The oesophagus (gullet/food pipe) normally passes through a small opening in the diaphragm (breathing muscle) to enter the abdomen. The size of the opening plays an important role in the effectiveness of the anti-reflux barrier preventing gastric acid from entering the oesophagus (and causing heartburn). Due to a variety of factors (like advancing age, obesity, constipation, chronic cough, etc.) the opening in the diaphragm can enlarge and lead to a hernia developing.
What are the related symptoms of Hiatal hernias?
Hiatal hernias are mostly asymptomatic but can lead to the development of heartburn and/or regurgitation of food. Other symptoms of Hiatal hernias may include:
How are hiatus hernias treated?
Occasionally these hernias can become quite large, and a part of or even most of the stomach can herniate into the chest. Most patients with small hiatus hernias and heartburn will respond well to medical therapy such as antacids to neutralize stomach acid (H-2 receptor blockers or proton pump inhibitors are used to block acid production and neutralise heartburn symptoms). Large symptomatic hernias will mostly need to be surgically corrected. Dr Cooper may recommend surgery if a part of your stomach squeezes through the hiatus hernia; this condition is called a para-oesophageal hernia. During the procedure, Dr Cooper makes small incisions in your abdomen where he will pass through a laparoscope. This sends images of your internal organs to a monitor to help guide him through the procedure. He will then pull the stomach out of the chest cavity down into your abdomen and then resect the hiatal hernia sac. The surgeon will then close the diaphragmatic opening and perform an anti-reflux procedure. Hiatal hernia surgery should be performed via a laparoscopic approach to minimize morbidity but can be very challenging.