Hiatal hernia is a common problem, especially as we age, as its incidence increases significantly after the age of fifty.
In this condition, part of the stomach pushes through an opening in the diaphragm, the muscle that separates the chest and abdomen, which can cause uncomfortable digestive symptoms. What are the causes of hiatal hernia? What are the most important symptoms that require seeing a doctor? (1)
Causes of hiatal hernia
A hiatal hernia occurs when part of the stomach pushes into the chest cavity through a weak point in the diaphragm. The diaphragm is the large muscle that separates the chest from the abdomen and naturally contains a small opening (the hiatus) through which the esophagus passes to reach the stomach. A hernia occurs if this opening weakens and dilated enough for part of the stomach to push through it. (1)(3)
Sometimes the cause of weakness in the diaphragm is a birth defect or surgery in the area, but in most cases, the cause of weakness is the cumulative pressure on the abdominal area over the years Due to factors such as: (2)
- Obesity.
- Constipation and straining during defecation.
- Pregnancy and Birth.
- Severe coughing or sneezing.
- Repeated vomiting.
- Old age: over the age of fifty.
- Continuous exertion, intense exercise and weight lifting.
- Genetic predisposition.
- Certain medical conditions such as diverticulosis or esophagitis. (3)
Symptoms of hiatal hernia
In most cases, a person with a minor hiatal hernia does not experience any symptoms and may not be aware of the condition until undergoing tests for other medical issues. Unlike other types of hernias, it does not involve a bulge in the abdominal area. Symptoms appear in only about 9% of patients and are associated with acid reflux. (2) Among these symptoms are the following: (3)(4)
- Heartburn, stomach or chest pain, or shortness of breath, often after eating.
- Small amounts of food or liquids reflux upward, and a bitter or acidic taste in the mouth.
- Feeling full quickly after eating a small amount of food.
- Bad breath.
- Frequent belching and feeling of bloating.
- Malaise and nausea.
- Difficulty or pain when swallowing.
- Hematemesis or melena.
- Cough or hoarseness.
Why you must See a doctor?
If your symptoms don't relieve after 3 weeks, even with conservative treatments and medications, if your symptoms are severe or getting worse, or if you're losing weight without trying. (3)
Seek medical attention as soon as possible in the following cases: (3) (5)
- Severe chest pain and sudden difficulty breathing and swallowing.
- Repeated vomiting, especially if it is bloody or looks like coffee grounds.
- Blood in the Stool.
- Severe abdominal pain.
If you are experiencing symptoms of a hiatal hernia or have concerns about your digestive health, do not hesitate to book an appointment today at Gastroenterology Department At Al-Ahli Hospital for a comprehensive consultation and accurate evaluation.
Treatment of hiatal hernia
A hiatal hernia usually does not need treatment if it is not causing you problems. In general, you can reduce acid reflux and the discomfort caused by the hernia by: (3)
- Lifestyle modifications: Such as maintaining a healthy weight, eating several small meals during the day while avoiding large meals, raising the head of the bed, not lying down immediately after eating, and quitting smoking.
- Diet changes: Such as avoiding stimulating foods, including spicy, acidic foods, spices, caffeine, and alcohol.
- Use of antacids: To relieve heartburn symptoms, such as omeprazole, famotidine, lansoprazole.
- Surgery: It may be necessary in severe cases or when conservative measures fail to control symptoms, and only considered for less than 5% of hernia cases. (1)
