Hiatal Hernia

Hiatal hernia

        Hiatal hernia is one of the most common types of hernias in the world. By the time people reach the third quarter of their life, after the age of 65 or so, almost 60% of persons are suffering from hiatal hernia to some degree, diagnosed or not. It is not exactly a condition you can miss, since it is known for being very painful in some stages.

       But what exactly is hiatal hernia? Well, the answer might be slightly confusing if you have little to no knowledge of anatomical details of your abdominal and chest cavity. In a few phrases, here is the explanation: your chest cavity is separated from your abdominal cavity by a membrane called diaphragm. This membrane has an orifice for the esophagus (the tube that connects your throat with your stomach) to pass through. When you suffer from hiatal hernia, the diaphragms' orifice is enlarged due to a weakening of the muscular fibers that keep it closed. That opening (called a herniation) not only allows your esophagus to pass, but also a portion of your stomach to enter your chest cavity. Obviously, your upper stomach has no business outside your abdominal cavity and, therefore, its entrapment by the herniation causes all sorts of problems.

       Hiatal hernia has been studied by many specialists and they have agreed that there are two different types of this condition:

• The sliding hiatal hernia: this is the less serious kind of hernia, since, just like the name suggests, it is reversible. During periods of stress, intense physical activity or emotional turbulence, the portion that connects your stomach to your esophagus slides through the orifice of the diaphragm, causing the patient severe and sharp pain. Once the excitement factor disappears, your upper stomach goes back into your abdomen and the pain stops. Do not be fooled, this does not mean you are cured. It simply means that you have a less severe form of hiatal hernia.
• The fixed hiatal hernia: also called paraesophageal hernia, its name describes it very well. It is the meaner sibling of the sliding type, implying that once a portion of your stomach passes through the herniation, there is no going back. Your upper stomach gets stuck in your chest cavity and the pain is permanent.

Hiatal hernia pictures

Hiatal hernia causes

        There are no certain causes for hiatal hernia, since it appears to a very large number of people that do not seem to have much in common. However, here are the most probable culprits:

• Obesity: this represents a sort of "double - trouble". On the one hand, the fatty tissue presses on your stomach, forcing it to seek the only relief it can and go up through your herniation. On the other hand, your stomach is already enlarged and has no more space to grow in the abdominal cavity. Therefore, it will penetrate the orifice of the diaphragm, causing hernia.
• Physical posture: if your posture is not correct, that means if you keep slouching or walking too stiff, your upper body will press on your abdomen, leading to your stomach moving a few centimeters up and, eventually, to hiatal hernia.
• Frequent coughing, straining with constipation, bending over and heavy lifting on a daily basis: all of these physical activities cause your diaphragm to move up and down too often for your esophagus to move along all the time. At some point, the membrane will get stuck on the upper portion of the stomach and cause your problems.
• Congenital defects: there are children born with a larger than normal herniation or stomach. These defects are corrected by surgery days after the birth.

Hiatal hernia symptoms

        The reason why hernia is such an easily ignored disease (that is until it hurts even at the slightest move) is because, in its early stages, it has no discernible symptoms. At least by non - specialists. The medical doctors have compiled a list of signs that you might want to watch for:

• Heartburn: it is a natural effect of your stomach getting closer and closer to your chest cavity. The stomach acid will easily penetrate its walls and cause burns in your esophagus.
• Chest pain or pressure: well, your chest cavity has only so much space inside. The stomach is not supposed to be there, so once it gets there, it causes pressure and pain due to the enlargement of the herniation.
• Difficulty swallowing and coughing: again, this is due to the modifications suffered by your chest cavity.
• Hiccups: this is a very interesting symptom, since it points to the exact moment that your hernia has started. Once the stomach enters the chest, your esophagus is squashed and, therefore, is no longer straight. The food that enters your throat is not led through a straight passage, but a rather curvy one, giving time to air to enter as well. The elimination of the unwanted air is called a hiccup.

Hiatal hernia treatment

        In its early stages, this type of hernia is not exactly life - threatening, just bothersome. To avoid its evolution into a dangerous condition, you should consider the following self - care tips:

• Minimize heavy lifting, straining and bending over.
• Improve your physical posture.
• Exercise more often.
• Lose weight.
• Change your lifestyle and your diet. You should avoid: coffee, chocolate, fried or fatty foods, peppermint and alcohol.
• Over - the - counter remedies: be sure to check with your attending physician if you are pregnant, have other medical conditions or are taking other drugs before you start home - therapy. The recommended OTCs' are antacids.