Hiatal Hernia: Symptoms, Causes & Management

Hiatal hernia is a condition where a part of the stomach in the upper regions pushes through the diaphragm, thus permeating the chest region.

The diaphragm is the muscle in the body that usually helps regulate breathing and efficient lung action. It lays between the chest and the abdomen, regulating movement that affects various functions in the body.

People who suffer from hiatal hernia have a hindrance in the natural placement of the diaphragm. The upper stomach muscles that push through the diaphragm into the chest region create interference that affects breathing patterns. The opening of the diaphragm wall through which the stomach muscles push upward is called the hiatus.

What Are The Hiatal Hernia Causes?

Hiatal hernias can be caused due to a number of reasons. The most common factor is weak muscles in the diaphragm that allows the abdominal and chest muscles to move beyond their limits. Another major factor is when there is too much exertion on the muscles during certain activities such as:

• Vomiting
• Lifting objects that are heavy
• Coughing
• Straining the muscles during bowel movement.

There are other factors that also contribute as the hiatal hernia causes such as:

• Ageing
• Smoking
• Obesity

Many people who suffer from hiatal hernia are born with enlarged hiatus. In the early stages, this can be treated with surgery to pull the stomach muscles back or simply extend the oesophagus. Surgeons will take into account the severity of the hiatal hernia causes before prescribing a method of treatment.

What Are The Hiatal Hernia Types?

Primarily there are two types of hiatal hernias that affect people based on the type of movement of the hernia. Here are the two hiatal hernia types:

Fixed Hiatal Hernia

This is a rare form of hiatal hernia wherein the part of the upper stomach region that pushes through the diaphragm, just stays put.

Since there is not much movement in the upper stomach regions, the condition is mostly not that serious. However, since the stomach muscles are stuck in the fixed hiatal hernia, there may be less and less blood flowing into it. Thus, it could block circulation in the stomach and result in severe consequences.

Sliding Hiatal Hernia

Sliding hiatal hernias are usually small and quite commonly found in people with hiatal hernias. In this condition, the stomach muscles and the oesophagus keep on sliding to and fro through the hiatus, thus resulting in a sliding hiatal hernia.

These hiatal hernia types are usually devoid of symptoms and rarely require treatment. 

What Are The Symptoms Of Hiatal Hernia?

The symptoms of hiatal hernia are usually a result of bile, air, and stomach acid making their way into the oesophagus. Here are the common symptoms of hiatal hernia:

• Chest pain or pain of the epigastric
• Belching
• GERD or Acid reflux
• Trouble when trying to swallow
• Heartburn that worsens with bending movements

What Is Involved In Hiatal Hernia Treatment?

Hiatal hernias can be small or big based on the cause and the growth. Most hiatal hernias are small and rarely require any form of treatment but if the hiatal hernia is large, then surgery is a viable option for hiatal hernia treatment.

Here are the types of surgeries available for hiatal hernia treatment:

Surgery For Hiatus Repair

It is ideal for people with early stages of hernia that could not be treated with a change in lifestyle. It is usually used to treat hiatal hernias by tightening the diaphragm. The surgeons use prosthetic mesh and sutures to tightly bind the hiatus so the stomach muscles cannot protrude into the chest cavity.

It is an effective technique to ensure that the stomach muscles and the muscles in the chest cavity stay in their designated regions and the diaphragm can regulate smooth breathing movements.

Nissen Fundoplication

In these hiatal hernia treatment types, the surgeon stitches together the bottom of the oesophagus to the fundus, which is the upper part of the stomach. The stitches create a hindrance for the acids and particles from the stomach from flowing back up.

The stitched portion is carefully placed below the hiatus in the diaphragm to prevent upward movements.

Collis-Nissen Gastroplasty

These hiatal hernia treatment surgeries involve extending the oesophagus to accomplish the same objective of keeping anything from the stomach flowing back up. In these surgeries, the surgeon takes parts of the tissues from the fundus and attempts to extend the oesophagus downward.

It is an excellent form of treatment for anyone with acute stages of hiatal hernia.

If small hernias cannot be treated by changes to your lifestyle, you may want to opt for surgery as well. In hiatal hernia surgery, the process involves pulling back the stomach muscles to their rightful place and tightening the muscles in the diaphragm. In case of a sliding hiatal hernia, medical professionals will readjust the muscles in the chest cavity as well.

Surgeons for hiatal hernia will help you decide if you need surgery at all or if your body can recoup on its own with a few changes in your lifestyle. If you do need surgery for hiatal hernia treatment, the surgeon will also take into account the type and stage of your hernia.

Usually, after hernia surgery, you will have to remain in the hospital for a couple of days for recovery. After some surgeries, you may need to adhere to a liquid or semi-solid diet for a period of time. It is best to avoid carbonated drinks for two weeks after any of the hiatal hernia types of surgeries.

Hiatal Hernia Treatment With Change In Lifestyle

You can start treating symptoms of hiatal hernia at home by simply making a few changes to your lifestyle. Avoid the following activities to begin homecare for hiatal hernia:

• Stop smoking right away
• Avoid caffeinated beverages
• Stop consuming alcohol
• Don’t lie down bend too much after eating
• Avoid spicy foods, onions, citric fruits, and chocolate
• Avoid food items made using tomatoes

If you suffer from the symptoms of hiatal hernia, it is best to be diagnosed once. Often, you can simply treat it with changes to your lifestyle but if need be, it is best to get surgical hiatal hernia treatments.