Hiatal Hernia

Hernia treatment

Last Updated December 20th, 2021

Defining Hiatal Hernia

A hernia occurs when an organ or tissue exits or moves abnormally from its location. The hiatus is found on the diaphragm, which separates the chest cavity and the abdomen. Hence, the name the hiatal hernia is used to describe the condition where the stomach starts protruding outside the abdominal cavity through the hiatal opening. The food pipe or esophagus travels through the hiatus and connects to the stomach. A hiatal hernia occurs when the upper part of the stomach starts jutting out of this opening.

A hiatal hernia can be broadly classified into two different categories – sliding type and para-esophageal type. The sliding type of a hiatal hernia occurs when the stomach and esophagus slide up the hiatus, intruding the chest cavity.

This is the most commonly occurring type with almost 95% cases of all the hiatal hernia falling in this category.

The para-esophageal type hernia, also known as fixed the hiatal hernia, is caused by the stomach pushing through the diaphragm wall and laying static in the chest cavity.

Though in a majority of para-esophageal hernia cases the symptoms are not that extreme, it may sometimes lead to restricted blood flow to the stomach.

 

Causes and risk factors

The chances of developing the hiatal hernia increase with age, mostly in the 50s.  Obesity and smoking also increase the likelihood of a hiatal hernia. It affects women more than men. The following causative factors explain the occurrence of this ailment:

  • If the abdominal muscles are weak and the individual experiences increased abdominal pressure, the hiatal hernia can occur. This is the reason why obese people and pregnant women are more likely to suffer from this disease.
  • The intra-abdominal pressure may also be created due to frequent vomiting and/or chronic constipation. Any prolonged difficulty in passing bowels may gradually lead to pressure build-up in the abdominal cavity and cause the oesophageal membrane to weaken.
  • Old age and smoking are also responsible for making the abdominal membranes weak such that they are not able to withstand the pressure.
  • Malfunctioning of the liver which leads to a collection of fluids in the stomach may also cause a hiatal hernia. The liquid increases pressure and causes the stomach to bulge out of the diaphragm.
  • The damage may also be caused by sudden or repetitive lifting of heavy luggage.
  • Persistent coughs, physical injury to the abdomen or being born with a larger hiatal opening may also contribute to a hiatal hernia.

 

How is a hiatal hernia detected?

Maximum cases of a hiatal hernia go undetected since they don’t tend to lead to the manifestation of visible symptoms. Nevertheless, mild to severe the hiatal hernia can cause the following symptoms to develop in an individual:

  • The most common symptom of a hiatal hernia is GERD or gastroesophageal reflux disease (acid reflux). Under this complication, the contents of the stomach tend to return back to the esophagus causing heartburn, chest pains and even vomiting. The person can experience a mild taste of acid in the back of the mouth. This pain, in case of a hiatal hernia, increases upon lying down.
  • Waterbrash is another side effect of acid reflux caused by a hiatal hernia where large amounts of saliva accumulate in the mouth.
  • Due to abnormalities within the food-pipe, the individual may also experience troubling in swallowing food and feeling much bloated after meals.
  • The person will belch more, may develop a sore throat and hoarse voice, and have shortness of breath.
  • A hiatal hernia might also cause internal gastrointestinal bleeding which can be detected through blood in vomit and/or passing of black stool.
  • If left untreated, the symptoms may acquire many severe forms and lead to anemia (iron-deficiency), complete bowel obstruction, and volvulus.

Since the symptoms of a hiatal hernia overlap those of many other ailments, this condition is also termed as the “great mimic”.

 

Diagnosis

A hiatal hernia can be diagnosed through the following methods:

  • Blood tests to check the iron-level in the blood since anemia is frequently detected alongside a hiatal hernia.
  • Esophagram or a Barium X-ray reveals the state of the upper abdomen in the individual. In this method, the person drinks a liquid containing barium prior to the X-ray. The movement of liquid through the digestive tract leaves a trace of barium which can be seen on the x-ray image. A the hiatal hernia is detected if the barium trace is intruding the diaphragm.
  • Endoscopy may also be used to check for inflammation and swelling of the hiatus. Any digestive tract obstruction can be easily detected through an endoscope.
  • A manometer or a thin catheter is used to detect the pressure inside the abdominal cavity. This is made to pass through the patient’s nose and check for oesophageal movements.

 

How is it treated?

The treatment of a hiatal hernia depends upon the severity of the symptoms and also upon the level of organ displacement. If the symptoms are limited to only GERD (acid reflux), then it can be treated with medications. If the conditions are more severe, then surgery would be required. An overall lifestyle change is also needed to completely treat a hernia.

  • Medication: The medicines are used to suppress the acid-reflux tendencies. Over-the-counter medicines such as Gelusil, which are effective antacids, are prescribed by the doctor. Certain drugs, which inhibit the acid-production in the stomach such Famotidine, are also helpful. Proton-pump inhibitors such as Omeprazole, which heal the damaged oesophageal tissues, also included within the treatment protocol.
  • Surgery: This surgical treatment is made necessary when the medications fail to improve the situation. The common surgical processes used are thoracotomy, laparotomy, or laparoscopic surgery.
  • Long-term lifestyle changes: These aim to control the severity of acid reflux and other associated symptoms. Eating smaller meals, quitting smoking, avoiding alcohol, and reducing weight have been helpful in bringing down the effects a hiatal hernia.

 

How can one prevent a hiatal hernia?

A hiatal hernia cannot be avoided completely; one can stick to the following guidelines to reduce the likelihood of contracting this disease:

  • Maintain a healthy weight.
  • Keeping bowel movements strain-free.
  • Eating a healthy balanced diet that doesn’t strain the digestive tract.
  • Lifting heavy objects with your knees.
  • Not indulging in smoking and excessive alcohol intake.

 

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Dos and Don'ts

Dos
  • Include herbal remedies in your diets such as chamomile tea, cinnamon, apple cider vinegar, and aloe vera.
  • Opt for a surgery only in extreme cases, such as if the size of the hernia is too big.
  • Have 6 smaller meals compared to 3 big meals. This reduces the pressure on the digestive tract.
  • Fruits that one can consume are apples and bananas. Additionally, you can consume green peas, broccoli, skim-milk, whole-grains, and low-fat yogurt.
Don'ts
  • Lie down flat on your back as this may cause the food in the stomach to reflux back.
  • Consume caffeine, spicy food, sugary drinks, chocolates, fatty food, and certain citrus fruits.
  • Indulge in smoking or drinking.

 

 

 

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Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
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Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
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Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
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Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
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DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
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Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
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VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
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Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
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Facts about the Shepherd’s diet Kristina Wilds promoted Shepherd's diet, a Christian-based diet that highlights Jesus Christ's diet as mentioned in the Bible.
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Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
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Gallbladder surgery :Tips on post-operative care and diet What to eat post a gallbladder surgery? What are the key things to avoid if you had a…

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