Hiatal hernia is a condition in which the upper portion of the stomach protrudes into the chest cavity through an opening of the diaphragm called the esophageal hiatus. This opening usually is large enough to accommodate the esophagus alone. With weakening and enlargement however, the opening (or herniation) can allow upward passage or even entrapment of the upper stomach above the diaphragm.
Possible Causes of Hiatal Hernia
Hiatal Hernia could be caused by:
- Injury to the area
- Being born with an unusually large hiatus
- Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting or straining during a bowel movement, or while lifting heavy objects.
- Hiatal hernia is a common condition. By age 60, up to 60% of people have it to some degree.
There are 2 types of Hiatal Hernia.
- The sliding type, as its name implies, occurs when the junction between the stomach and esophagus slides up through the esophageal hiatus during moments of increased pressure in the abdominal cavity. When the pressure is relieved, the stomach falls back down with gravity to its normal position.
- The fixed type (or paraesophageal) implies that there is no sliding up and down. A portion of the stomach remains stuck in the chest cavity.
- Poor seated posture (such as slouching)
- Frequent coughing
- Straining with constipation
- Frequent bending over or heavy lifting
- Congenital defects
Medical Treatment for Hiatal Hernia
- Treatment for a sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn. Lifestyle changes and medication are the preferred treatments.Medical treatment for hiatal hernia may include prescription-strength antacids such as omeprazole or rabeprazole.
- Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked or the stomach becomes entrapped in the hiatus sometimes compromising its blood supply. This is usually an emergency condition which requires urgent surgical emergency.