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Hiatal Hernia

Diaphragm normally has a small opening (hiatus) that allows passage of esophagus to connect with stomach. A hiatal hernia occurs when the upper part of stomach pushes through this opening into the chest region to form a bulge.

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Hiatal hernia commonly occurs in older people above 50 years of age. Generally it doesn’t cause problems, and may remain undiagnosed. But patients with large hiatal hernia can suffer from symptoms like food and acid regurgitation leading to heartburn.

Hiatal hernia is of two types:
  • Sliding hiatal hernias
  • Fixed or Para esophageal hernias
Causes of Hiatal Hernia

In most of the cases, the cause of hiatal hernia is not known. A person may be born with an abnormally large hiatal opening or can develop hiatal hernia due to repeated pressure on stomach muscle wall because of following reasons:

  • Aging
  • Multiple pregnancies
  • Chronic constipation & cough
  • Excessive vomiting
  • Heavy weight lifting
  • Obesity
  • Straining to urinate because of an enlarged prostate

In some cases weakening of muscle tissue may also occur due to some injury or other damage.

Symptoms of a Hiatal Hernia

Hiatal hernia may remain unnoticed as it rarely causes any symptoms. Most of the symptoms are usually related to stomach acid, bile, or air entering the esophagus like:

  • Heartburn that worsens on leaning over or laying down
  • Belching
  • Troubled swallowing
  • Chest or abdominal or epigastric pain
  • Feeling of fullness after meals
  • Blood in vomiting or stools
How Is a Hiatal Hernia Diagnosed?

A hiatal hernia can be diagnosed with following tests:

  • Barium X-ray (specialized X-ray using a barium swallow to see the esophagus)
  • Endoscopy
  • Blood tests to check anemia due to blood loss
How Are Hiatal Hernias Treated?

As most of the hiatal hernias dont cause any symptom, they also dont require any treatment. In cases where hernia causes GERD symptoms, medications may be given but if they dont work, surgery is recommended. The patients with Para esophageal hernia need surgery as it can cause stomach strangulation.

Medications include:
  • Antacids to neutralize stomach acid
  • H2-receptor blockers to lower acid production
  • Proton pump inhibitors to prevent acid production
Surgery to repair a hiatal hernia

Surgery is performed to put the stomach back in abdomen, make smaller diaphragm opening and rebuild the weak oesophageal muscles. Surgery can be performed using a single incision in the chest wall (thoracotomy) or abdomen (laparotomy).
Laparoscopic or “minimally invasive,” surgery can also repair the hiatal hernia. The procedure is performed through few small (5 to 10 millimeter) incisions in the abdomen. The laparoscope and surgical instruments are inserted through these incisions that allows the surgeon to see inside the abdomen and perform surgery. The advantages of laparoscopic surgery include

  • Smaller & fewer incisions
  • Reduced risk of infection
  • Lesser pain and scarring
  • Rapid recovery
Advantages of Hiatal Hernia Repair at Vikramsclinic
  • Our surgeon performs tension-free repairs that are minimally invasive and do not require the use of general anesthesia
  • Painless and hassle free procedure
  • Chances of recurrence is negligible
  • Patient is discharged on the same day and can resume their daily activities in a weeks time.
  • Even activities like weight lifting is allowed in 10 days time after surgery