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Hiatus hernia: Treatment, symptoms, advice & help

About Hiatus hernia

Hiatus hernia is a common gastro-intestinal problem characterised by the protrusion of the stomach into the chest cavity via an opening in the diaphragm called as the oesophageal hiatus. Most of the times, it is an incidental finding due to absence of any characteristic symptoms.

Hiatus hernia: Incidence, age and sex

Hiatus hernia may occur at any age, but its chances increases with increasing age due to loss of elasticity and muscle weakening as a process of aging. Hiatus hernia is more frequently encountered in women as compared with men.

Signs and symptoms of hiatus hernia: Diagnosis

Hiatus hernia is usually asymptomatic and do not present with any clinical features. Thus hiatus hernia in most cases is an incidental finding. However it may be associated with gastro-oesophageal reflux disease in most of the individuals. The symptoms of gastro-oesophageal reflux disease like pain in the epigastric region, a bloating sensation or regurgitation may also be present.

A detailed history and physical examination, in most cases may point towards the diagnosis of hiatus hernia. However, it is usually an incidental finding during routine investigations. Upper gastro-intestinal x-ray or even endoscopy may help in establishing the diagnosis.

Causes and prevention of Hiatus hernia

Hiatus hernia occurs due to loss of elasticity and weakness of the muscles, controlling the oesophageal opening in the diaphragm. Thus, its chances of occurrence are more in older individuals. Increase intra-abdominal pressure as in pregnancy, ascitis or obesity is an important factor in the causation of hiatus hernia. Moreover, several conditions are known to predispose individuals to hiatus hernia and these conditions include chronic cough, persistent constipation, straining during bowel movement. Heavy-weight lifting or tight clothing may also lead to hiatus hernia.

Regular physical exercise, balanced diet and maintaining optimal weight may help in preventing this condition. Moreover, drinking ample water and taking a high fibre diet may help in preventing constipation. Smoking cessation and avoidance of lifting heavy objects may also help in preventing the occurrence of Hiatus hernia.

Hiatus hernia: Complications

Hiatus hernia, in most of the cases is asymptomatic, leading to its long-standing presence without treatment. This may lead to increased chances of complications, which include damage and inflammation of the oesophageal wall and even oesophageal ulcer, resulting in bleeding in some individuals. This, in turn may result in iron deficiency anaemia.

Hiatus hernia: Treatment

The treatment of hernia may include both medical and surgical modality, depending upon the severity of the hernia. The medical treatment is same as that of gastro-oesophageal disease, and includes antacid medications which provide symptomatic relief. Other medications like proton pump inhibitors and H2 antagonists can be prescribed to suppress the production of gastric acid. Severe cases of hernia may require surgical correction and include restoration of the normal anatomy by pulling down the stomach in the abdominal region and making the oesophageal opening smaller. It is advisable for the individual to maintain a follow-up consultation with the doctor to monitor any recurrence in the future.