3 things you should know about hiatal hernias

We've all heard about hernias, but do we really know anything about them other than that they're kind of gross? There are several different types of hernias out there, as well as several different levels of severity. One of the most common hernias we come into contact with in our industry, however, is the hiatal hernia. If you suffer from GERD related symptoms, are overweight, or above 50, you're at higher risk for developing a hiatal hernia. Even if you don't necessarily fit into those categories, you could still be at risk. Here are a few basic things everyone should know when it comes to hiatal hernias. 

“What is a hiatal hernia?”

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in the surrounding muscle or connective tissue. In simpler terms, any time an internal body part pushes into an area where it doesn’t belong, that’s called a hernia. They’re actually more common that you might think, with over half a million hernia operations performed in the US each year, and many more hernias left untreated.

A hiatal hernia happens when part of the upper stomach squeezes through the hiatus, an opening in the diaphragm that the esophagus passes through. This is usually due to a combination of pressure and a weakness of muscle or fascia. There are two different types of hiatal hernias: sliding and paraesophageal. A sliding hernia occurs when the stomach and the part of the esophagus that joins the stomach slide up into the chest through the hiatus. In a paraesophageal hernia, the esophagus and stomach both stay in their normal place, but a small section of the stomach squeezes through the hiatus and ends up next to the esophagus. Paraesophageal hernias are the less common of the two, and in many cases are more dangerous.

“How can you tell if you have a hiatal hernia?”

Interestingly enough, there appears to be a link between hiatal hernias and patients who have GERD. Although one condition can occur without the other, they’re often seen together. GERD related symptoms are, in many cases, the reason why hiatal hernias are discovered in the first place. By itself, a hiatal hernia causes no symptoms. If a hiatal hernia patient does experience symptoms, they’re typically GERD related symptoms like heartburn, nausea/vomiting, or burping.

Most hernias are found incidentally, typically on x-rays or during endoscopies of the esophagus, stomach, or duodenum. In many cases patients will go in to be tested for GERD, only to find out that they also have a hiatal hernia.

“How do you get rid of hiatal hernias?”

Because there are no symptoms caused by hiatal hernias, they are often left untreated if they occur in conjunction with no other conditions. In severe paraesophageal hernia cases the stomach can become strangled. In cases like these, surgery may be necessary to reduce the hernia.

In cases where hiatal hernias are coupled with GERD, treatment for the hernia typically consists of treating the patient’s GERD and attempting to minimize their reflux.  There are many different treatment options for GERD, from simple changes in lifestyle and diet to medication or, in more severe cases, anti-reflux surgery.

Hiatal hernias can be kind of disturbing, but at the end of the day most of them are harmless. If you’re experiencing GERD-related symptoms or suspect you may have a hiatal hernia, the best thing you can do is to sit down with a reflux specialist and get tested. 

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