/ HIATAL HERNIA

HIATAL HERNIA

Hiatal Hernia is a condition in which the top part of the stomach protrudes through the diaphragm & into the chest region. Diaphragm is a muscle that divides the lungs from the abdomen and helps in breathing.

In most cases, Hiatal Hernias are small and may not cause any problems. However, if the hernia is a larger, it could lead to the entire stomach & other organs sliding up into the chest cavity.

Treatment for Hiatal Hernia can involve medications, surgical interventions & lifestyle changes.

What are the types?

Hiatus Hernia is of two main types. These are Sliding Hiatus Hernia & Rolling Hiatus Hernia.

• Sliding Hiatus Hernia: This is when a part of the stomach & gastro-esophageal junction slide up into the chest cavity. It is the common type of Hiatal Hernia & is especially seen in women above 50 years of age, people who are overweight & long term smokers.
• Rolling Hiatus Hernia: This condition, also known as para-oesophageal hiatus hernia, causes a part of the stomach to protrude into the chest cavity. In this case, the gastro-esphageal junction remains where it should be.

This condition, also known as para-oesophageal hiatus hernia, causes a part of the stomach to protrude into the chest cavity. In this case, the gastro-esphageal junction remains where it should be.

Of the two types of Hiatal Hernia, Rolling Hiatal Hernia is more uncommon but it tends to cause more severe symptoms.

What are its Symptoms?

Hiatal Hernias generally do not cause any signs or symptoms. However following are some of the symptoms of Sliding Hiatus Hernia

Some of the diagnostic tests recommended for Achalasia are:

• Burping
• Heartburn
• Nausea
• Vomiting
• Regurgitation into Oesophagus

Rolling Hiatus Hernia can cause more severe symptoms, which include:

• Abdominal or chest pain
• Abdominal bleeding
• Trouble swallowing
• Shortness of breath or trouble breathing
• Acid reflux
• Regurgitation

How is it Diagnosed?

Your gastroenterologist can suspect hiatal hernia based on the symptoms & risk factors. To confirm the diagnosis, the following tests may be recommended:

• Chest X Ray - A simple chest X ray can reveal a large hiatal hernia
• Barium Swallow is a diagnostic test in which the patient is asked to swallow a small amount of liquid barium that coats the oesophagus, stomach & upper part of the small intestine.
• CT Scan: A patient is asked to swallow a dye or have it injected into the vein to ensure clear images of the organs
• Upper Endoscopy: It is a procedure in which an endoscope is inserted into the oesophagus through the patient’s mouth. It allows the doctor to see the upper digestive tract.
• Manometry - This test helps diagnose muscle movements inside the oesophagus.

Get the Best Treatment for Hernia

In most cases, Hiatal Hernia may not require any treatment at all. If it is associated with symptoms such as heart burn, certain lifestyle changes such as the following can help.

Lifestyle Changes:

• Weight loss
• Avoid tight clothing or anything else that causes pressure on the stomach
• Aim to quit tobacco, if you are a smoker.
• Cut down on alcohol consumption
• Avoid eating dinner too close to bedtime
• Have frequent small meals

Medications

If lifestyle modifications are not helpful enough, your gastroenterologist may recommend antacids or proton pump inhibitors. Consult your doctor to know which medications can help ease your symptoms of indigestion or heart burn.

Surgical Intervention

If other treatment methods prove to be ineffective, your doctor may advise you to go ahead with a surgery. There are three ways it can be done.

• Open SurgeryThis is a more traditional form of surgery in which a large incision is made in the abdomen and the stomach is pulled back into place & is manually wrapped around the lower portion of the oesophagus.
• Laparoscopic Surgery With a laparoscopic surgery, the stomach is moved back into abdominal cavity with just 3 to 5 small incisions.
• Endoluminal Fundoplication This is the latest procedure in treating Hiatal Hernia & is the least invasive method. The Doctor places small clips at the place where stomach meets the esophagus and this is done with the help of an endoscope that is inserted through the mouth & into the esophagus.

Dr Kiran Peddi is the Best Gastroenterologist in Hyderabad and has a proven expertise in successfully treating all Gastro related Disorders. Dr Kiran Peddi is has over 15 years of experience in treatment of hiatal hernia.