Hiatal hernia and its effects
Hiatal hernia is a condition where the upper part of the stomach bulges through the opening in the diaphragm called the hiatus, and into the chest cavity. This can occur due to a weakening or a tear in the diaphragm muscles. Hiatal hernia is quite common, affecting up to 60% of people over the age of 50, but many people don’t experience any symptoms.
There are two types of hiatal hernia: sliding and paraesophageal. Sliding hiatal hernia is the most common type, accounting for 95% of cases. In this type, the gastroesophageal junction (where the esophagus meets the stomach) and part of the stomach slide up into the chest through the hiatus. Paraesophageal hiatal hernia is less common but can be more serious. In this type, a portion of the stomach protrudes through the hiatus and sits next to the esophagus, without sliding up into the chest.
Many people with hiatal hernia don’t experience any symptoms. When symptoms do occur, they can be similar to those of gastroesophageal reflux disease (GERD). Common symptoms of hiatal hernia include:
Heartburn: This is a burning sensation in the chest or throat, caused by acid reflux from the stomach.
Chest pain: This can be a sharp, intense pain in the chest that may be mistaken for a heart attack.
Difficulty swallowing: This is due to the stomach pushing up into the chest and putting pressure on the esophagus.
Belching: This is a release of gas from the stomach through the mouth, which can be caused by acid reflux.
Shortness of breath: This can occur due to the herniated stomach putting pressure on the diaphragm.
Nausea or vomiting: This can occur if the hernia is causing a blockage in the stomach or if acid reflux is severe.
GERD: Hiatal hernia can lead to GERD, a condition where stomach acid flows back up into the esophagus, causing heartburn and other symptoms.
Esophagitis: Chronic acid reflux from a hiatal hernia can cause inflammation of the esophagus, leading to esophagitis.
Stricture: Long-term inflammation of the esophagus can cause narrowing, or stricture, making it difficult to swallow.
Barrett’s esophagus: In some cases, chronic acid reflux can damage the lining of the esophagus, leading to a condition called Barrett’s esophagus, which increases the risk of esophageal cancer.
Anemia: Hiatal hernia can lead to bleeding in the stomach, which can cause iron deficiency anemia.
Respiratory problems: The herniated stomach can put pressure on the diaphragm and lungs, causing shortness of breath, chronic cough, and other respiratory problems.
Treatment for hiatal hernia depends on the severity of symptoms and the type of hernia. Mild cases can often be managed with lifestyle changes and over-the-counter medications. These include:
Weight loss: Losing excess weight can reduce the pressure on the stomach and help alleviate symptoms.
Diet: Avoiding trigger foods, such as spicy or fatty foods, can help reduce acid reflux.
Elevating the head of the bed: Sleeping with the head elevated can help reduce acid reflux.
Medications: Over-the-counter antacids, such as Tums or Rolaids, can help neutralize stomach acid. H2 blockers, such as Pepcid or Zantac, can reduce the production of stomach acid.