A hiatal hernia is one that occurs when part of the stomach pushes upwards, into the chest through the diaphragm. This type pf hernia occurs in approximately fifteen percent of the population. Of those people, very few experience symptoms. Hiatal hernias are most common in overweight people, especially women, and people who are fifty years of age and older.
There are two types of hiatal hernias; paraesophageal and sliding. The most common is the sliding hiatal hernia, which occurs when the stomach and a section of the esophagus slide up into the chest via the hiatus. The paraesophageal hernia is less common, but much more serious. It occurs when the a section of the stomach squeezes through the hiatus while the esophagus and the rest of the stomach remain in place. This results in the blood supply to the stomach becoming shut off.
There are three possible causes of a hiatal hernia. The most common reason is an esophageal hiatus that is larger than most, resulting in the stomach slipping into the chest. The two less common causes are a shortened esophagus, usually due to the regurgitation of stomach acid, and a loose attachment of the diaphragm to the esophagus.
Symptoms of hiatal hernias include, but aren't limited to, heartburn, vomiting, regurgitation, sour taste, frequent belching and hiccups, difficulty swallowing, gas, coughing, difficulty swallowing, pain or pressure in the chest, esophageal pain, bloating and abdominal pain or discomfort. Most people with a hiatal hernia will not experience any symptoms. This is especially true of the sliding hiatal hernia. People with paraesophageal hernia are much more likely to experience symptoms due to the loss of blood supply to the stomach.
Hiatal hernias are diagnosed through an x-ray conducted of the esophagus or through endoscopy. If the patient is diagnosed with a paraesophageal hernia, surgery is performed to treat it. If the patient is diagnosed with a sliding hernia, and is experiencing symptoms, he is usually treated with medications for gastric reflux. When a person doesn't experience any symptoms of the hiatal hernia, treatment isn't necessary. If, after diagnosis, the patient develops severe chest or abdominal pain, nausea, vomiting or the inability to pass gas, he should call his doctor immediately, as it is a medical emergency.
Patients who have had hernia surgery are usually able to walk around the next day. Dietary restrictions aren't necessary and most patients can resume normal activity within a week. Even after surgery, there is still a possibility the hernia will return.