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Hiatal hernia


The hiatal hernia is a condition that sometimes no symptoms, others may manifest acidity related gastroesophageal reflux (GER). Although there appears to be a link, one condition does not appear to cause the other, because there are many people with a hiatal hernia without GER and vice versa.

Sometimes the resulting symptoms include chest pain, which can be mistaken for a heart attack. That is why it is so important to undergo the corresponding tests and obtain a proper diagnosis.

Below, we detail the nature of this condition in greater detail, with special attention to the symptoms of a hiatal hernia and its treatment .

Types of hiatal hernia

There are two main types:

  • Sliding : The stomach and the section of the esophagus that joins it slide into the chest through the hiatus. This is the most common type.
  • Paraesophageal (next to the esophagus): less common, but more concerning. The esophagus and stomach remain in their normal location, but part of the stomach contracts through the hiatus and places it next to the esophagus. Although it may not show any symptoms, there is a danger that the stomach will strangle or cut off the blood supply.

Symptoms of a hiatal hernia

In reality, a hernia alone does not usually cause clear consequences that can be understood as symptoms. Its detection usually occurs incidentally , when a person undergoes a chest or abdominal X-ray (including upper GI series and CT scans, where the patient ingests barium or other contrast material).

It is also found incidentally during gastrointestinal endoscopy of the esophagus, stomach, and duodenum (EGD).

If symptoms do occur, they are due to gastroesophageal reflux disease (GER), where digestive juice containing stomach acid travels up the esophagus.

Symptom appearance process

Food mixes with digestive secretions in the stomach, to start the digestive process. This organ has a protective coating that prevents acid from causing inflammation. However, the esophagus does not have similar protection. Instead, it uses an esophageal duct or lower sphincter (LES), a band of muscle located at the connection to the stomach and esophagus. It also uses the musculature of the diaphragm around the esophagus to act as a valve that prevents acid from flowing back from the stomach into the esophagus.

Also, the normal location of the stomach and the esophageal junction within the abdominal cavity are important to keep the acid in place. In the situation of a sliding hiatal hernia, the GE junction moves above the diaphragm and into the chest, and the part of the area of ​​increased pressure due to the diaphragm is lost .

The acid is allowed to reflux back into the esophagus, causing inflammation of the lining of the esophagus and the symptoms of gastroesophageal reflux disease (GER).

These symptoms can include :

  • Heartburn: pain or burning in the chest.
  • Nausea, vomiting, or nausea (retching).
  • Content.
  • Appearance of a large amount of saliva in the mouth that is stimulated by the refluxing acid.

Symptoms are usually worse after meals and during sleep and are reduced by sitting or walking.

There are people for whom reflux into the lower esophagus causes coughing and jerking movements in the small airways inside the lungs ( asthma ).

Some patients may reflux drops of acid in the back of the throat, which in turn reach the lungs, resulting in coughing, asthmatic processes, or infection resulting in pneumonia or bronchitis. This can occur in people of all ages, from infants to the elderly, although it is rare.

Most paraesophageal hernias do not have reflux symptoms because the GE junction remains below the diaphragm, but if the hernia is large, the way the stomach rotates in the chest there is the possibility of stomach volvulus in which the stomach is twists. Fortunately, paraesophageal hernias are relatively rare. However, stomach volvulus is a surgical emergency and causes difficulty swallowing, chest pain, and vomiting.

Causes of a hiatal hernia

Most of the time, the cause is not known . There are people who have a wider hiatus in their opening area and, in other cases, the pressure to which the abdomen is subjected during pregnancy or due to excess weight, in the case of obese people, also cause it.

Having a strong cough or exerting a lot of effort when defecating can also be a trigger. Women, overweight people and people over 50 years of age are the most affected groups.

How is it diagnosed?

With a specialized x-ray (using barium) that allows the doctor to view the esophagus or with an endoscopy.

Tips to cope with this ailment

There are a number of recommendations to improve the quality of life when suffering from this ailment. Among them are the following:

  • Avoid intense physical effort.
  • No Smoking.
  • Sleep a little incorporated.
  • Wear comfortable clothes and avoid pressure on the stomach.
  • Lead a relaxed lifestyle, avoid stress .

Most people do not experience any hiatal hernia symptoms so no treatment is necessary. Yes it is in cases such as paraesophageal hernia (when part of the stomach contracts through the hiatus), and sometimes surgery is even recommended. But in most cases, following the recommendations is enough to cope with the hiatal hernia and avoid more complicated treatment. However, people diagnosed with severe chest or abdominal pain, nausea, vomiting, defecation, or gas may have a strangulated hernia or obstruction, which are medical emergencies . Therefore, it is recommended to go to the doctor immediately.


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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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