(Tuesday, 31st Mar, 2015)
A hiatus hernia is a condition in which a portion of the upper stomach slips through the diaphragm and up into the chest. In individuals with hiatus hernias, the hiatus opening (where the oesophagus goes through the diaphragm) is larger than normal, and a portion of the upper stomach slips through the hiatus.
They can be caused by oesophageal hiatus which are bigger than normal. A shortened oesophagus and an abnormally loose attachment from the oesophagus to the diaphragm is also a factor, allowing the oesophagus and stomach to slip upwards. Where people are over-weight (or pregnant) the extra abdominal pressure can cause the oesophagus and stomach to slip upwards.
The larger the hernia, the more likely symptoms will feature, including:
To confirm the diagnosis your doctor may need to perform :
Generally hiatus hernias do not require treatment. Eating a balanced diet and not eating before going to bed ease the symptoms. Also not eating and drinking at the same meals helps reduce the volume of the stomach contents and thus reduces episodes of painful acid splashes (heartburn) Losing weight and avoiding tight belts also help prevent symptoms. Where the oesophagus has become inflamed from repeated splashes of gastric acid (Gastro-oesophageal Reflux) treatment with antacids, or acid suppressing medication may be required to reduce the inflammation. Dietary restriction of foods that aggravate the condition (e.g. tea, coffee, alcohol, citrus fruits or chocolate) and stopping smoking may also help.
In severe cases, surgery is required. This involves pulling the stomach down into the abdomen, attaching the oesophagus to the diaphragm, and making the hiatus smaller. However only about 5% of patients require surgery.
It is difficult to prevent it. But taking a few precautionary steps, may reduce your risk of the condition:
However those with a hiatus hernia can avoid painful symptoms of Gastro-oesophageal Reflux by following the advice above.
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