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Hiatal Hernia
Hiatal Hernia(Hiatus Hernia)Pronounced: High-AY-tal HER-nee-uh
by
Amy Scholten, MPH DefinitionA hiatal hernia is a movement of part of the stomach up into the chest cavity. The stomach presses up through a small hole in the diaphragm muscle. The diaphragm is the muscular wall that separates the abdominal cavity from the chest cavity. Different types of hiatal hernias include:
CausesThe exact cause of hiatal hernias is not clear. Some people are born with a hiatal hernia but most will develop it later in life. The diaphragm has an opening that the esophagus can pass through. A weakening or injury to this opening can allow a hiatal hernia to develop. Increased pressure in the abdomen can also push the stomach up into the chest cavity. Risk Factors TOPHiatal hernias are more common in adults over 50 years of age. Other factors that increase your chance of getting hiatal hernia include:
Symptoms TOPMost people with hiatal hernias have no symptoms. A hiatal hernia can make stomach acid moves up into the esophagus. This is known as gastroesophageal reflux disease (GERD). Symptoms of GERD can include:
Diagnosis TOPYour doctor will ask about your symptoms and medical history. A physical exam will be done. Because they often have no symptoms, hiatal hernias are sometimes only detected during a visit to the doctor for other reasons. Your doctor may recommend imaging tests to investigate your symptoms. Pictures of the stomach are taken with an upper GI series or endoscopy. Treatment TOPTalk with your doctor about the best treatment plan for you. Hiatal hernias are usually treated only when there are symptoms. When GERD is present, treatment may include one or more of the following: Weight LossFor people who are obese, losing weight may relieve symptoms. Dietary ChangesAvoid foods that can relax the muscle that controls the opening between the esophagus and the stomach, including:
Avoid foods and beverages that can irritate the internal lining of the esophagus, such as:
To minimize acid reflux:
Smoking CessationIf you smoke, quit. Smoking weakens the lower esophageal sphincter, a muscle that controls the opening between the esophagus and the stomach. Reduce Pressure on Your Abdomen
ElevationElevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge reduces heartburn. This position helps prevent stomach contents from refluxing backward into the esophagus. AntacidsYour doctor may recommend over-the-counter antacids. These can neutralize acid and temporarily relieve heartburn. Prescription MedicationsFor chronic reflux and heartburn, several types of medications may be prescribed to reduce acid in the stomach. These include H2 blocker and proton pump inhibitors. SurgerySurgery may be needed if:
Prevention TOPThere is no known way to prevent hernias. RESOURCES:American College of Gastroenterology http://www.acg.gi.org National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov References:Gastroesophageal reflux disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated March 27, 2013. Accessed April 8, 2013. Heartburn, gastroesophageal reflux, and gastroesophageal reflux disease. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.aspx. April 30, 2012. Accessed April 8, 2013. Hiatal hernia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated March 14, 2013. Accessed April 8, 2013. Hiatus hernia. The Merck Manual for Health Care Professionals. Available at: http://www.merckma.... Updated February 2012. Accessed April 8, 2013. Last reviewed March 2013 by Peter Lucas, MD; Brian Randall, MD Last Updated: 4/8/2013 | |