Hiatus Hernia

The diaphragm is a muscular wall that separates the abdomen from the chest. In hiatal hernia part of the stomach protrudes upward into the chest through an esophageal opening in the diaphragm. Any internal organ that pushes itself into another area of the body is called a hernia.    The esophagus goes through the hiatus and then meets with the stomach. The stomach bulges up through that opening and this condition is called hiatus hernia.

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Causes of Hiatal Hernia

There are two types of hiatus hernia: para-esophageal hernia and sliding hiatal hernia.

Para-esophageal hernia

In this condition, the stomach and esophagus locations are undisturbed. Part of the stomach actually pushes itself upward through the hiatus and lodges itself next to the esophagus. Blood supply to the stomach is strangled.

Sliding hiatal hernia

This hernia is very common. The stomach and the part of the esophagus both together slide up into the chest area.

Hiatal or hiatus hernia can be caused by:

  • Congenitally large hiatu
  • Injury to the area
  • Immense and continuous pressure while vomiting, straining during bowel movement, lifting heavy objects and chronic coughing
  • Advanced age – because at such an age the diaphragm muscle weakens
  • Indigestion or dyspepsia

Hiatal Hernia Symptoms

  • Acid reflux symptoms : the sphincter muscle does not work normally and the pressure of the diaphragm muscle on the esophagus is lost
  • Heart burn: a burning feeling emerges from the abdomen or upper stomach to the lower chest area and into the neck
  • Pain in upper abdomen and chest
  • Acidic taste in the mouth
  • Feeling bloated in the stomach
  • Excessive belching
  • Unable to swallow hot drinks due to burning pain in the stomach
  • Persistent coughing at night due to reflux acid irritating the trachea
  • Asthma symptoms
  • Gum problems and bad breath
  • Hoarseness
  • Feeling of lump in the throat
  • Severe chest pain

Hiatus Hernia Diagnosis

X-ray study

A barium swallow followed by an x-ray allows examination of the esophagus and stomach.

Endoscopy or Gastroscopy

An endoscope is inserted into the gullet to examine the esophagus for any abnormalities.

Esophageal Manometry Test

This is a pressure study which checks the strength and muscle coordination of the esophagus whilst swallowing.