Understanding Hiatus Hernias
What is a Hernia?
A hernia occurs when an organ or tissue pushes through an opening in the muscle or connective tissue that normally holds it in place. In the case of an abdominal wall hernia, the intestine or other abdominal contents protrude through a weakened section of the abdominal wall. Hernias can be either congenital (present at birth) or acquired (developed over time due to various factors).
Causes and Risk Factors of Hernia
Hernias may form due to a failure of the abdominal lining to close properly before birth. They can also result from degeneration of connective tissue, leading to increased abdominal pressure and the formation of a bulge. Several factors contribute to hernia development or worsening, including:
- Chronic cough
- Obesity
- Constipation
- Pregnancy
- Poor nutrition
- Smoking
- Straining or lifting heavy objects incorrectly
What is a Hiatus Hernia?
A hiatus hernia occurs when part of the stomach pushes through the diaphragm—a muscular sheet separating the lungs and chest from the abdomen—and protrudes into the chest cavity. This condition can affect people of all ages and is relatively common.
Types of Hiatus Hernias
Hiatus hernias come in different forms, including:
- Sliding Hiatal Hernia – The stomach and the oesophagus move up through the diaphragm.
- Rolling Hiatal Hernia – The stomach itself rolls up into the chest cavity.
- Mixed or Complex Hiatal Hernia – A combination of both sliding and rolling types.
- Size Variations – Hernias can range from small (about 1 cm) to cases where the entire stomach moves into the chest.
Symptoms of Hiatus Hernia
While some people may experience no symptoms, common symptoms include:
- Chest pain
- Heartburn
- Belching
- Hiccups
Diagnosis of Hiatus Hernia
Doctors diagnose hiatus hernia through:
- Physical examination
- CT
- Endoscopy – A procedure using a thin, flexible tube with a camera to examine the oesophagus and stomach.
Understanding the nature of hiatus hernia and recognizing its symptoms can help in early diagnosis and treatment, improving patient outcomes.
Treatment
Surgery is the best treatment for hiatal hernias as they can increase in size over time. The concern is not only worsening symptoms but that the stomach can get entrapped in the chest and have a restricted blood supply which may affect the blood supply to the stomach and therefore ischaemia.
Hiatal hernia repair is usually performed as a keyhole operation with a one-night stay in hospital.
