Hiatus hernia is a condition when part of the stomach protrudes into the chest cavity. The lump enters through the diaphragm, which is the muscle that separates the chest cavity and the abdominal cavity.
Normally, the stomach is below the diaphragm . However, in hiatus hernia sufferers, part of the stomach protrudes into the chest cavity through the diaphragm. Hiatus hernia or hiatal hernia can be experienced by everyone, but more often occurs in someone who is 50 years old or older.
If the protruding part of the stomach is still small, the hiatus hernia is generally not dangerous. However, when the bulge gets bigger, swallowed food and stomach acid can return to the esophagus or trigger the rise of stomach acid and cause a sensation like a burning chest.
Causes of Hiatus Hernia
Hiatus hernias generally occur due to increased pressure in the abdominal cavity. It is not known exactly what caused it. However, there are several factors that are suspected to be the trigger, among others:
- Chronic cough
- Smoking habits
- Obesity
- Vomiting
- Pregnancy
- Age increase
- The habit of straining too hard when defecating
- Frequent lifting of heavy loads
- Birth defect in the form of a gap in the diaphragm
- Injury to the diaphragm or side effects of certain surgical procedures
Hiatus Hernia Symptoms
Hiatus hernia generally consists of two types, namely sliding and fixed . Here is an explanation of each type of hiatus hernia:
Sliding hiatal hernia
Sliding hiatal hernia is the most common type of hiatal hernia. This condition occurs when the stomach and esophagus protrude from the chest cavity through an open diaphragm muscle.
Sliding hiatal hernias are usually small and cause no symptoms. Therefore, this condition may not require special treatment.
Fixed hiatal hernia
In this type of hiatus hernia, part of the stomach protrudes into the chest cavity through the diaphragm and settles in the chest cavity. Fixed hiatal hernia is an emergency condition that risks obstructing blood flow to the stomach.
Hiatal hernias that are still small generally do not cause symptoms. However, if the lump continues to grow, symptoms such as:
- Gastric acid disease (GERD)
- The stomach feels full for a moment after eating
- Heartburn _ _
- Difficulty swallowing
- Stomachache
- Chest pain
- Shortness of breath
When should you go to the doctor?
Immediately check with a doctor if you experience the above symptoms. You are also advised to immediately seek medical help or go to the nearest health service if you experience the following complaints:
- Vomit blood
- BAB is black or dark
- Pain in the chest or stomach
- Abdominal pain that does not improve
- Can't defecate or pass gas
Hiatus Hernia Diagnosis
The doctor will ask questions about the patient's symptoms, followed by a physical examination. To confirm the diagnosis, the doctor will perform further examinations, including:
1. X-ray photo of OMD ( oesophagus-stomach-duodenum )
OMD X-rays aim to check the condition of the esophagus, stomach, and upper intestine more clearly.
2. Barium esophagogram or barium X-ray
In this examination, the patient will be asked to swallow a special liquid before undergoing the scan. This is intended so that the upper digestive tract can be seen more clearly when the scan is performed.
3. Endoscopy
Endoscopy is performed using a flexible tube with a camera (endoscope). This examination is performed by inserting an endoscope into the body through the mouth, to check the condition of the inside of the patient's esophagus and stomach.
4. Esophageal manometry
This examination aims to measure the strength and coordination of the muscles in the esophagus when swallowing food.
5. Measurement of esophageal acid levels
This examination aims to measure the level of acid in the esophagus and help diagnose symptoms related to hiatus hernia.
6. Gastric emptying test
The purpose of this examination is to measure the time required for the stomach to empty food.
Hernia Treatment Hernia
Asymptomatic hiatal hernias usually resolve without treatment. However, some sufferers can experience GERD symptoms. To deal with these conditions, there are several efforts that can be done at home, among others:
- Stop smoking
- Lose weight and maintain an ideal weight
- Eat smaller portions, but more often
- Do not lie down or sleep after eating
- Sleep with the head slightly higher than the body
- Avoid acidic foods, such as tomatoes and oranges
- Limit caffeinated, fizzy, and alcoholic beverages
If the above efforts do not reduce the complaint or the hiatal hernia symptoms worsen, the doctor can prescribe medicine. The medicine can be in the form of an ulcer medicine, both neutralizing stomach acid ( antacid ) and reducing the production of stomach acid, such as omeprazole and lansoprazole.
If the patient's condition does not improve with the above treatment or the symptoms worsen, the doctor will recommend surgery. The operation aims to return the stomach to the abdominal cavity and narrow the gap in the diaphragm.
There are two methods of operation that can be performed, namely by making one large incision in the chest and then opening the chest cavity (thoracotomy), or making several small incisions for the entrance of a device in the form of a flexible hose with a camera at the end ( laparoscopy ).
Hernia Complications Hernia
A hiatus hernia that is not treated properly can cause a number of health complications, namely:
- GERD
- Inflammation of the lining of the esophagus ( esophagitis )
- Barrett's esophagus
- Esophageal cancer
- A twisted or obstructed hiatus hernia
Hiatus Hernia Prevention
Hiatus hernia can be prevented by doing some of the following:
- No smoking
- Eat smaller portions, but more often
- Lose weight when obese
- Do not lift heavy objects
- Do not wear clothes or belts that are too tight so that the stomach is not depressed
- Do not strain too hard when defecating
- Drink enough water, exercise regularly, and consume fibrous foods to prevent constipation