Hiatal Hernia

A hiatal hernia is a condition developed when the upper part of the stomach bulges through an opening in the diaphragm. The diaphragm is a muscle that separates the abdomen and chest. It has a small opening through which the food tube passes and connecting to the stomach. In a hiatal hernia, the stomach pushes up through the opening in the diaphragm and bulges into the chest. The bulging of stomach to the chest can cause food and acid back up into the esophagus causing heartburn.

  • Heartburn
  • Backflow of food and liquids into the mouth
  • Backflow of stomach acid into the esophagus
  • Difficulty swallowing
  • Chest or abdominal pain
  • Shortness of breath
  • Vomiting of blood
  • Passing of black stools

A hiatal may be caused by:

  • Age-related changes in the wearing the muscles of the diaphragm
  • Injury to the area after trauma or surgery
  • Birth defects with an unusually large hiatus
  • Persistent and intense pressure on the surrounding muscles of the diaphragm
  • Obesity

The doctor performs an endoscopy to diagnose the condition. The procedure involves inserting a thin flexible tube with a camera attached to inside of the esophagus and stomach and check for inflammation. Other test includes x-ray of the upper digestive system and esophageal manometry to measure the rhythmic muscle contractions and coordination and force exerted by the muscles of the esophagus when food is swallowed.

Medications are prescribed to ease the symptoms including recurrent heartburn and acid refluxes and production. Medication along with little lifestyle modification is advised by the doctor and these changes include:

  • Consume several smaller meals rather than a few large meals
  • Avoid fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine that trigger heartburn
  • Avoid lying down right after a meal
  • Have the dinner at least two to three hours before bedtime.
  • Maintain a healthy weight or reduce the excess weight
  • Stop smoking and alcohol consumption
  • Elevate the head while lying
  • Perform any kind of physical activity or exercises at least 5 days a week

Surgical treatment options include pulling back the bulged abdomen into the stomach and reconstructing an esophageal sphincter. In laparoscopic surgery a laparoscope is used, which is a thin long tube that has a camera attached to its end to view the irregularities inside the abdominal cavity. The surgeon makes a small incision and inserts the laparoscope to investigate the abnormality and later few more small incisions are made to insert the surgical tools and perform repair of the required organs and muscles. The surgeon pulls back the bulged stomach from the diaphragm and closes the incision. If necessary, the surgery is also performed by making a single incision in the chest wall and the procedure is termed as thoracotomy.

Contact Details

Dr. R. Padmakumar
Senior Consultant Laparoscopic and Metabolic Surgeon &
Director - Verwandeln Institute (Transforming Lives)
(Specialist in Laparoscopy, Hernia, Cancer, Obesity, Diabetes Surgery, Endoscopic Thyroid Surgery, Thoracoscopy, Intragastric Balloon)
Keyhole Clinic, Thammanam Road, Plarivattom, Kochi, Kerala, India
VPS Lakeshore Hospital, Maradu, Kochi, Kerala, India
Chairman - Association of Surgeons of India, Kerala Chapter

Mobile: +919447230370, +919846320370
Email: drrpadmakumar@gmail.com


Chairman, Association of Surgeons of India - Kerala Chapter
National President - Indian Hernia Society (2016)
GC Member, Association of Surgeons of India (2013 - 2018)
Vice President- Society of Endoscopic and Laparoscopic Surgeons of India
Jt. Secretary - Indian Association of Endocrine Surgeons (2016)
Founder Member, Obesity and Metabolic Surgery Society Of India
Founder Member, Association of Minimal Access Surgeons of India
International Faculty of IASGO on Hernia and Diabetic Surgery
International Faculty of IFSO on Diabetic Surgery
Associate Editor : Diabetes and Obesity International Journal