These Symptoms May Indicate a Hiatal Hernia!

Hiatal hernia, recognized by bad breath, heartburn and hoarseness, can lead to reflux if left untreated, creating a difficult period for patients. However, hiatal hernia diagnosed in early stages can be successfully treated with laparoscopic methods. Assoc. Prof. Fatih Çiftçi from the General Surgery Department of Memorial Hizmet Hospital provided information about the causes and treatment methods of hiatal hernia.

Pay attention if you are over 50!

Hiatal hernia occurs as a result of weakening or atrophy of the muscles between the stomach and esophagus, causing the stomach to sag toward the esophagus. Weakness and tendency toward enlargement of the muscles in the upper part of the stomach due to various reasons can also cause hiatal hernia. In other words, this disease develops with weakening of the diaphragm muscle. Hiatal hernia can appear at any age but generally occurs in people 50 years and older. There are many reasons leading to hiatal hernia. Obesity, chronic constipation due to unhealthy eating, muscle weakness related to advanced age, chronic smoking, genetic predisposition to the disease, anxious and stressful living increase the likelihood of developing hiatal hernia. Heavy lifting, pregnancy and excessive physical strain can also be counted among the causes. If hiatal hernia is left untreated, it can cause severe reflux in some patients.

Can start without symptoms

Hiatal hernia often progresses insidiously without causing any symptoms. In later stages it may manifest with the following symptoms:

• Bad breath,
• Burning and heartburn in the stomach and behind the chest
• Sensation of food getting stuck in the throat and esophagus while eating
• Need to sleep with high pillows at night,
• Coughing fits, hoarseness
• Sudden belching
• Burning or pain behind the chest cage when lifting weights, bending, or defecating
• Sudden appearance of food particles in the mouth
• Paraesophageal type stomach bleeding, bloody vomiting

Do not eat late at night

Not eating late at night or swimming on a full stomach are preventive measures for hiatal hernia. Diet should include fiber-rich foods which also prevent constipation. Workers in heavy occupations should take ergonomic precautions. Pregnant women should not overeat. Coffee, chocolate, acidic foods and beverages, excessively fatty foods, spicy, tomato paste-based and seasoned foods relax the gastric sphincter. Food intake should be stopped 2 hours before bed. Caution should be exercised against these. Avoiding stress is also very important.

Patients recover in a short time

Hiatal hernia treatment is similar to reflux treatment. There is no specific medication therapy. It is very important for the person to maintain stomach health by paying attention to their diet. With laparoscopic camera surgery in light of technological advances, patients can be treated. With hiatal hernia surgery performed this way, patients can be discharged on the day of surgery or one day after surgery. In this technique, the herniated section is repaired through small incisions and a patch is applied if necessary. Subsequently, the fundoplication procedure, which creates a gastric valve, is performed under laparoscopic camera guidance. The success rate of the surgery is above 90 percent.

Situations requiring surgery for hiatal hernia

In some cases, hiatal hernia must be treated urgently with surgery. The situations requiring surgery are as follows;

• Acid in the stomach causes damage to the epithelium lining the inside of the esophagus. If this condition becomes chronic, changes occur in the esophagus called Barrett's, which have the potential to turn into cancer. In this case, definite surgery is recommended.
• Patients who do not want to take medication for life can be treated with surgery.
• In some types of hiatal hernia, hernia strangulation can occur. In such cases, emergency surgery is required regardless of the severity of reflux.
• Oral contraceptives, blood pressure medications, bone loss medications and pain relievers trigger reflux. When it is not possible to discontinue these medications, surgery is needed.
• In reflux patients who have difficulty losing weight, live in stressful environments, and struggle with continuous medication use, surgery is considered as an option.