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What Can a Doctor Do for a Hiatus Hernia?

A hiatus hernia, commonly referred to as a hiatal hernia, occurs at the opening in the diaphragm where the esophagus joins the stomach. A part of the stomach pushes through this opening and causes a hiatus hernia. Treatment will depend on the size of the hernia and the symptoms the patient is experiencing.

  1. Treatment

    • A small hiatus hernia does not usually cause any symptoms. Larger hernias will cause symptoms as stomach acids back up into the esophagus. Heartburn, chest pain, belching, and nausea are common symptoms. Physicians usually discover the hiatus hernia when attempting to diagnosis the cause of heartburn, upper abdominal pain, or chest pain. Two procedures used to diagnose hiatus hernia are the barium x-ray and the endoscopy. Once the hiatus hernia is diagnosed, treatment can help relieve symptoms. Certain medications can be prescribed to neutralize stomach acidity, help strengthen the muscle that prevents acid from backing up into the esophagus and to decrease acid production. Antacids can be used to help neutralize acid and stop heartburn. H-2 blockers reduce the amount of acid secreted by the stomach. Proton pump inhibitors block acid production and allow time for esophageal tissue to heal. These medications can be taken alone or in conjunction with one another. Physicians commonly recommend that patients avoid large and heavy meals and avoid lying down or bending over after eating. Not smoking and weight loss is also recommend if applicable to the patient. If medications and recommendations fail to control the symptoms of the hiatus hernia, surgical options might be necessary. Surgery can consist of either pulling the stomach down into the abdomen and making the opening in the diaphragm smaller, reconstructing the esophageal sphincter, or removal of the hernia sac.

    Complications

    • Hiatus hernias can be easily treated with the proper medications and, if needed, surgery. A complication of a large hiatus hernia is gastroesophageal reflux disease, commonly referred to as GERD. Reflux that is left untreated or recurrent GERD can lead to serious complications. A patient can experience difficulty swallowing and can develop Barrett's esophagus. This is a condition in which the esophagus has had repeated, long-term exposure to stomach acid. Patients who are diagnosed with Barrett's esophagus need to be followed closely by a gastroenterologist because they are at an increased risk for esophageal cancer. The majority of patients with Barrett's esophagus do not develop esophageal cancer. However, an esophageal tumor makes swallowing a difficult task and patients eventually patients may lose the ability to swallow. Patients should always notify a physician if symptoms worsen or new symptoms develop.

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