Studies show that 55-60% of the worldwide population over 50 is affected by hiatal hernia. The human body has a diaphragm muscle covering the area between the chest and abdomen that helps with breathing. Typically, the stomach is located beneath the diaphragm.

However, in people who experience hiatal hernia, a part of their stomach can push up through an opening on the diaphragm muscle called hiatus. Doctors recommend medication and dietary changes to treat the above-mentioned health conditions. However, at times, surgery might be necessary. To learn more about hiatal hernia, please keep reading. 

What is a Hiatal Hernia?

A hiatal hernia is a health condition involving muscles at the top of an individual’s stomach. It can lead to issues similar to heartburn, and the medical treatment methods to resolve these issues to some extent.

Clinically speaking, a hiatal hernia occurs when the upper part of the stomach or other adjacent organs is abnormally inserted through the diaphragm’s hiatus aperture. Other names for hiatal hernia include diaphragmatic hernia, hiatus disease, or hiatus hernia. 

Causes of Hiatal Hernia 

The condition of a hernia arises when, specifically, there’s a weak spot within the tissues that creates boundaries among the body’s different organs. Those weak spots elevate the chances of developing a hernia.

However, a hiatal hernia occurs through a diaphragmatic opening that naturally exists. As this opening widens, the chances of experiencing a hiatal hernia increase. In certain cases, a particular surgery, internal injury, or even a common birth defect can cause weakness, causing a hernia. 

However, in the majority of cases, a hernia results from cumulative damage over several years. Any action or agent that exerts excessive pressure in your abdominal cavity can cause wear and tear on your diaphragm. 

The following are some common causes that generate abdominal pressure and may give rise to hiatal hernia:

• Chronic coughing or sneezing
• Chronic obesity (BMI or body mass index more than 30)
• Frequent vomiting
• Constipation or chronic straining to poop
• Heavy lifting or intense workout
• Pregnancy and childbirth 

However, in most scenarios, a hiatal hernia is not severe. Even most of them do not exhibit any symptoms. Therefore, an individual may never learn about having this medical condition. Symptoms only become prominent when the hiatal hernia is prominent.

When it comes to the risk factors, a hiatal hernia is more likely to occur among women and men who are overweight or those who are above the age of 50. 

Symptoms of a Hiatal Hernia

As mentioned, most people with hiatal hernia do not even get to experience any symptoms. However, others can go through:

• Heartburn caused by gastroesophageal reflux disease (GERD)
• Bloating
• Burping
• Frequent chest pain
• Trouble swallowing
• A stomach upset or frequent vomiting 
• Backflow of liquid or food into the mouth from the stomach
• Bad or sour taste in the mouth

Moreover, individuals can suffer from shortness of breath if a hiatal hernia is compressing their lungs. Therefore, people should immediately go see a doctor when they suspect they may be experiencing:

• Noticeable pain in their belly or chest
• Frequent scenarios of stomach upset
• Difficulty in pooping or passing gas
• Vomiting

All these signs may indicate a strangulated hernia or similar obstructions, which can later on develop into medical emergencies. 

Diagnosis of Hiatal Hernia

Doctors detect hiatal hernias by referring to the images of the stomach and oesophagus. In most cases, hiatal hernias emerge as an accidental finding during the diagnosis of another medical condition. Otherwise, if they are actively looking for the issue, then probably because the body has shown signs of acid reflux. 

If the doctor suspects the persistence of a hiatal hernia, they may start the diagnosis with an oesophagal potential of hydrogen (pH) test. This test helps confirm whether the oesophagus is filled with gas or not. If the doctor notices gas, several imaging tests need to be conducted to find out the root cause behind the scenario. 

Medical examinations that are suggested to diagnose a hiatal hernia comprise of:

• Chest X-Ray

A radiograph or chest X-ray is useful for taking still, black-and-white pictures of the inner parts of an individual’s chest cavity. This technology relies on radiation to secure images of the oesophagus. 

• Upper Endoscopy

In this method, a slender tube equipped with a miniature camera enters the oesophagus and stomach during an upper endoscopy. This setup produces real-time visual depictions that are shown on a monitor.

• Esophageal Manometry

In this test, a catheter is attached to a person’s oesophagus to collect pressure measurements of the surrounding muscles. This device converts the raw data into a topographical pressure map. 

• Esophagram

An esophagram is a video X-ray used by doctors to check the inside of an individual’s oesophagus when they swallow food. It captures real-time footage of the inside of the oesophagus. 

Treatment Options for Hiatal Hernia

To establish the most effective long-term treatment strategy, the healthcare provider will conduct a comprehensive assessment of the hernia’s nature, reflux patterns, and underlying symptoms. The resulting treatment options include:

• Cautious Observation 

When the hernia is not causing harm, it may not require treatment. However, your healthcare provider will keep a cautious eye on the situation. In most cases, if proper precautions are not taken, the hernia is expected to grow bigger over time. 

• Medications for Hiatal Hernia

Medicines cannot cease acid reflux. However, they can minimise the acidity in the gut. This lowers the effects of acid reflux and relieves any pain associated with it. For less frequent reflux episodes, people can rely on over-the-counter (OTC) antacids. However, chronic reflux necessitates a prescription for long-term, daily medication. 

Physicians typically prescribe proton pump inhibitors (PPIs) to manage the effects of hiatal hernia. PPIs effectively inhibit acid-related damage to the oesophagus. They do not, however, address regurgitation or impede the progression of a hiatal hernia.

• Surgery

Minor surgical processes can be the key to curing a hiatal hernia. However, if the procedure is optional, individuals can decide whether to proceed. In most cases, the situation only worsens. Thus, some people plan the surgery sooner, while some plan it later.

Medical professionals advise surgical intervention for hernia repair under the following conditions:

• The hernia produces symptoms or complications that pharmaceutical treatments cannot alleviate.
• Medicinal treatments that are effective may induce adverse effects on a patient’s health or quality of life.
• A hernia presents a substantial risk of future severe complications due to its size.

Hiatal hernia surgery cures the hernia and reflux through these actions:

• Surgeons reposition the stomach and lower oesophagus beneath the diaphragm.
• They also close the diaphragmatic opening through which the hernia protrudes.
• Finally, the surgeons tighten the connection between the stomach and the oesophagus.

This surgical process, termed fundoplication, involves manipulating the stomach’s fundus. During fundoplication, surgeons encircle the lower oesophagus with the fundus and secure it using surgical staples or sutures. 

This action strengthens the lower oesophagal sphincter, the muscle separating the stomach and oesophagus. Surgeons prioritise minimally invasive laparoscopic techniques whenever feasible.

FAQs about Hiatal Hernia 

1. What is the best treatment for hiatal hernia?

To prevent hiatal hernia, individuals should eat meals at least three to four hours before lying down. They should also eat moderate to small portions and maintain a healthy body weight.

2. What does a hiatal hernia feel like?

Type I hiatal hernia does not cause any symptoms. However, in advanced stages, the concerned individual can experience heartburn, burping, vomiting, nausea, and so on. 

3. Do bananas help hiatal hernia?

Yes, bananas, apples, and other types of non-citrus fruits are often prescribed to people with hiatal hernia. Some other foods that individuals can include in their diet are lean meats like chicken and turkey, crackers, rice, breads, and pasta. 

4. What is a stage 4 hiatal hernia?

In stage 4, hiatal hernia, the stomach, alongside other abdominal organs such as the spleen, colon, or small bowel, moves into the thoracic cavity due to a substantially widened oesophagal hiatus. Medical experts also refer to this condition as a ‘giant’ or ‘complex’ hiatal hernia.

5. Is hernia 100% curable?

Hernias are very common and can be treated completely. With an appropriate surgical procedure, doctors can fully cure hernias and allow people to return to their normal lifestyles. 

Conclusion

Hiatal hernia surgery is considered low-risk with minimal complications. However, depending on their condition and the type of surgery they underwent, the patient may still need a day or two to recover. Follow DocTutorials for more such informative blogs on medical topics that can assist you in your NEET PG exam 2025 preparation.