Hiatal Hernias - Causes, Symptoms, and Treatment

A hiatal hernia occurs when part of the stomach protrudes through an opening in the diaphragm — the muscle that separates your chest from your abdomen. Usually, a hiatal hernia does not cause noticeable symptoms. But it can cause heartburn or make it difficult to swallow. You may even have a hiatal hernia and not know it. If you do have symptoms, they usually can be controlled with diet and lifestyle changes or medication. Surgery is rarely needed unless the hernia produces life-threatening problems or causes severe reflux that doesn't respond to medical therapy.

Causes

A hiatal hernia occurs when the upper part of your stomach bulges through an opening in your diaphragm — the muscle that separates your chest from your abdomen. The diaphragm has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach. This opening usually is only large enough to accommodate the food tube. When part of the stomach protrudes through this hiatus into your chest, it's called a hiatal hernia. A hiatal hernia sometimes is called a paraesophageal hernia because part of the stomach bulges next to the esophagus rather than into the chest cavity as in other types of hiatal hernias.

Symptoms

Most commonly, a hiatal hernia causes no symptoms and you don't even know you have one unless an x-ray or endoscopy for some other condition reveals the diagnosis. If you have a large hiatal hernia, it's possible that you could experience heartburn or other signs and symptoms of gastroesophageal reflux disease (GERD). A small percentage of people with a hiatal hernia — less than 5 percent — develop severe GERD or Barrett's esophagus, which is linked to an increased risk of developing esophageal cancer. Because GERD and Barrett's esophagus often are found together in people with large hiatal hernias, some experts suggest checking for both conditions if you're diagnosed with a large hiatal hernia on an imaging test performed for another reason. Signs and symptoms associated with GERD include:

Acid reflux — backflow (regurgitation) of acidic stomach contents into your lower throat Burning sensation behind your breastbone (heartburn) Chest pain aggravated by lying down or bending over Cough Diarrhea Hoarseness or sore throat Nausea Regurgitation of undigested food Vomiting blood or coffee-ground-like material Weight loss for no known reason Widening of your esophagus

Treatment

If you have heartburn only occasionally — such as after eating spicy foods — antacids may provide relief. Antacids neutralize existing stomach acid and offer short-term relief for occasional heartburn. You might take antacids every day if you experience frequent heartburn (more than two times per week). Side effects can include constipation, diarrhea, belching and upset stomach because antacids contain high levels of sodium bicarbonate, calcium carbonate or magnesium hydroxide. Stronger medications known as proton pump inhibitors (PPIs) can decrease stomach acid production by 70 percent to 90 percent offering long-lasting relief from frequent heartburn for many people who use them regularly according to Mayo Clinic research studies. Side effects may include headache; nausea; vomiting; abdominal pain; flatulence; fatigue; insomnia; anxiety; depression and itching.) For most people who have occasional heartburn or indigestion without more-serious associated health problems, making lifestyle changes creates lasting symptom relief without taking medications on a regular basis according to Harvard Health Publishing.)]

Although most commonly asymptomatic, a hiatal hernia can cause heartburn or other signs and symptoms of gastroesophageal reflux disease (GERD). Treatment typically involves antacids for neutralization of existing stomach acid and occasional relief from heartburn. For those experiencing GERD more frequently than twice per week, proton pump inhibitors can be prescribed for long lasting relief from symptoms such as heartburn, flatulence, fatigue, anxiety, depression and itching.. Making lifestyle changes such as avoiding fatty foods , eating smaller meals ,and not eating close to bedtime can also create lasting symptom relief without taking medications on a regular basis.

This blog post has covered hiatal hernias the causes, symptoms, and treatment options available to you. Talk to your doctor about which hiatal hernia treatment plan is right for you, or contact Hernia Innovations where we specialize in Hernia Surgery Treatments for patients like you. Contact us today for an appointment by sending us a message or calling us at (925) 940-1020.