Talking about issues related to the stomach or any other organ that is part of the digestive system has become very common among people of all ages who want to have healthier habits.
The hiatal hernia, for example, a name that may be new to you, is a topic that has gained a lot of attention because it is a common finding in endoscopic or imaging exams.
But, you may be wondering… “What is a hiatal hernia? What are the main symptoms? How to diagnose? What are the most appropriate treatments? How to prevent?”
It may seem strange when we hear this name for the first time, but know that it is something common. Thinking about helping you to know more about the hiatal hernia, we have prepared an updated content rich in information that will keep you informed about everything.
Let’s go together!
What is a hiatal hernia?
Initially, it is important to say that the diaphragmatic hiatus is an opening in the diaphragm (breathing muscle that separates the chest from the abdomen) that opens for the passage of food from the esophagus to the stomach, in addition to important veins and arteries of our body.
Being very direct, the hiatal hernia is when a small portion of the stomach, which should always be completely inside the abdomen, rises through the diaphragm and penetrates the chest, precisely when the hiatus is wider than usual.
This abnormality is the displacement or overflow of a small portion of the stomach into the chest, usually occurring in overweight people, the elderly, or smokers.
The most common types of hiatal hernia
The sliding hernia and the paraesophageal hernia are the two main hiatal hernias that exist. Shall we get to know them?
Sliding hiatal hernia
The sliding hiatal hernia is the most common and is found when the junction of the esophagus to the stomach, which should be in the usual position below the diaphragm, projects upwards. It is the most common type of hiatal hernia.
Paraesophageal hiatal hernia
The paraesophageal hiatal hernia is different from the sliding hernia. In this type of hiatal hernia, the junction of the esophagus to the stomach remains in its usual place, but a part of the gastric fundus (the highest part of the stomach) ends up entering the chest next to the esophagus (paraesophageal means next to the esophagus).
These two types of hernia can also appear together, being called mixed hernias, which are rarer.
What are the symptoms?
Before we talk about the most known symptoms, we need to understand in the first place that the appearance of the hiatal hernia is not an indication of some disease.
This is because the hiatal hernia itself is not yet considered a disease by modern medicine, so it is simply seen as a small change in the anatomy of the stomach.
Although the hiatal hernia is not yet considered a specific disease, it can facilitate the appearance mainly of reflux, a sign of (GERD) Gastroesophageal Reflux Disease.
So among the main symptoms are:
- constant belching;
- heartburn;
- chest pain;
- throat irritation followed by cough;
- regurgitation; and
- gastroesophageal reflux.
- In more severe cases, difficulty in eating
Remembering that many patients have a hiatal hernia, but do not present symptoms, only discovering after performing exams for other reasons.
The detail is that reflux can arise from several factors very similar to those of the hernia, such as: excess food, excess caffeine, smoking, excess physical exercise and obesity that is growing alarmingly in our country.
To avoid doubt, it is interesting to seek a specialist doctor and do the exams, ok?
How to diagnose?
The diagnosis of the hiatal hernia is very simple and can be done in a routine exam or even by more specific requests.
The exams normally requested to verify the existence of the hiatal hernia are endoscopy, manometry, esophageal pHmetry and contrasted radiography of the esophagus.
We cannot fail to emphasize that it is always important to visit the doctor regularly, even without presenting some of the symptoms already mentioned, after all, prevention still makes a lot of difference.
If you do not present the symptoms, but want to recover or maintain the health of the intestinal apparatus, visiting the doctor periodically is essential.
What are the treatment options?
In cases where the person presented some of the described symptoms of reflux and already has the diagnosis of hiatal hernia, the next step is to start corrective actions with the most appropriate treatment.
In simpler cases, the most indicated treatment is the use of medications such as antacids that directly combat the symptoms aiming at their reduction or the total elimination of symptoms related to reflux.
For more severe cases, where the reflux treatment is not responding adequately or there are more important symptoms, the specialist may request a laparoscopy surgery (which is a very well-known procedure and commonly used also for stomach reduction, gallbladder removal and appendicitis treatment), where the stomach is repositioned inside the abdomen and the opening of the diaphragmatic hiatus is reduced to the normal size, thus correcting the anatomical defect.
Good news is that, generally, the basic treatment with the use of medications reduces and even eliminates the symptoms, without the need for corrective surgery.
Prevention tips
Prevention is the first path to a healthier life and if the goal is to take some care with our health, the fact is that following some steps make a huge difference in the short and long term.
It seems like a cliché, but it’s the pure truth. Since you’ve come this far and want to know how to prevent a hiatal hernia, check out these super useful tips we’ve listed for you.
Some of the following tips are even very obvious and concern our behavior in small daily attitudes. Check out the list with me:
- avoid wearing tight clothes, especially in the abdominal region;
- avoid excessive consumption of spicy and fatty foods, alcohol, caffeine, chocolate, citrus fruits, tomato sauce and tobacco;
- avoid excess liquids during meals;
- fractionate the amount of food per meal;
- maintain the body mass index within normal standards (lose weight, if necessary); and
- seriously follow the treatment prescribed by the doctor.
If you also intend to have a more balanced routine and have a healthy life, do not stop following these steps.
These are actions that contribute a lot to the good state of our body and, consequently, to a healthier aging.
Conclusion
After learning many important information about the hiatal hernia, from the most recurrent related symptoms, to the main forms of treatment and prevention, you became curious and eager to learn more about the digestive system, didn’t you?
So, you are on the Gastroblog, the right place to stay informed about everything that involves the health of the digestive system.
The Gastroblog is a specialized site that provides updated and very well elaborated content based on solid information provided by the best and most renowned professionals in the area.
With a clear and didactic approach, we always provide guidance and tips to assist you in a totally online and free way.
Our mission is to help you always find the best answers to your doubts with what is newest in the area of medicine. We are looking forward to helping you.
Image by Robystarm from Pixabay
Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.