaches to find out whether you have a ruptured eardrum:

1. A liquid test in which your specialist tests liquids that might spill from your ear from infection.
2. An otoscope exam in which a specific gadget with a light is used to investigate your ear channel
3. An audiology exam, in which your specialist tests your listening to range and eardrum limit
4. Tympanometry, in which your specialist uses a tympanometer to test the pressure changes in your ear.

Treatment: The treatments are as follows:

• Patching: In the event that your ear does not recuperate by itself, your specialist may fix the eardrum. Fixing includes setting a sedated paper patch over the tear in the film.
• Antibiotics: Anti-toxins can clear up contaminations that may have prompted your eardrum break. They additionally shield you from growing new diseases from the aperture. Your specialist may endorse oral antibiotics or eardrops.
• Surgery: In uncommon cases, surgery might be required to fix the gap in the eardrum. A surgical repair of a punctured eardrum is called tympanoplasty.

A cracked eardrum generally recuperates without any invasive measures. Many patients with cracked eardrums encounter just transitory listening problems.

In case you have a concern or query you can always consult an expert & get answers to your questions!