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Hiatal Hernias

A hiatal hernia happens when the stomach bulges up into the chest through an opening in the diaphragm. The opening that allows this to happen is called a hiatus, which gives the condition its name. There are two kinds of hiatal hernias, sliding and paraesophageal.

Symptoms

The symptoms of this condition are:

  • Chest pain
  • Heartburn
  • GERD
  • Burping
  • Trouble swallowing
  • Having an upset stomach and vomiting
  • Backflow of liquid from the stomach into the mouth
  • Shortness of breath
  • Bad taste in the mouth

More severe symptoms include:

  • Vomiting
  • Inability to pass gas or stool
  • Persistent upset stomach
  • Severe pain in the chest or in the belly

Causes & Risk Factors

The cause of a hiatal hernia can include:

  • Being born with a large hiatal opening
  • Injury to this part of the body
  • Changes in the diaphragm related to ageing
  • Obesity
  • Persistent coughing
  • Lifting things that are too heavy
  • Straining on the toilet

The risk factors for hiatal hernia are being over the age of 50 and being overweight. This kind of hernia happens more often to women than men as well.

Diagnosis

There are a few different tests that can be done to diagnose this condition:

  • A barium swallow to watch food pass through the GI tract via X-ray
  • Endoscopy to examine the stomach and the oesophagus
  • A pH test to check the acid levels in the oesophagus
  • Oesophageal manometry, which is done using a tube that checks the pressure in the oesophagus when the patient swallows

Treatment & Prevention

The treatment of hiatal hernias depends upon the severity of the condition. For small hernias that are not causing major symptoms, treatment might involve giving the patient antacids to weaken the stomach acid or proton pump inhibitors that keep the stomach from producing as much acid as before.

Some patients can also be treated with prokinetics that make the oesophageal sphincter stronger. This medication can also help the stomach to empty and improve the muscle function of the oesophagus. Some patients will need surgery to correct their hiatal hernia to prevent strangulation of the stomach.

Prevention of hernias involves making sure to lift heavy items carefully and being sure that you are not eating lots of acidic foods or neglecting the signs of severe acid reflux. Persistent coughing should also be treated by your doctor to prevent hiatal hernia development.

Consider ceasing to smoke and losing weight as well if they are factors in your overall health. Limiting your intake of fatty foods, reducing your intake of alcohol, and drinking less caffeine can also help to prevent hiatal hernias.

 
 
 

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