Hiatal Hernia Associated with Your GERD

Hiatal Hernia is the most common lesions of the gastrointestinal tract that makes Gastroesophageal Reflux a main suggestive symptom (burning behind the breastbone), especially if it is postural (pain increases when we increase the pressure on the abdomen).

What is Hiatal Hernia?

It is the permanent or intermittent passing of a portion of the stomach through the oesophageal opening (or gap) of the diaphragm. This passage of the upper end of the stomach into the hiatal orifice occurs when the fastening means of the lower esophagus and stomach are failing.

Hiatal Hernia is a stomach portion that passes through the diaphragm upwards, ending up in the chest. Normally, only the esophagus passes through a small hole in the diaphragm for this purpose: the hiatus. As for the stomach, it stays in place below the diaphragm in the abdominal cavity. In case of hiatal hernia, the stomach contents back much easier to the esophagus and may cause Gastroesophageal Reflux Disease (GERD). Hiatal hernia, however, does not always accompany GERD.

In 90% of cases, there is sliding upwardly cardia (upper part of the stomach) and leaving from the abdomen and in the thorax. The causes are for example an increase in abdominal pressure, obesity, congenital shortening of the esophagus.

In 10% of cases, there is turnover in the fundus of the stomach that passes through the diaphragmatic hiatus while the lower esophagus and cardia remain in place. The cause is usually a congenital defect of the gap of the diaphragm, it may also be a trauma.

Symptoms of Hiatal Hernia

Gastroesophageal Reflux Disease is the most suggestive symptom (burning behind the breastbone), especially if it is postural (pain increases when we increase the pressure on the abdomen). But other signs are these:

Pain when swallowing (dysphagia which threatens to esophagitis);A pain in the pit of the stomach;
A mild anemia with pallor and fatigue due to micro-gastrointestinal bleeding;
Venous thrombosis of the lower limbs (phlebitis);
Vomiting of blood (hematemesis).

Other diseases of the digestive tract are often associated and must be systematically sought: gallstones, ulcers, gastritis, diverticular disease. Similarly, it is usual to search for a Hiatal Hernia in the past.

Hiatal Hernia Treatment

The rules of hygiene and nutrition are the same as those treatments of GERD:

Lose weight if overweight.
Split food intake and do more 5 or 6 small meals and 2 snacks abundant.
Avoid soft drinks, spices, coffee, fats, and alcohol, dressing, fruit acids.
Avoid foods slow digestion as fatty food.
Avoid tobacco.
Take dinner long before bedtime and avoid naps after lunch.
Avoid wearing girdles, corsets and belts too tight.
Elevate the head of the bed.
Avoid leaning forward postures.

Treating esophagitis is necessary to prevent the formation of ulcers (wounds) on the mucosa of the esophagus. When these wounds heal, they can leave scars that impede or make it impossible to swallow. In some people, esophagitis long can cause Barrett's Esophagus, a condition that is a precursor of cancer. Most cases of esophagitis respond to antacids, lower weight as well as lifestyle changes.

In sliding hernias, surgical treatment is indicated only if there is an important and troublesome reflux despite the correct treatment or in Severe Esophagitis.

GERD Care