Hiatal hernia Contents of this page:
Alternative Names Definition Causes Symptoms Exams and Tests Treatment Outlook (Prognosis) Possible Complications When to Contact a Medical Professional Prevention References Illustrations Hiatal hernia - X-ray Hiatal hernia Hiatal hernia repair - series Alternative Names
Hernia - hiatal Definition -Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.
The cause is unknown, but hiatal hernias may be the result of a weakening of the supporting tissue. Increasing age, obesity, and smoking are known risk factors in adults. Children with this condition are usually born with it (congenital). It is often associated with gastroesophageal reflux in infants. Hiatal hernias are very common, especially in people over 50 years old. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.
Belching Chest pain Heartburn, worse when bending over or lying down Swallowing difficulty A hiatal hernia by itself rarely causes symptoms -- pain and discomfort are usually due to the reflux of gastric acid, air, or bile. Reflux happens more easily when there is a hiatal hernia, though a hiatal hernia is not the only cause of reflux.
Exams and Tests
Barium swallow x-ray Esophagogastroduodenoscopy (EGD)
The goals of treatment are to relieve symptoms and prevent complications. Reducing the backflow of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain. Medications that neutralize stomach acidity, decrease acid production, or strengthen the lower esophageal sphincter (the muscle that prevents acid from backing up into the esphagus) may be prescribed.
Other measures to reduce symptoms include:
Avoiding large or heavy meals Not lying down or bending over immediately after a meal Reducing weight and not smoking If these measures failure to control the symptoms, or complications appear, surgical repair of the hernia may be necessary. Outlook (Prognosis) Return to top Most symptoms are alleviated with treatment. Possible Complications Return to top Pulmonary (lung) aspiration Slow bleeding and iron deficiency anemia (due to a large hernia) Strangulation (closing off) of the hernia When to Contact a Medical Professional Return to top Call your provider if symptoms indicate you may have developed a hiatal hernia. Call your provider if you have a hiatal hernia and symptoms worsen or do not improve with treatment, or if new symptoms develop. Prevention Return to top Controlling risk factors such as obesity may help prevent hiatal hernia.
Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier: 2008. Update Date: 3/8/2008