Hiatal Hernia: Causes, Types and Treatment

Hiatus Hernia

What is Hiatus Hernia ?

Hiatus Hernia can be defined as displacement of a portion of the stomach through the opening in the diaphragm through which the oesophagus passes from the chest to the abdominal cavity.

In Hiatus Hernia disease a normal oesophagus, in its long, narrow descent from the mouth to the stomach, must pass through a taut sheet of muscle: the diaphragm, which may be thought of as both the floor of the chest and the ceiling of the abdominal cavity. To get to the ‘stomach, the oesophagus pokes through a teardrop-shaped opening in the diaphragm called the hiatus. It’s at this point that the oesophagus and stomach join, and where a valve system (the lower oesophageal sphincter) keeps deposited food (and the acid working to digest it) from backing up into the oesophagus.

In a hiatus hernia, the upper part. of the stomach has slid up past the diaphragmatic hiatus (weakened, perhaps, by age) and into the chest. From 75 to 95 per cent of hiatus hernias are of this ‘sliding’ type. These come and go, sliding back and forth, depending on body position and other factors.

Hiatus hernia occurs at the oesophageal opening. The disease is common after middle age. It is estimated that about half the people above 60 years of age suffer from it, although most of them may not have any symptoms. The correct diagnosis of hiatus hernia can be arrived at by means of berium meal x-ray test.

What are the types of hiatus hernia ?

There are 2 main types of hiatus hernia.

  1. Sliding hiatus hernia :- It occur when the junction of the oesophagus and stomach, and part of the stomach protrude into the chest, when swallowing.
  2. Rolling hiatus hernia :- This is sometimes called a para-oesophageal hiatus hernia by doctors. In this case, part of the stomach bulges into the chest out of the weakest part of the diaphragm, which is the oesophageal opening. The junction of the oesophagus and stomach stays down within the abdomen, and the top part of the stomach (the fundus) bulges up into the chest cavity. This type of hernia normally remains in one place, sitting next to the oesophagus, and does not move in or out when you swallow.

Hiatus Hernia Symptoms

Hiatus Hernia is characterised by pain in certain areas. The most common areas are behind the breast bone at the nipple level and lower, at the end of the breast one. Pain may also occur on the left chest and this is often mistaken for angina. Other symptom of Hiatus Hernia are heartburn, especially after a meal, a feeling of fullness and bloatedness, flatulence and discomfort on swallowing.

Hiatus Hernia Causes

Hiatus hernias can occur when there is weakening of the muscle tissue around the gap where the oesophagus passes through the diaphragm or where this gap is otherwise stretched. A number of factors appear to contribute to hiatus hernias developing including:

  • Hereditary factors
  • Obesity
  • Pregnancy
  • Sudden, hard physical exertion, such as lifting
  • A birth defect
  • Trauma or surgery to the abdominal area.

Home Remedies for Hiatus Hernia

  1. In the beginning of the treatment, it would be advisable to raise the head end of the bed by placing bricks below the legs of the bed. This will prevent the regurgitation of food during the night. More pillow can also be used for the same purpose.
  2. Losing weight nearly always cures it. Eating small meals each day instead of 2 or 3 large ones helps. You must have a light evening meal without alcohol and avoid supper so that your stomach is empty on retiring. It takes about 1 hour for the stomach to empty.
  3. The diet of hiatus Hernia patient should consist of seeds, nuts and whole cereal grains, vegetables and fruits, with emphasis on fresh fruits, raw or lightly cooked vegetables and sprouted seeds.This is the proper hiatus Hernia diet for the patient of this disease. The foods which should be avoided are over-processed foods like white bread and sugar, cakes and biscuits, rice puddings and over cooked vegetables. At least 50 per cent of the diet should consist of fruits and vegetables, and the remaining 50 per cent of protein, carbohydrates and fat.
  4. Reduce alcohol, coffee and give up the smoking.

How can prevent hiatus hernia?

It is difficult to prevent it. But taking a few precautionary steps, may reduce your risk of the condition :-

  1. Maintaining a healthy diet, and avoiding smoking.
  2. Avoid abdominal strain.
  3. Avoid spicy food.
  4. Have light meals instead of single heavy meal.
  5. Request stool-softening medication if you frequently need to strain when you move your bowels.
  6. Take antacid when there is a need.

Useful References

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