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Can the muscles/ligaments be strengthened to reverse a sliding hiatal h...
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Can the muscles/ligaments be strengthened to reverse a sliding hiatal hernia?


  Is it possible to strengthen the muscles and ligaments that contribute to a hiatal hernia?  If these are strengthened, could it return the stomach to it's original position?  Would sit-ups help?  I was diagnosed with a small hiatal hernia, so isn't it possible to reverse this some type of way?
  Please advise....thanks!
Dear Cathy,
There are two types of hernias that occur in the region of the lower esophagus i.e., a sliding hiatal hernia and a paraesophageal hernia. Sliding hiatal hernias are more common and are probably the type that you are referring to. A sliding hiatal hernia is a congenital abnormality where the lower esophagus and part of the stomach protrudes upward into the chest cavity. This is due to a weakness in the muscles and ligaments that support the stomach in its proper position. You describe a "small" hiatal hernia. That probably means that only a small portion of the stomach is seen above the diaphragm. Hiatal hernias are commonly seen on chest x-rays and upper GI series. They can play a role in the development of gastroesophageal reflux or they can be totally asymptomatic. A sliding hiatal hernia is usually an anatomic abnormality that causes no problems, doesn't get bigger or smaller with time and does not require surgical repair. In patients with hiatal hernia and gastroesophageal reflux symptoms, the usual treatment for gastroesophageal reflux suffices. On the other hand, a paraesophageal hernia is a protrusion of the stomach into the chest cavity where part of the stomach lies along the lower esophagus and can actually cause a mechanical obstruction (blockage). These are less common than sliding hiatal hernias and usually require surgical repair. Currently there are no strengthening exercises known to reverse this anatomic abnormality. Many people have hiatal hernias and don't even know it. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you want to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: hiatal hernia, gastroesophageal reflux disease, management
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