Hiatus Hernia | Fundoplication | Surgery for Hiatus Hernia | Cure for Hiatus Hernia | Punjab | India

STAR Hospital - Region's First Super-Specialist Centre for Bariatric Surgery | Weight Loss Surgery | Metabolic Surgery | Diabetes Surgery

Dr. Jasmeet Singh Ahluwalia
(MS, FNB-MAS, FBMS)
Super-Specialist Bariatric, Metabolic & Advanced Laparoscopic Surgeon

STAR Hospital
9A, Link Road
Jalandhar-144003
India

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HIATUS HERNIA

What is a hiatal hernia?

In this condition where upper part of stomach is pulled into chest and now lies in chest rather than abdome. Normally stomach lies in abdomen (tummy). Food pipe joins stomach after coming out from chest through diaphragm (which separates chest from abdomen). Once stomach goes to chest, this disturbs the mechanism that prevents reflux of acid and food back into food pipe and leads to all the symptoms felt by such patient. The opening through which food pipe passes to reach abdomen is call hiatus and hence this condition is called Hiatus Hernia.
This condition mostly occurs in people who are over 50 years old but can happen at any age. These days many young people are seen to be suffering from this condition and require surgery.

Types of hiatal hernia:

Sliding hiatal hernia
This is the most common type of hiatus hernia. Stomach and food pipe (esophagus) slides into the chest through the hiatus opening.

Fixed hiatal hernia (Paraesophageal type)
The junction of food pipe and stomach stays in abdomen but part of stomach moves into the chest just parallel to the food pipe from the hiatus.

What causes a hiatal hernia?
The exact cause may not be evident in most cases. Still some cases may be related to:

Prolonged coughing
Prolonged vomiting
Chronic constipation
Heavy weight lifting
Can be a defect at birth as well
Obesity
Old age
Smoking

Symptoms:
Heartburns – especially on lying down
Reflux of acid or food into chest or mouth
Chest heaviness or pain
Belching
Feelling of vomiting or vomiting

GERD vs hiatal hernias:
Gastroesophageal reflux disease is said to occur when food from stomach enters back into food pipe. The cause behind this may or may not be Hiatus Hernia.

Tests for Hiatus Hernia:

Endoscopy
This is the gold standard and most commonly done test for Hiatus Hernia these days. A long flexible scope is inserted into from mouth via food pipe into stomach and hernia can be directly seen. Any complication due to hernia can also be seen.

Other tests like barium X-ray are not common these days.

Lifestyle changes:
Eating smaller meals split across several times a day instead of three large meals may help
Avoid any form of spices
Avoid oily food like parantha, samosa etc.
Decrease oil in sabzi
Avoid tea and coffee
Avoid alcohol, smoking
Avoid mint and chocolate
Avoid too citrus food like lemon juice, mosanbi juice etc
Do not sleep prone (belly down)
Avoid lifting heavy weight
Avoid tight clothes tied across abdomen
Treatment options for hiatal hernias:
If the hernia is small (under 2cm) and is not causing any symptom, it may not require any surgery. But if it is big (over 2cm) and especially if it is causing symptoms, it may require surgery. Medicines may be able to decrease symptoms of hernia but can not cure it. If left untreated, size of hernia may increase with time and become more difficult to operate upon.

Surgery:
You must seek an opinion from a surgeon who performs such type of surgeries if you require surgery for this disease. Since such surgeries are not being performed by all surgeons, you may not get a satisfactory reply from all doctors regarding need of surgery.

Laparoscopic Fundoplication:
This surgery is done by key hole method and hence there will be no big cut on abdomen (tummy). Migrated stomach is brought back into abdomen, loose hiatus is tightened and a wrap of upper stomach is created around food pipe to form a new valve to prevent reflux of food into food pipe. This is the most common surgery being done worldwide for hiatus hernia and gives excellent results. There are subtypes of this surgery which you may discuss with your surgeon before surgery.

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