Hiatal Hernia: Causes, Types, & Treatment. Medically Reviewed by Steven Kim, MD. September 2. 6, 2. In most cases, a small hiatal hernia doesn't cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another. Written by Amanda Delgado What is a hiatal hernia? A hiatal hernia occurs when the upper part of your stomach pushes up through your diaphragm and into your chest region. The diaphragm is a large muscle that lies between your abdomen and chest. You use this muscle to help you breathe. Normally, your stomach is below the diaphragm, but in people with a hiatal hernia, a portion of the stomach pushes up through the muscle. The opening it moves through is called a hiatus. This condition mostly occurs in people who are over 5. It affects up to 6. Esophageal Cancer Awareness Association. Causes What causes a hiatal hernia? The exact cause of many hiatal hernias isn’t known. In some people, injury or other damage may weaken muscle tissue. This makes it possible for your stomach to push through your diaphragm. Another cause is putting too much pressure (repeatedly) on the muscles around your stomach. This can happen when: coughingvomitingstraining during bowel movementslifting heavy objects. Some people are also born with an abnormally large hiatus. This makes it easier for the stomach to move through it. Factors that can increase your risk of a hiatal hernia include: Types of hiatal hernia Types of hiatal hernia. There are generally two types of hiatal hernia: sliding hiatal hernias and fixed, or paraesophageal, hernias. Sliding hiatal hernia. This is the more common type of hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. Sliding hernias tend to be small. They usually don’t cause any symptoms. They may not require treatment. Fixed hiatal hernia. This type of hernia isn’t as common. It’s also known as a paraesophageal hernia. In a fixed hernia, part of your stomach pushes through your diaphragm and stays there. Most cases are not serious. However, there is a risk that blood flow to your stomach could become blocked. If that happens, it could cause serious damage and is considered a medical emergency. Symptoms Symptoms of a hiatal hernia. It’s rare for even fixed hiatal hernias to cause symptoms. Your diaphragm is the muscle that controls. Hiatal hernia surgery and treatment options. If symptoms aren’t present in hiatal hernia then treatment may not be required, but if symptoms begin to interfere with. Hiatal Hernia. A hernia is most likely to occur in puppies less than a year old and is usually inherited (congenital). However, trauma may also bring on an acquired. Hiatal hernias occur when contents of the abdominal cavity protrude through the esophageal hiatus of the diaphragm. Factors that contribute to the development of a. If you do experience any symptoms, they’re usually caused by stomach acid, bile, or air entering your esophagus. Common symptoms include: heartburn that gets worse when you lean over or lie downchest pain or epigastric paintrouble swallowingbelching. Emergencies Medical emergencies. An obstruction or a strangulated hernia may block blood flow to your stomach. This is considered a medical emergency. Call your doctor right away if: you feel nauseatedyou’ve been vomitingyou can’t pass gas or empty your bowels. Don’t assume that a hiatal hernia is causing your chest pain or discomfort. Hernia Repair Overview. Every year, more than half a million hernia repairs are performed in the United States. A hernia occurs when inner layers of abdominal muscle. Most people do not experience any symptoms of their hiatal hernia so no treatment is necessary. However, the. It could also be a sign of heart problems or peptic ulcers. It’s important to see your doctor. Only testing can find out what is causing your symptoms. GERD and hiatal hernias What is the connection between GERD and hiatal hernias? Gastroesophageal reflux disease (GERD) occurs when the food, liquids, and acid in your stomach end up in your esophagus. This can lead to heartburn or nausea after meals. It’s common for people with a hiatal hernia to have GERD. However, that doesn’t mean either condition always causes the other. You can have a hiatal hernia without GERD or GERD without a hernia. Tests and diagnosis Testing for and diagnosing hiatal hernias. Several tests can diagnose a hiatal hernia. Barium X- ray. Your doctor may have you drink a liquid with barium in it before taking an X- ray. This X- ray provides a clear silhouette of your upper digestive tract. The image allows your doctor to see the location of your stomach. If it’s protruding through your diaphragm, you have a hiatal hernia. Endoscopy. Your doctor may slide a thin tube in your throat and pass it down to your esophagus and stomach. Your doctor will then be able to see if your stomach is pushing through your diaphragm. Any strangulation or obstruction will also be visible. Treatment Treatment options for hiatal hernias. Most cases of hiatal hernias don’t require treatment. The presence of symptoms usually determines treatment. If you have acid reflux and heartburn, you may be treated with medications or, if those don’t work, surgery. Medications. Medications your doctor may prescribe include: over- the- counter antacids to neutralize stomach acidover- the- counter or prescription H2- receptor blockers that lower acid productionover- the- counter or prescription proton pump inhibitors to prevent acid production, giving your esophagus time to heal. Surgery. If medications don’t work, you might need surgery on your hiatal hernia. However, surgery is not commonly recommended. Some types of surgery for this condition include: rebuilding weak esophageal musclesputting your stomach back in place and making your hiatus smaller. To perform surgery, doctors either make a standard incision in the chest or abdomen, or use laparoscopic surgery, which shortens recovery time. Hernias can come back after surgery. You can reduce this risk by: staying at a healthy weightgetting help lifting heavy objectsavoiding strain on your abdominal muscles. Lifestyle changes Lifestyle changes Acid reflux causes most hiatal hernia symptoms. Changing your diet can reduce your symptoms. It may help to eat smaller meals several times a day instead of three large meals. You should also avoid eating meals or snacks within a few hours of going to bed. There are also certain foods that may increase your risk of heartburn. Consider avoiding: spicy foodschocolatefoods made with tomatoescaffeineonionscitrus fruitsalcohol. Other ways to reduce your symptoms include: stopping smokingraising the head of your bed by at least 6 inchesavoiding bending over or lying down after eating. Prevention Reducing your risk of hiatal hernias. You may not avoid a hiatal hernia entirely, but you can avoid making a hernia worse by: losing excess weightnot straining during bowel movementsgetting help when lifting heavy objectsavoiding tight belts and certain abdominal exercises.
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