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.
A hiatal may be caused by:
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:
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.