The diaphragm is a big muscle that lies in between your abdomen and chest. You use this muscle to assist you breathe. Typically, your stomach is listed below the diaphragm, but in people with a hiatal hernia, a portion of the stomach rises through the muscle. The opening it moves through is called a hiatus.
This condition mainly happens in people who are over 50 years old. It impacts up to 60 percent of people by the time they’re 60 years of ages, according to the Esophageal Cancer Awareness Association.
What is a hiatal hernia?
- A hiatal hernia happens when the upper part of your stomach pushes up through your diaphragm and into your chest area.
- There are generally two types of hiatal hernia: sliding and fixed.
- This condition primarily takes place in people who are over 50 years old.
A hiatal hernia takes place when the upper part of your stomach rises through your diaphragm and into your chest area.
What causes a hiatal hernia?
The exact cause of many hiatal hernias isn’t understood. In some individuals, injury or other damage might deteriorate muscle tissue. This makes it possible for your stomach to press through your diaphragm.
Another cause is putting too much pressure (consistently) on the muscles around your stomach. This can occur when:
- coughing
- vomiting
- straining during defecation
- raising heavy items
Some individuals are also born with an unusually large hiatus. This makes it simpler for the stomach to move through it.
Aspects that can increase your risk of a hiatal hernia include:
- obesity
- aging
- smoking cigarettes
Types of hiatal hernia
There are normally two types of hiatal hernia: moving hiatal hernias and fixed, or paraesophageal, hernias.
Sliding hiatal hernia
This is the more common type of hiatal hernia It takes place when your stomach and esophagus slide into and from your chest through the hiatus. Moving hernias have the tendency to be small. They normally do not cause any symptoms. They might not require treatment.
Fixed hiatal hernia
This type of hernia isn’t as common. It’s also referred to as a paraesophageal hernia.
In a fixed hernia, part of your stomach presses through your diaphragm and remains there. Most cases are not serious. However, there is a risk that blood flow to your stomach could end up being blocked. If that takes place, it might cause serious damage and is considered a medical emergency situation.
Symptoms of a hiatal hernia
It’s rare for even fixed hiatal hernias to cause symptoms. If you do experience any symptoms, they’re generally caused by stomach acid, bile, or air entering your esophagus. Typical symptoms include:
- heartburn that becomes worse when you lean over or rest
- chest pain or epigastric pain
- trouble swallowing
- belching
Medical emergencies
An obstruction or a strangulated hernia might obstruct blood flow to your stomach. This is considered a medical emergency. Call your doctor immediately if:
- you feel nauseated
- you’ve been vomiting
- you can’t pass gas or empty your bowels
Don’t assume that a hiatal hernia is triggering your chest pain or discomfort. It could likewise be a sign of heart problems or peptic ulcers. It’s essential to see your doctor. Only testing can find out what is causing your symptoms.
What is the connection between GERD and hiatal hernias?
Gastroesophageal reflux disease (GERD) takes place when the food, liquids, and acid in your stomach wind up in your esophagus. This can cause heartburn or queasiness after meals. It’s typical for individuals with a hiatal hernia to have GERD. Nevertheless, that doesn’t imply either condition constantly causes the other. You can have a hiatal hernia without GERD or GERD without a hernia.
Testing for and detecting hiatal hernias
A number of tests can diagnose a hiatal hernia.
Barium X-ray
Your doctor may have you drink a liquid with barium in it prior to taking an X-ray. This X-ray offers a clear shape of your upper digestive tract. The image allows your doctor to see the location of your stomach. If it’s extending through your diaphragm, you have a hiatal hernia.
Endoscopy
Your doctor may move a thin tube in your throat and pass it down to your esophagus and stomach. Your doctor will then be able to see if your stomach is pushing through your diaphragm. Any strangulation or obstruction will likewise be visible.
Treatment for hiatal hernias
Most cases of hiatal hernias do not need treatment. The presence of symptoms typically determines treatment. If you have heartburn and heartburn, you may be treated with medications or, if those don’t work, surgery.
Medications
Medications your doctor might recommend include:
- over-the-counter antacids to reduce the effects of stomach acid
- over the counter or prescription H2-receptor blockers that lower acid production
- over the counter or prescription proton pump inhibitors to avoid acid production, giving your esophagus time to recover
Surgery
If medications do not work, you may need surgery on your hiatal hernia. Nevertheless, surgery is not frequently advised.
Some types of surgery for this condition include:
- restoring weak esophageal muscles
- putting your stomach back in place and making your hiatus smaller sized
To carry out surgery, medical professionals either make a conventional incision in the chest or abdominal area, or use laparoscopic surgery, which reduces recovery time.
Hernias can return after surgery. You can reduce this risk by:
- staying at a healthy weight
- getting help lifting heavy objects
- avoiding strain on your stomach muscles
Lifestyle changes
Acid reflux causes most hiatal hernia symptoms. Changing your diet can reduce your symptoms. It might help to eat smaller sized meals several times a day rather of 3 big meals. You must likewise prevent eating meals or snacks within a few hours of going to bed.
There are likewise certain foods that may increase your risk of heartburn. Think about avoiding:
- hot foods
- chocolate
- foods made with tomatoes
- caffeine
- onions
- citrus fruits
- alcohol. We strongly recommend quitting drinking alcohol and smoking.
Other methods to reduce your symptoms include:
- stopping smoking
- raising the head of your bed by a minimum of 6 inches
- avoiding bending over or lying down after eating
Minimizing your risk of hiatal hernias
You may not avoid a hiatal hernia totally, however you can avoid making a hernia even worse by:
- losing excess weight
- not straining during defecation
- getting help when raising heavy objects
- preventing tight belts and certain abdominal exercises