Hiatal Hernias-Cause, Symptoms and Treatment.

By Raymond Harper

What is a Hernia

Hernias are produced when there is a protrusion through a part of the body. Hernia’s can develop anywhere but are usually found in the stomach area when there is a tear or weakness in the muscle of the abdominal wall. The diaphragm is the muscle that separates the abdomen from the chest. There is a hole in the diaphragm through which the esophagus passes called the esophageal hiatus.A hiatal hernias occur in the esophageal hiatus where there is a protrusion through the diaphragm up into the chest. It is also know as a diaphragmatic hernia.

A hiatus hernia is a known factor in some individuals with Gastroesophageal reflux disease (GERD), but not all people with GERD have a hiatal hernia. Therefore the presence of a hiatus hernia does not mean you will automatically have acid reflux disease. But, many people who have a hiatus hernia also have acid reflux disease.

A hiatus hernia occurs in about 15% of the population but mostly cause no problem. You may never know you have one unless the doctor finds it while looking for something else usually when looking for symptoms of acid reflux. However larger hiatal hernias are different. When there is one present a small part of the upper stomach pushes up through the esophageal hiatus and into the chest. As a result the lower esophageal sphincter is not in the same position level with the diaphragm and this can be a factor in people having acid reflux disease.

The diaphragm and the LES seem to work in conjunction as a barrier to prevent acid reflux by contracting but relaxing when you swallow. When there is a hiatal hernia the LES moves into the chest it continues to contract but it is now not working in conjunction with the diaphragm contractions. It is believed that the pressure they once exerted together to form a powerful contraction are weakened thus allowing acid reflux to occur easier. This is one of the ways a hiatal hernia contributes to Gerd.

A second way in which a hiatus hernia may be involved in the production of acid reflux disease is when a portion of the stomach protrudes into the chest and is situated above the diaphragm and below the LES. In this situation stomach acid can be trapped near the esophagus and when the Les relaxes it is easier for the acid to enter the esophagus causing severe heartburn.

Another way that the hiatal hernia can contribute to acid reflux disease is at the juncture of the Les and the esophagus there is a flap of tissue that acts as a valve, opening to allow food to pass through and then shutting to prevent acid reflux. The hiatus hernia impairs or distorts this valve because the angle of the diaphragm and the Les have changed, and it is no longer effective in stopping stomach acid from refluxing into the esophagus.

Hiatal Hernia Causes

The cause of hiatal hernias is largely unknown but may be the result of a weakening of the supporting tissue. It is thought that it can be from a larger than normal esophageal hiatus which allows part of the stomach to protrude into the chest. Another factor could be the shortening of the esophagus.

Other possible causes can be after sustaining an injury to that area of the body; others are born with a weakness. Some experts suspect that increased pressure in the abdomen from coughing, straining during bowel movements, pregnancy and delivery may contribute to the development of a hiatal hernia. Obesity and lifting heavy weights can also contribute.

Hiatal Hernia Symptoms

Most small hiatal hernias do not produce any symptoms. But the larger hernias will most likely show the symptoms of gastro esophageal reflux disease (GERD). Acid reflux disease symptoms include Gastric reflux (backflow of stomach contents into the esophagus), A sour or bitter taste in the mouth, Frequent belching, Difficulty swallowing, Chest pain radiating from below the breastbone (heartburn), Feeling of pressure in the chest

At times, a hiatal hernia causes chest pain or upper abdominal pain when the stomach becomes trapped above the diaphragm through the narrow esophageal hiatus.

If you suffer from any or all of these symptoms it is best to consult your doctor for professional advice before acid reflux disease becomes Chronic. With some of these symptoms you should see your doctor immediately because severe GERD can turn into even more serious conditions. You may need acid reflux medication to combat GERD now.

Hiatal Hernia Types

There are two kinds of Hiatal Hernia:

The first of which 95% of people have is the sliding hiatal hernia, where the gastroesophageal junction moves above the diaphragm together with some of the stomach. Often this type of hernia moves into the chest only when swallowing.

The second kind is rolling or paraesophageal hiatal hernia, when a part of the stomach passes or bulges into the chest next to the esophagus and remain there at all times, they do not move, and complications can occur with this type of hiatus hernia.

Hiatal Hernia Diagnosis- Treatment- Complications