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A hiatal hernia, also called a hiatus hernia, is where a section of the stomach protrudes through a hole in the diaphragm called the hiatus. There are usually few symptoms associated with this problem, except that sufferers have an increased likelihood of suffering from GORD. However, hernias can worsen if left untreated. Treatment for a hiatus hernia may consist of lifestyle changes combined with prescription medication but surgical intervention is an alternative to having to take medication for the rest of your life. A hiatal hernia can occur in anybody of any age. However, women are more likely to develop this type of hernia and people over the age of 50 are more prone. Being overweight, pregnant, or a smoker also increases the chances that you will develop this hernia. Losing weight and quitting smoking are two lifestyle changes that are often advised by doctors. It is not known exactly why these hernias present but some cases would point to a weakening of the diaphragm as we age as one possible reason for the formation of a hiatus hernia. Diagnosing a hiatal hernia usually means an endoscopy will be used. An endoscope is placed into the mouth and down the throat and this is then used to examine a person’s insides. While a sedative may be given to help you relax, the procedure is normally undertaken while you are awake. A barium meal x-ray is a highly effective means of identifying a hiatus hernia. The patient drinks a barium solution and once this moves into the digestive system, a number of x-rays are taken to identify possible problems. Your doctor or specialist will usually recommend that you make some lifestyle changes if you do suffer from a hiatal hernia. This means eating smaller meals more regularly and ensuring that you eat three hours before going to bed. You should avoid night-time drinking and avoid those foods that cause symptoms to present. Raising the head of your bed can also help prevent the symptoms of GORD which are commonly associated with this type of hernia. Losing weight and quitting smoking can also help reduce the severity and frequency of symptoms suffered. Medication may be used to control the symptoms. Antacids are readily available in many shops and they neutralise the acid in your stomach. They do not work for all patients, should not be considered a long term solution, and cannot be taken at the same time as other medications because they may reduce the effects of these other drugs. Alginates, H2-receptor antagonists, Proton-pump inhibitors, and prokinetics are some of the other types of medication that may also be considered. If medication and lifestyle changes fail to properly address the problem then surgery may be advised. Laparoscopic Nissen Fundoplication is a keyhole procedure. Small incisions are made in the abdomen and carbon dioxide is then used to inflate the abdomen and allow the surgeon room to work. The stomach is replaced back in the correct position and the diaphragm tightened to prevent the problem from recurring in the future.
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