Treatment of hiatal hernia – symptoms and diagnosis
What is a hiatal hernia?
Hiatal hernia is a condition that occurs when part of the stomach moves from the abdominal cavity into the chest through the hiatus in the diaphragm. The most common form is a hiatal hernia.
The diaphragm plays an important role as the muscle that separates the abdominal cavity from the thorax and has an opening through which the oesophagus runs. In the case of a hernia, this perianal opening can become too large or too loose, leading to abnormal displacement of the organs of the digestive tract, i.e. the upper part of the stomach moves into the thorax.
Do you have questions about the procedure?
Do you need more information about the treatment? Our coordinators will be happy to provide you with the necessary information, arrange all the necessary appointments and guide you through the entire diagnostic treatment process.
Hiatal hernia – causes
The main symptoms of hiatal hernia are related to a variety of factors that can increase pressure in the abdominal cavity. Here are some of them:
Do you have questions about the procedure?
Do you need more information about the treatment? Our coordinators will be happy to provide you with the necessary information, arrange all the necessary appointments and guide you through the entire diagnostic treatment process.
Obesity puts significant pressure on internal organs, which favours the formation of hernias, weight reduction is usually recommended before surgery. Pregnancy is another aspect that can contribute to this condition. Hormonal changes and a growing abdomen increase abdominal pressure. In addition, thoracic injuries can damage the diaphragm, leading to abnormal organ displacement.
Over the years, the elasticity of the diaphragm decreases, facilitating the formation of an oesophageal hiatus hernia. Also, sedentary work and heavy lifting increase the risk of the problem by putting constant strain on the abdominal muscles and diaphragm.
Characteristic symptoms of hiatal hernia
Symptoms can take many forms, often the condition itself can be asymptomatic and problems only manifest themselves some time after its onset. Here are the most commonly reported symptoms of hiatal hernia:
If these occur, it is a good idea to consult a specialist who will assess the condition and suggest appropriate treatments for hiatal hernia.
Do you have questions about the procedure?
Do you need more information about the treatment? Our coordinators will be happy to provide you with the necessary information, arrange all the necessary appointments and guide you through the entire diagnostic treatment process.
Diagnosis of sliding hernia
Diagnosis plays an extremely important role in determining staging and appropriate treatment. The process involves a variety of testing methods to accurately assess the patient’s condition. One of the key examinations is gastroscopy, also known as endoscopy. With this procedure, the doctor is able to see the inside of the oesophagus and stomach directly using a thin instrument ending in a camera. X-ray of the gastrointestinal tract with contrast in the anti-tenderenburg position is also a key investigation – the examination allows the anatomy to be assessed. Other important tests in the diagnostic process are pH meter, which is the assessment of gastro-oesophageal reflux, and manometry, which is the assessment of the workings of the oesophagus. Sometimes the diagnosis is expanded to include a chest and abdominal CT scan with contrast.
Obtaining a comprehensive clinical picture is key to taking appropriate therapeutic action. Early diagnosis can minimise the symptoms of a hernia and is of paramount importance for the effectiveness of treatment and for improving the quality of life of sufferers.
Surgical treatment of hiatal hernia
Treatment of this type of hernia
can take place surgically. In contrast, treatment of the reflux symptoms associated with the disease can be done pharmacologically, followed by diagnosis and, if pharmacology is not sufficient, surgical treatment should be considered. Pharmacological treatment is often based on gastric acid antacids such as proton pump inhibitors (PPIs), prokinetic drugs that promote normal gastrointestinal motility and barrier drugs that line the mucosa and protect against acid secretion. However, when drug therapies for symptom relief do not work or more serious complications develop, in-depth diagnosis and surgical intervention – laparoscopic surgery – are required for a cure. The surgery consists of plastic surgery of the oesophageal foramen of the diaphragm, i.e. oesophageal dissection, restoring and reconstructing the normal anatomy of the upper digestive tract, strengthening the diaphragm muscles and performing fundoplication. Fundoplication involves wrapping the distal part of the oesophagus, part of the stomach floor, which helps to reconstruct and strengthen the anti-reflux mechanisms.
It is also important to regularly monitor the progress of the therapy and adapt the treatment to the individual patient’s needs.
When is surgery necessary?
Surgery becomes necessary when drug treatment is unsuccessful. In the case of a severe form of hiatal hernia or congenital damage to this area, surgical intervention may be the only solution. The main aim of such a procedure is to alleviate the symptoms of a displaced part of the stomach and to prevent complications. Typically, surgery involves repairing the hernia by strengthening the muscles surrounding the oesophagus and stomach. The doctor may suggest performing a fundoplication. This procedure effectively prevents backflow of gastric contents into the oesophagus.
Hiatal hernia diet and postoperative care
Diet and lifestyle play a key role in controlling the symptoms associated with a slipped hernia. It is worth betting on easily digestible meals, which means avoiding:
After eating, it is better to avoid intense exercise. Instead, it is more beneficial to eat smaller portions, which can help to reduce pressure on the lower oesophageal sphincter and relieve reflux symptoms. Maintaining a healthy lifestyle is of paramount importance. Regular physical activity (not right after meals, of course) and striving to maintain a healthy body weight can significantly improve the wellbeing of people struggling with an oesophageal hernia. Please note that consultation with a dietitian is essential in the management of hiatal hernia symptoms and before qualifying for surgery.
General surgeons of Medicus Clinic
A visit to the general surgeon at Medicus Clinic is a key part of the comprehensive diagnosis and treatment of hiatal hernia. Our experienced specialists carry out thorough examinations, select optimal treatment methods and offer effective solutions tailored to each patient’s needs.
