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Hiatal Hernia

A hiatal hernia occurs when an upper portion of the stomach pushes through the opening of the diaphragm muscle, also known as the hiatus. Although small hiatal hernias usually do not cause any symptoms, large hernias can cut off blood flow to the stomach and require surgery. Large hiatal hernias can be accompanied by heartburn, frequent belching, or difficulty swallowing. Hiatal hernias typically occur due to a weakening of the diaphragm because of natural aging or obesity. If you believe that you might have a hiatal hernia, Dr. Cofrancesco, Dr. Quijano and the staff at GI North can diagnose the problem, address your symptoms, and repair the hernia.

To learn more about hiatal hernias, continue to read below:

  • What is a hiatal hernia?
  • What are the symptoms of a hiatal hernia?
  • What causes a hital hernia?
  • How is a hiatal hernia diagnosed?
  • What is the treatment for hiatal hernia?
  • What can I do to lessen the symptoms of a hiatal hernia?
  • Points to Remember

What is a hiatal hernia?

A hiatal hernia occurs when a part of the stomach pushes through the opening of the diaphragm muscle (known as the hiatus). Typically, the esophagus passes through the diaphragm at the hiatus and connects to the stomach. In response to an increase in pressure, the stomach can push through the hiatal opening.

Small hiatal hernias usually do not cause any symptoms and can go undiagnosed for a large period of time. Large hiatal hernias can cause food and stomach acid to back up leading to heartburn. In extreme cases, blood flow to the stomach can be cut off and the hernia can only be fixed via surgery.

What are the symptoms of a hiatal hernia?

Small hiatal hernias cause no symptoms or discomfort. However, large hiatal hernias can lead to heartburn, difficulty swallowing, or abnormal, frequent belching. Sometimes, frequent heartburn can lead to chest pain.

What causes a hiatal hernia?

Hiatal hernias are common among people over 50 years of age. A weakening of the diaphragm muscle tissue caused by normal aging or obesity can lead to a hiatal hernia. Also, an increase in internal pressure from coughing, sneezing, vomiting, bowel movements, or lifting a heavy object may cause a hiatal hernia. When found in children, the cause is usually that the child was born with an abnormally large hiatus.

How is a hiatal hernia diagnosed?

A hiatal hernia can be diagnosed in one of two ways:

Upper endoscopy. After giving you a sedative to help you become drowsy, Dr. Cofrancesco or Dr. Quijano passes a long, thin tube called an endoscope through your mouth and gently guides it down the esophagus, into the stomach. Through the endoscope, Dr. Cofrancesco or Dr. Quijano can look for inflammation.

Barium x ray. After fasting for 12 hours, you will drink a thick liquid called barium, which coats the esophagus and stomach, making them show up on the x ray. A radiologist will then examine the position of the stomach in relation to the surround muscle and tissue.

What is the treatment for a hiatal hernia?

Treatment of a hiatal hernia depends on the severity of the condition. In most instances, the symptoms related to backflow of acid and heartburn are addressed through medication to neutralize stomach acid; to reduce acid production; or to strengthen a weak esophageal sphincter in order to lessen backflow of acid. In extreme cases, the hernia will be fixed by surgery. In surgery, the herniated portion of the stomach may be pulled back through the diaphragm opening while the hiatus is made smaller. In some cases, the herniated portion of the stomach may be removed. The surgery may be performed through a single incision or several incisions to the abdomen or chest.

Points to Remember

  • Small hiatal hernias usually do not cause any symptoms.
  • Large hiatal hernias can cause food and stomach acid to back up leading to heartburn.
  • Hiatal hernias can be congenital or caused by normal aging, being obese, or an intense increase in internal pressure such as lifting a heavy object or sustained coughing.
  • A hiatal hernia can be diagnosed through a barium x ray or a upper endoscopy.
  • Treatments of hiatal hernias range from addressing the backflow of acid or heartburn symptoms through medication to surgery in extreme cases.

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