A hiatal hernia (HH) is the herniation (protrusion) of the upper part of the stomach into the thorax through a weakness in the diaphragm.
The diaphragm is the muscular wall separating the chest cavity from the abdomen. Normally, the esophagus goes through the hiatus and attaches to the stomach. In HH, the stomach bulges up into the chest through that opening.1
Types of hiatus hernia
There are two types of hiatas hernias (HH):
Sliding hiatas hernia (HH) and
Paraesophageal hiatas hernia (HH).
The most common type is the sliding hiatas hernia (HH) in which the stomach and the part of the esophagus that joins the stomach slide up into the chest through the hiatus.
Although less common, the paraesophageal hiatas hernia (HH) is more cause for concern. In this type, the esophagus and stomach remain in their normal positions, but part of stomach bulges up through the diaphragm hole alongside the esophagus.
Causes of hiatus hernia
In most cases, the cause is not known. Hiatas hernia has an increased frequency in people aged above 50 years, possibly owing to weakening of the diaphragm muscle with age.
Hiatal herniais also associated with conditions that increase the abdominal pressure such as coughing, straining during bowel movements, pregnancy or obesity.
Symptoms of hiatus hernia
Often HH has no symptoms. However, people with hiatas hernia (HH) may have heartburn or GERD.
Diagnosis of hiatus hernia:
It can be diagnosed with a barium X-ray study or with endoscopy.
Complications of hiatus hernia
Occasionally, hiatas hernia (HH) can lead to serious problems such as ulcer formation or Barrett’s esophagus with cancerous changes.2
Treatment of hiatus hernia
When (hiatas hernia) HH is symptomatic, acid reflux usually produces the symptoms. In these patients, the treatment is similar to that discussed for GERD therapy. When the hernia itself is causing chest discomfort or other symptoms, surgery may be necessary.
The Nissen fundoplication performed laparoscopically is more preferred, as it lowers morbidity and shorter hospital stay compared to the open procedure performed previously.3
Written by: Healthplus24 team
Date last updated: July 06, 2011