When the opening between the diaphragm and the esophagus grows too large, a hiatal hernia can result. This type of hernia occurs when the top of the stomach bulges through the opening and into the chest. Although the exact cause of a hiatal hernia is unknown, medical researchers have discovered an increase in risk for those who are obese. Increased occurrence has also been noted in those over the age of 50 as well as in smokers. Often, the condition causes painful reflux of gastric acid, and children can be born with it.
As with all hernias, many people with hiatal hernias experience no symptoms at all. The most common symptoms include chest pain, heartburn and difficulty swallowing, but the hernia itself is seldom the sole reason for these symptoms, all of which are caused by the reflux of stomach acid or bile. Therefore, treatment focuses on eliminating uncomfortable symptoms in most cases.
In treating a hiatal hernia, the goal is to relive symptoms and prevent complications. Medication may be prescribed to control stomach acid or to strengthen the esophagus muscles in order to eliminate acid reflux from the stomach. In some cases, surgery is required to repair the hiatal hernia.
Those living with a hiatal hernia can reduce the discomfort of this condition by doing the following:
- Eating small portions and avoiding heavy meals
- Sitting or standing during digestion rather than lying down after eating
- Maintaining a healthy weight
- Avoiding constipation
- Avoiding tight, restrictive clothing around the waist
- Refraining from heavy lifting of any kind
- Not smoking
- Sleeping at a slight incline with the head of the bed raised about five inches
Although surgery is sometimes necessary, most symptoms can be controlled through these types of treatments. Exercising regularly and maintaining a healthy weight may help to reduce the risk of a hiatal hernia.
Complications from a hiatal hernia are rare but serious. Pulmonary aspiration, a compromise in lung capacity, can result if a lung is displaced by a particularly large hiatal hernia. If it grows too large, strangulation of the hiatal hernia can occur when it gets stuck in the hole between the esophagus and the diaphragm. Internal bleeding or iron deficiency can also result from a large hiatal hernia. Most of the time, these complications can be addressed with surgery.
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