A hiatal hernia occurs when a portion of the stomach prolapses through the diaphragmatic esophageal hiatus. Most Hiatal hernias are asymptomatic and are discovered incidentally, but rarely, a life-threatening complication may present acutely.
What Is a Hiatal Hernia?
A hiatal hernia is when your stomach bulges up into your chest through an opening in your diaphragm, the muscle that separates the two areas. The opening is called the hiatus, so this condition is also called a hiatus hernia.
There are two main types of Hiatal hernias: sliding and Paraesophageal.
Ordinarily, your esophagus (food pipe) goes through a hiatus and attaches to your stomach. In a sliding hiatal hernia, your stomach and the lower part of your esophagus slide up into your chest through the diaphragm. Most people with Hiatal hernias have this type.
A Paraesophageal hernia is more dangerous. Your esophagus and stomach stay where they should be, but part of your stomach squeezes through the hiatus to sit next to your esophagus. Your stomach can become squeezed and lose its blood supply. And your doctor might call this a strangulated hernia.
What is a Hernia and what is a Hiatus Hernia?
A hernia occurs when part of an organ pushes (protrudes) through a muscular wall that holds it in place. There are different types of hernia. For example, an inguinal hernia is the most common type when part of the lower bowel protrudes through the muscle in the groin.
A hiatus hernia occurs when part of one of the organs in the tummy protrudes through the diaphragm. Most commonly this is a part of the stomach; however, it may be other organs, such as the pancreas, spleen, or the upper gut (small intestine).
Surgery for Hiatus Hernia
Surgery is usually performed laparoscopically. However, open surgery may be required, especially in patients who have had previous upper abdominal surgery (due to adhesions and scar tissue), or a recurrent hiatus hernia after a previous attempt at repair. Emergency procedures can also be performed laparoscopically, but have a much higher risk of needing open surgery, especially if the stomach is damaged due to a severe twist.
The operation involves:
- Carefully removing the sac (the lining) of the hernia. This is important to avoid the risk of the hernia coming back.
- Fully freeing the stomach and any other contents of the hernia so it lies in the abdomen and not in the chest. After this, the lower part of the esophagus (gullet) should lie back in the upper abdomen.
- Repairing the hole in the diaphragm by narrowing it with several stitches or sutures. The sutures are non-absorbable.
- Fundoplication is usually also performed to reduce the risk of reflux and also to suture the stomach to the diaphragm to try to reduce the risk of recurrence.
The most important thing during the early recovery is to ensure no severe retching or vomiting occurs. This is achieved by administering regular anti-sickness medication. Vomiting or retching can put stress on the repair and stress the stitches. This could potentially lead to an early recurrent hernia which would require further surgery.
What Causes Hiatal Hernia?
Suspected causes or contributing factors
- Obesity
- Poor seated posture (such as slouching)
- Frequent coughing
- Straining with constipation
- Frequent bending over or heavy lifting
- Heredity
- Smoking
- Congenital defects
What Are Hiatal Hernia Symptoms and Signs?
Many Hiatal hernias, especially smaller ones, cause no symptoms and require no treatment. right up But if your hiatal hernia is causing the backflow of acid and other stomach contents in your esophagus, you may experience the following symptoms:
- Heartburn
- Acidic or sour taste in your mouth or throat right up
- Regurgitation of foods or beverages into your mouth
- If you have an inguinal hernia, you may feel a lump in the region where the groin and upper thigh meet.
- You feel pain and discomfort that is worse at the end of the day or after standing for long periods.
- Pain while bending, coughing, or lifting objects.
- A feeling of weakness or pressure in the groin.
- Discomfort or pain during urination or bowel movements.
- You may not be able to swallow food comfortably and you may feel a burning sensation in the chest region in the case of a hiatal hernia.
A hiatal hernia can also lead to gastroesophageal reflux disease (GERD), a chronic disease characterized by frequent, sever
Medical Treatment and Surgery for Hiatal Hernia
Medical treatment for hiatal hernia may include prescription-strength antacids such as lansoprazole (Prevacid), omeprazole (Prilosec), or rabeprazole (Aciphex). Surgical treatments rarely are necessary except when an emergency exists, such as a strangulated hiatal hernia or aggressive conservative therapy has failed. Some people don’t respond to home care or medical treatment and seek the advice of a general surgeon or thoracic surgeon about the latest options. Various techniques have been tried to fix the defects of hiatal hernia with some success.
Types of Hiatus Hernia
There are 2 main types of hiatus hernia.
Sliding hiatus hernia- is the most common type, accounting for about 90 percent of cases. It occurs when the junction between the esophagus and the upper part of the stomach protrudes up through the oesophageal opening in the diaphragm into the chest cavity. The herniated portion of the stomach can slide back and forth, into and out of the chest.
Rolling hiatus hernia- (sometimes called a para-oesophageal hiatus hernia) is the other type. In this case, the junction of the esophagus and stomach stays down within the abdomen, and the top part of the stomach (the fundus) bulges up into the chest cavity. This type of hernia normally remains in one place, sitting next to the esophagus, and does not move in or out when you swallow.
How Are Hernias Treated?
Hernias usually require surgery to repair them. Your doctor will recommend the best treatment plan for you and your type of hernia.
How is Hiatal Hernia Diagnosis?
Patients are needed to undergo one of the tests mentioned below to diagnose a hiatal hernia, including:
Barium Swallow: You may be asked to drink a liquid that becomes visible on an X-ray for your doctor to get a proper view of your abdomen and esophagus.
Endoscopy: Your doctor will insert a long, thin tube known as an endoscope down your throat that has a camera on end. The camera captures pictures from inside tour esophagus and abdomen, thereby helping the doctor diagnose the hiatal hernia.
Esophageal Manometry: In esophageal Manometry, the doctor will insert a different kind of tube down your throat to monitor the pressure in your esophagus when you swallow. Any visible changes will confirm the diagnosis.
What Does A Hiatal Hernia Feel Like?
The answer to this can be tricky. It’s not uncommon for Hiatal hernias that are on the small side to never cause any symptoms, which is why a lot of the time patients with minor hernias never even realize that they have one unless their doctor discovers it while looking for something else. Moderate to severe hernias, however, usually cause several uncomfortable symptoms and can be dangerous if left untreated. If you have a larger hernia, you may “feel” the following hiatal hernia symptoms:
- Heartburn
- Shortness of breath
- Dysphagia (difficulty swallowing)
- Regurgitation of food
- Acid reflux
- Chest or abdominal pain
- Vomiting
If you’re experiencing one or several of the symptoms listed above, you should schedule an appointment with your doctor.
Home Remedies For Hernia
1. Maintain a Healthy Weight
Being overweight or obese puts extra pressure on the valves and sphincter that allow the release of stomach acid. In addition, obesity is often associated with low levels of stomach acid. In eight of nine studies included in a large review, as BMI (body mass index, a measure of body fat ) rose, so did GERD symptoms. Try to reach and remain at a healthy weight. Eat an unprocessed diet, get more exercise and manage other unhealthy habits.
2. Quit Smoking
Smoking cigarettes increases inflammation and impairs muscle reflexes that are important for controlling the release of digestive contents. Smoking may also increase the production of stomach acid. Avoid smoking if you are suffering from acid reflux.
3. Aloe Vera Juice
Aloe vera is one of the best natural treatments for digestive problems caused by a hiatal hernia. It soothes the inner lining of the intestines and reduces abdomen pain. It also controls heartburn by reducing inflammation.
- Drink ¼ cup of aloe vera juice about 20 minutes before eating a meal.
Note: Do not use more than 2 tablespoons of aloe vera gel to make the juice. It may cause diarrhea.
4. Ginger
Whether it’s abdominal pain, gastric issues, or hernia, ginger root is the superb cure for such problems. We all know ginger is a rich source of antioxidants and nutrients that help to reduce the pain and inflammation of hernia. Also, it helps to protect your stomach and esophagus from the toxic build of gastric juices. Therefore, if you want the best remedy for treating hernia, then you can choose ginger root for a better cure.
5. Apple Cider Vinegar
Apple cider vinegar is an excellent remedy to reduce symptoms like heartburn and acidity due to a hiatal hernia. Though acidic in nature, apple cider vinegar produces an alkaline effect in the body.
- Add 1 to 2 teaspoons of raw, unfiltered apple cider vinegar to a glass of warm water.
- Sip it slowly before meals.
- Do this whenever you have heartburn or acidity.
6. Cinnamon
This popular spice helps calm and soothe the stomach. It can relieve abdominal pain and bloat, especially after eating a meal. It also works as a natural\ antacid.
- Add ½ teaspoon of cinnamon powder to a cup of hot water.
- Cover and steep for a few minutes.
- Drink this tea while it is still warm, 2 or 3 times a day.
- In addition, include cinnamon in your cooking.
7. Regular Cycling
Cycling exercises are the best for treating problems linked with the abdomen and gastric system. You can lie on a mat, bend your knees in an elevated position, and practice cycling motion to reduce stubborn fat and get rid of toxic gastric problems. This is one of the best ways to treat hernia naturally.
What to Eat When You Have a Hiatal Hernia
Foods to eat
- Leafy green vegetables should be enclosed in a Hiatal herniation diet.
- Non- or low-acidic foods will reduce the likeliness and severity of Hiatal herniation symptoms. The best food choices for people with Hiatal herniations are non-
acidic, maximally processed, and contain dietary fiber.
There are some exceptions for those who have food intolerances. Elimination diets may be helpful for optimum improvement in symptoms.
Safe foods to eat may include:
- leafy greens
- beans and peas
- whole grains
- lean macromolecules, including bean curd and fish
- whole balmy and seeds
- non-citrus fruits and juices
- artichoke and asparagus
- cinnamon
- ginger
- low-fat, non-sugared dairy farm products
- cardamom
- coriander
- apple cider vinegar
- non-caffeinated teas, especially green teas
Foods to avoid
Tomatoes and onions should be avoided as they will aggravate a Hiatal herniation. Avoiding certain foods mightiness help reduce and prevent symptoms of dyspepsia, including pyrosis, bloating, gas, and regurgitation.
It is best for people with a Hiatal herniation to stay away from foods that are acidic, rich, oily, or contain preservatives.
Foods to avoid may include:
- deep-fried or oily foods
- fatty foods
- red meat
- caffeine
- alcohol
- cocoa and chocolate
- tomatoes and tomato sauces
- soft drinks and effervescent drinks
- most types of mint, so much as peppermint and spearmint
- candies
- sugared juices or teas
- high amounts of cookery oils
- garlic, onions, green onions, shallots, scallions, leeks, and chives
- cucumbers
- high-fat dairy farm products
- salty foods
- deli meats
- pre-prepared or fast foods
- bread and cereals
Also read: Mouth Sores: Everything You Need To Know
When to See a Doctor
The vast majority of Hiatal hernias can be easily managed with over-the-counter medications, weight loss, and an adjustment to your diet.1 Hiatal hernia generally does not need to be medically managed unless the symptoms are persistent or worsening.
With that being said, you should see a doctor if your symptoms don’t improve despite conservative management. In some cases, adjusting your prescription drugs and other interventions may be needed.