What is a Hiatal Hernia?
Hiatal hernia is a hernia of a different form than usual, as it occurs inside the abdomen, usually as a projection of the stomach into the chest, through the diaphragm. It is a common condition as it affects 10% of the population over 40 years old, while it reaches 50% in people over 70 years old.
The main forms of the condition are sliding and paraesophageal hiatal hernia, depending on the part and form of slippage of the stomach.
What are the most common causes of a Hiatal hernia?
Some of the most common causes that cause the appearance of hiatal hernia are the following:
- increased intra-abdominal pressure (due to chronic cough, constipation)
- increased contractility of the oesophagus
- age over 50 years
- -obesity
- -smoking
What are the main symptoms of a Hiatal hernia?
In small hiatal hernias, symptoms are almost non-existent and the condition is usually discovered accidentally during gastroscopy. However, over time, patients can develop mild to severe discomfort.
Essentially, most people with hiatal hernia do not have discomfort from the hernia itself but from gastroesophageal reflux, which is perhaps the most stable characteristic of hiatal hernia. Some of the symptoms of the condition are:
- Indigestion / bloating
- Dysphagia (difficulty swallowing)
- Nausea / regurgitation
- Retrosternal pain (burning)
- Acid belching
- Another common symptom of hiatal hernia is the appearance of a feeling of shortness of breath, which can often coexist with pain in the upper stomach area and chest.
How is a Hiatal hernia diagnosed?
The tests required to diagnose hiatal hernia are:
- Upper gastro-intestinal tract endoscopy or gastroscopy, during which the area is checked through a connected video camera.
- CT scan of the chest and upper abdomen
- X-ray of the upper digestive tract using barium (a special dye).
How is a Hiatal hernia treated?
Treatment with medications
When hiatal hernia is in its early stages, the treatment is essentially medication against coexisting acid reflux.
Physical exercise
In early stages of the condition, aerobic physical exercise is suggested that can strengthen the diaphragm while reducing persistent symptoms. To reduce the symptoms of hiatal hernia it is also important that patients maintain a normal weight. Especially in cases of obesity, significant weight loss is essential.
Diet
Diet plays an important role in treating the symptoms of hiatal hernia. Large meals and fatty foods exacerbate symptoms such as heartburn, nausea and indigestion. For this reason, it is preferable to eat frequent, small meals.
Minimally invasive surgical treatment of Hiatal hernia
Patients suffering from hiatal hernia which is increasing in size or with severe symptoms refractory to medical treatment are candidates for definitive surgical treatment. The operation is performed with minimally invasive laparoscopic technique and the part of the stomach that had moved to the chest is repositioned in its normal position in the abdomen. At the same time, a form of valve is created in the upper part of the stomach by rapping the upper part of the stomach- fundus- to the lower part of the oesophagus (fundoplication) to prevent recurrence and completely eliminate gastroesophageal reflux.
Recovery after surgical repair of Hiatal hernia
The laparoscopic technique, in addition to guaranteeing the best result, also offers a short and easy postoperative recovery. Specifically
-hospitalization lasts one day
-postoperative pain is minimal
-the patient can immediately return to his/her daily activities
-The aesthetic result is excellent.