Hiatal Hernia Piece
Important information regarding your health
A hiatal hernia occurs when part of your stomach pushes upward through your diaphragm. Your diaphragm normally has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.
In most cases, a small hiatal hernia doesn’t cause problems, and you may not know you have a hiatal hernia unless your doctor discovers it when checking for another condition.
A large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.
Most small hiatal hernias cause no signs or symptoms. However, larger hiatal hernias can cause signs and symptoms such as:
- Difficulty swallowing
- Chest or abdominal pain
- Feeling especially full after meals
- Vomiting blood or passing black stools, which may indicate gastrointestinal bleeding
Possible Causes of Hiatal Hernia:
- Injury to the area
- Being born with an unusually large hiatus
- Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting or straining during a bowel movement, or while lifting heavy objects.
A hiatal hernia is often discovered during a test or procedure to determine the cause of heartburn or chest or upper abdominal pain. Such tests or procedures include:
• Blood testing: Your doctor may recommend a complete blood count to check for anemia due to blood loss.
• An esophagram (barium swallow): During this procedure, you drink a chalky liquid containing barium that coats your upper digestive tract. This provides a clear silhouette of your esophagus, stomach and the upper part of your small intestine (duodenum) on an X-ray.
• Endoscopy: During an endoscopy exam, your doctor passes a thin, flexible tube equipped with a light and video camera (endoscope) down your throat and into your esophagus and stomach to check for inflammation.
• Manometry: During this test, a thin, pressure-sensitive tube (catheter) is passed through your nose, down through the esophagus and into the stomach. The catheter then measures pressure and movement inside the esophagus.
Most people with a hiatal hernia don’t experience any signs or symptoms and won’t need treatment. If you experience signs and symptoms, such as recurrent heartburn and acid reflux, you may require treatment, which can include medications or surgery.
Medications for heartburn
If you experience heartburn and acid reflux, your doctor may recommend medications, such as:
Antacids that neutralize stomach acid. Over-the-counter antacids may provide quick relief.
Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine, famotidine, nizatidine and ranitidine. Stronger versions of these medications are available in prescription form.
Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole and omeprazole. Stronger versions of these medications are available in prescription form.
Surgery to repair a hiatal hernia:
In a small number of cases, a hiatal hernia may require surgery. Surgery is generally reserved for emergency situations, which are rare, and for people who aren’t helped by medications to relieve heartburn and acid reflux.
An operation for a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing a weak esophageal sphincter, or removing the hernia sac.
In some cases, surgery is done using a single incision in your chest wall (thoracotomy) or abdomen (laparotomy). In other cases, your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen. The operation is then performed while your surgeon views images from inside your body that are displayed on a video monitor (laparoscopic surgery).
For more information:
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American Gastroenterological Association
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