Hiatus Hernia Definition, Reason, Symptoms, Treatment & Prevention
Understanding
A hiatal hernia or hiatal hernia occurs when part of the stomach sticks out into the chest area through an opening in the diaphragm (hiatus). The diaphragm is a large, thin layer of muscle between the chest and abdomen.
Hiatal hernias can affect all people, but are more common in people over 50 years old, overweight, and pregnant women. Hiatal hernias can also affect newborns due to congenital abnormalities. Nevertheless, this is quite rare.
There are two types of hiatal hernia:
- Sliding hiatal hernia (80% of cases) – the hernia can move up and down the chest area
- Paraesophageal hiatus hernia – hernia is on the side of the esophagus (more dangerous)
This disease rarely produces symptoms. However, a hiatal hernia usually causes another problem, namely gastroesophageal reflux disease (GERD). GERD appears when stomach acid spreads upward to the esophagus or esophagus. This can happen when a hiatal hernia prevents the lower esophageal valve from working properly. Thus, the esophagus can be irritated by stomach acid.
Several other complications that can arise due to leakage of stomach acid into the esophagus include ulcers or ulcers, scarring and cell changes in the esophagus. So the risk of esophageal cancer increases.
Symptom
Hiatal hernias do not cause symptoms. Symptoms of this disease are usually caused by GERD. Here are some symptoms that can arise:
- burning sensation in the chest
- chest pain
- bitter taste in mouth
- difficulty swallowing (dysphagia)
Reason
The cause of a hiatal hernia is still unknown. Hiatal hernias in newborns are usually caused by an underdeveloped stomach or diaphragm. While in adults, it may be caused by a weakness in the diaphragm due to aging or pressure on the stomach.
Diagnosis
It is quite difficult to determine the diagnosis of a hiatal hernia only from symptoms and physical examination. Generally, additional investigations are needed to confirm this disease. For example through X-rays with barium and endoscopy.
The patient will be asked to drink a barium solution before an X-ray procedure. This liquid will show if there are abnormalities in your stomach. Meanwhile, endoscopy is a procedure in which a camera tube is inserted through the mouth to assess parts of the digestive system.
Treatment
Treatment of a hiatal hernia is usually done to treat GERD symptoms. The following classes of drugs can be used, namely: antacids, Proton-pump inhibitors (PPIs), H2-receptor antagonists (H2RA), and alginates.
Lifestyle changes are also needed to reduce symptoms, such as:
- small frequent feeding, eating in small portions but more often
- Avoid lying down after eating for at least 3 hours
- avoiding foods or drinks that stimulate stomach acid production or irritate the stomach –such as alcohol, caffeine, tomatoes, chocolate, oily and fatty foods, and spicy and sour foods
- raise the head of the mattress about 20 cm, do not just add a pillow because it can increase the pressure on the stomach
- lose weight if overweight
- quit smoking
Surgery may be an option if other treatments don’t work or it’s a long-term treatment. This type of paraesophageal hiatal hernia often requires surgery because it can cause strangulation (stomach pinched so that tissue can die).