What is a hiatus hernia?
This happens when the upper part of the stomach pushes into your chest through the diaphragm.
The oesophagus(food pipe) enters the abdomen from the chest through an area in the diaphragm called the hiatus. In some cases, the muscle around the hiatus becomes weak and therefore the upper part of the stomach pushes into the chest resulting in a hiatus hernia.
What are the causes?
There are some factors that makes the muscle weak and increase the risk of hiatus hernia which include:
- Repeatedly putting too much pressure on the abdominal muscles
- Heavy lifting
- Chronic cough
- Straining during bowel movements
- Trauma resulting in damage to the muscles
- Congenital (Born with a large hiatus)
What are the different types of hiatus hernia?
Sliding Hiatus hernia
This is the most common type of hiatus hernia. The stomach and part of the oesophagus that joins the stomach slides into and out of the chest through the hiatus.
Para-oesophageal Hiatus hernia
Unlike the sliding hernia, with this type of hiatus hernia, the junction between the oesophagus and stomach remain in the abdomen. The upper part of the stomach bulges in to the chest besides the oesophagus. This type is not common.
What are the symptoms?
- Heart burn or Acid Reflux
Sometimes you can have acid reflux without it being a symptom of a hiatus hernia.
- Chest pain/Upper abdominal pain (If you are experiencing these symptoms, it is important to see your doctor to exclude a heart problem)
Complication risks include Obstruction and Strangulation.
Treatment depends on the symptoms that the patient presents. In most cases, treatment is not required. Therefore, the presence of symptoms will determine if treatment is needed.
Symptoms can usually be controlled with medication and Lifestyle changes.
There are certain changes you can make to your lifestyle that can make a difference:
- Loose weight
- Stop smoking
- Avoid lifting heavy weight
- Avoid straining during bowel movements
- Dietary changes – avoid certain types of food including:
Spicy food, Caffeine, Onions, Citrus, Chocolates, Alcohol
- Eat small meals several times a day instead of large meals
- Not eating within a few hours of going to bed
- Avoid bending over or lying down soon after eating
- Raise the head end of your bed
Hiatus hernia is commonly repaired by keyhole (Laparoscopic) surgery.It involves bringing the stomach back in to the abdomen and rebuilding the weak muscles.
Further discussion with Mr Marzook regarding surgery would be necessary.
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