Hiatal hernia or paraesophageal hernias are common and are often the cause of reflux symptoms (GERD). A hernia occurs when one part of your body pushes into an area in which it does not belong. A hiatal hernia, is when your stomach pushes into your chest through an opening in your diaphragm called the hiatus.
There are four types of hiatal hernias:
- Type I or sliding hiatal hernia – your stomach and a portion of your esophagus slide up and down into your chest
- Type II or paraesophageal hernia – less common but more serious type of hernia. The upper part of your stomach slides up by your esophagus into your chest and remains there.
- Type III – the most common type of hiatal hernia. When any portion of your stomach and sometime the entire stomach slides up into your chest and remains there.
- Type IV – a hernia involving your stomach and other organs such as small bowel, colon, etc.
Symptoms of Hiatal Hernias
Symptoms may include:
- Indigestion and heartburn
- Regurgitation
- Chest pain
- Difficulty swallowing
- Nausea and vomiting
- Shortness of breath
- Early satiety
Causes of Hiatal Hernias
Hiatal hernias may develop by conditions that cause increased pressure on your abdomen. This may include:
-
Persistent cough
- Severe constipation
- Obesity
- Pregnancy
- Trauma to the area
Diagnosing Hiatal Hernias
Tests that may be used when diagnosing hiatal hernias include:
Treating Hiatal Hernias
Hiatal and paraesophageal hernias are repaired with surgery.
Laparoscopic surgery repair of hiatal hernia
During laparoscopic surgery, several small incisions are made in your abdomen. These are used to insert surgical instruments and a laparoscope – a small thin tube with a video camera attached that allows your surgeon to see inside your body during surgery.
To fix the hernia, the stomach is moved into its proper position in the abdomen and the opening in the diaphragm allowing it to move out of place is closed.
Once the stomach is in the correct position an anti-reflux procedure must be performed.
Anti-Reflux Surgical Procedure Options: