Hiatal Hernia – A Very Common Condition

by Dr. Ramalinga Kedika

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_8245b52a-b163-11e7-9720-079e5674f3e0.html

Patients often come to me very worried after having been told they have a hiatal hernia. A hiatal hernia is very common and often not a cause for alarm.

What is a hiatal hernia?

A hiatal hernia simply means that a part of your stomach is in your chest. Normally your stomach cavity is separated from your chest cavity by a muscle called the diaphragm. Defects in the diaphragm muscle lead to a herniation of the stomach into your chest.

Hiatal hernias are very common.

Up to half of all people in the western world will have a hiatal hernia. Approximately 70 percent of patients older than 70 years old will have one. And most people do not even know they have a hiatal hernia.

Does having a hiatal hernia cause problems? 

Generally it does not. Some patients with hiatal hernia will have acid reflux or heartburn. To this date, we still don’t know exactly what causes acid reflux. There is a sphincter muscle at the connection of the esophagus and stomach and it is thought that abnormal relaxation of this sphincter muscle allows acid to reflux into the esophagus. A hiatal hernia can displace the normal position of this sphincter and may contribute to acid reflux.

When does a hiatal hernia need treatment?

If you experience heartburn regularly, the first thing you should do is modify your dietary and lifestyle habits. If this is ineffective, acid reflux medications could be considered. Surgery to repair a hiatal hernia is an option, but this should be carefully considered with your doctors. Five percent of hiatal hernias are a more problematic para-esophageal hernia that has a small risk of becoming strangulated requiring emergency surgery … but this is rare.

What are the risk factors for a hiatal hernia and how is it diagnosed.

Age is probably the biggest risk factor. Some people may simply be born with a larger opening in the diaphragm muscle. Conditions which increase pressure in the abdomen can also lead to a hiatal hernia. Examples of these conditions include pregnancy, obesity, coughing and straining. Hiatal hernia can be diagnosed on radiology tests or upper endoscopy.

If you feel that you or someone you care about may have a hiatal hernia, visit with your primary care physician or call ProCare Gastroenterology at 432-640-3007.