Hiatus Hernia & GERD
What is Hiatus Hernia?
A hiatus hernia occurs when a part of the stomach pushes up through the diaphragm into the chest cavity. The diaphragm is a muscle that separates the chest from the abdomen, and the esophagus passes through an opening in the diaphragm known as the hiatus. When the stomach bulges through this opening, it forms a hiatus hernia. There are two main types of hiatus hernias:
What is GERD?
Gastroesophageal Reflux Disease (GERD) is a chronic digestive condition where stomach acid or, occasionally, bile irritates the food pipe lining. The condition occurs when the lower esophageal sphincter (LES), a ring of muscle that connects the esophagus and stomach, becomes weak or relaxes inappropriately, allowing stomach contents to flow backward into the esophagus. Over time, this reflux can cause inflammation, leading to symptoms and complications such as heartburn, regurgitation, and swallowing difficulties.
How Hiatus Hernia and GERD? are Linked
A hiatus hernia can increase the risk of GERD, as the hernia can cause the LES to malfunction. When part of the stomach moves upward through the diaphragm, it may push against the LES, impairing its function and allowing acid to flow back into the esophagus more easily. This is why many people with a hiatus hernia also experience GERD symptoms.
However, it is important to note that not all people with a hiatus hernia develop GERD, and vice versa. Each condition can occur independently of the other, but they often coexist, exacerbating symptoms.
Symptoms of Hiatus Hernia & GERD
The symptoms of hiatus hernia and GERD can be similar, and they often overlap, making it difficult to distinguish between the two conditions without proper medical evaluation.
Symptoms of Hiatus Hernia
- Heartburn: A burning sensation in the chest, often after eating or when lying down.
- Regurgitation: The feeling of food or acid rising into the throat or mouth.
- Chest Pain: Discomfort or a feeling of fullness in the chest, which can sometimes mimic heart problems.
- Difficulty Swallowing: A sensation of food being stuck in the chest or throat.
- Belching and Bloating: Feeling full or gassy, often after meals.
- Shortness of Breath: Occasional difficulty breathing, especially when lying flat.
Symptoms of GERD
Obesity results from a combination of factors, including:
- Heartburn: A recurring burning sensation in the chest, particularly after eating or lying down.
- Acid Regurgitation: A sour or bitter taste in the mouth due to stomach contents coming up into the throat
- Persistent Cough: A dry cough, especially at night.
- Sore Throat: Irritation or a feeling of a lump in the throat.
- Hoarseness: A raspy or muffled voice due to acid irritation in the throat.
- Chest Pain: A burning, tight sensation in the chest, which can be mistaken for a heart attack.
Diagnosis of Hiatus Hernia and GERD
Both conditions are diagnosed through a combination of medical history, physical examination, and diagnostic tests. Some common tests include:
- Upper Endoscopy (EGD): A thin, flexible tube with a camera is inserted through the mouth to examine the esophagus and stomach.
- Barium Swallow: A special X-ray that can reveal a hernia or abnormal reflux.
- Esophageal pH Monitoring: A test to measure acid levels in the esophagus and determine the severity of GERD.
- Manometry: This test measures the pressure and function of the esophageal muscles and LES.
Treatment Options for Hiatus Hernia & GERD
Lifestyle and Dietary Modifications
Treatment for hiatus hernia and GERD can vary depending on the severity of symptoms and the underlying causes of the conditions. The goal of treatment is to manage symptoms, prevent complications, and improve the patient’s quality of life.
- Weight Management: Reducing excess weight can decrease the pressure on the abdomen, which can help reduce symptoms of both hiatus hernia and GERD.
- Dietary Changes: Avoiding trigger foods like spicy, acidic, or fatty foods can help minimize reflux. Eating smaller, more frequent meals instead of large ones can also be beneficial.
- Elevation of the Head While Sleeping: Raising the head of the bed can help prevent acid reflux during sleep.
- Avoiding Alcohol and Tobacco: Both can relax the LES and increase the risk of reflux.
Medications
For GERD, doctors typically recommend medications that help reduce stomach acid and promote healing of the esophagus. These may include:
- Antacids: For quick relief of heartburn.
- H2-receptor antagonists: Medications that reduce stomach acid production.
- Proton Pump Inhibitors (PPIs): Stronger medications that block acid production and allow the esophagus to heal.
- Prokinetic Agents: These medications help strengthen the LES and improve stomach emptying.
Surgical Treatment
In some cases, when lifestyle changes and medications are insufficient to control symptoms, surgery may be required. The most common surgical procedure for hiatus hernia and GERD is
fundoplication. This procedure involves wrapping the top of the stomach around the lower esophagus to prevent acid reflux and repair the hernia.
In severe cases of paraesophageal hiatus hernia, surgery is necessary to reposition the stomach and prevent complications.
Prevention
While you can’t always prevent hiatus hernia or GERD, some lifestyle changes can help reduce your risk or minimize symptoms. These include maintaining a healthy weight, eating smaller meals, avoiding foods that trigger reflux, and staying upright after meals.
Hospital Address
Max Super Speciality Hospital W-3, Ashok Marg, Sector-1, Vaishali, Ghaziabad, UP
FAQs
Yes, a hiatus hernia can increase the risk of GERD because it can impair the function of the lower esophageal sphincter, allowing stomach acid to flow back into the esophagus.
If left untreated, GERD can lead to complications like esophagitis (inflammation of the esophagus), ulcers, bleeding, and even an increased risk of esophageal cancer.
No, surgery is typically considered only for severe cases where lifestyle changes and medications do not provide relief. Most cases can be managed with medication and lifestyle adjustments.
Not necessarily. Surgery is an option for severe cases, but many individuals benefit from a combination of diet, exercise, and behavioral therapy.
Yes, with proper treatment and lifestyle changes, most people with hiatus hernia and GERD can lead normal, active lives. It's important to work closely with a healthcare provider to manage symptoms.