Hiatus is a natural opening in the diaphragm, a muscular wall that separates the chest region and the abdominal region. Through this Hiatal opening the oesophagus (food pipe) and major blood vessels gets inside the abdominal region to join the stomach. If the hiatus opening is larger, then the stomach begins to get into the chest region due to the breach in the hiatus.
Types of Hiatal Hernia
There are two types of Hiatal Hernia, sliding and paraesophageal. In a sliding hiatal hernia, the stomach and the oesophagus attached to the stomach slide up through the hiatal opening into the chest region. In a paraesophageal hernia, part of the stomach gets squeezed through the hiatal opening into the chest region. This hiatal hernia type is of more concern as the strangulation of the stomach part that has slide into the chest region is quite a possibility. Strangulation can lead to cut in blood supply and it can lead to life threatening situation.
Symptoms and Diagnosis of Hiatal Hernia
More often there are no symptoms produced at all if the hiatal hernia is of sliding type. Sometimes people may experience heartburn due to the acid reflex. Sometimes the heartburn can be confused as a chest pain due to the proximity to the heart. A proper diagnosis should settle if the condition is hiatal hernia.
An endoscopy reveals if the patient has hiatal hernia. Sometimes a specialized X-ray is employed to find the position of the oesophagus through which the presence of hiatal hernia is confirmed.
Hiatal Hernia Surgery
If the hiatal hernia is a sliding type, it often does not produce any symptoms and normally no surgery is done as it does not poses any risk or danger. If the opening is very large or has caused strangulation of the stomach region in the diaphragm only then a surgery is mandated.
Advanced laparoscopic surgical methods are used by gastro surgeons to rectify hiatal hernia conditions. Three to five keyhole incisions are made in the abdomen region to get the strangulated stomach to its normal position. The surgery would also involve tightening the hiatal opening to prevent the occurrence of hiatal hernia.
Post-op on Hiatal Hernia Surgery
The patient can experience difficulty in swallowing for few months after the surgery. Gas bloating is also common after surgery and this may be present for few days after the hiatal hernia surgery.
Can Hiatal Hernia Recur?
Sometimes yes. It should be understood that hiatal hernia is caused by physiological and genetic reasons. Factors like strong coughing, bowel movements and obesity can also induce the hiatal hernia to return. The return has nothing to do with the quality of surgery but it has more to do with the physiology, genetics and lifestyle of the patient.
Dr Maran is an experienced Surgeon in the field of Gastro-enterology. He specializes in Advanced laparoscopic Surgery procedures of the gastro-intestinal (GI) tracts. Dr. Maran is also a leading Bariatric Surgeon in Chennai and has a penchant for addressing problems concerning Obesity.