Also known as a hiatal hernia, the stomach hernia is when the stomach bulges into your chest through an opening in the diaphragm, the muscle separating the two areas. This opening is called the hiatus. Hence, this condition is referred to as a hiatus hernia. Heartburn and abdominal discomfort are associated symptoms of the condition. With timely diagnosis and following treatment plans, one can manage the condition from progressing.
Types
Typically, there are two kinds of stomach hernias – paraesophageal and sliding. Generally, the esophagus or the food pipe passes through the hiatus and annexes to the stomach. In a sliding hiatal hernia, the esophagus’ lower part and the stomach slide into the chest via the diaphragm. Usually, people with stomach hernias have this type, but paraesophageal hernia is relatively more dangerous. In this, the stomach stays where it should be, but a part of it squeezes through the hiatus to sit next to the esophagus. Consequently, the stomach squeezes and loses the blood supply.
Symptoms
Most people with stomach hernias never have any symptoms. However, some people with hiatal hernia will have the same symptoms as GERD or gastroesophageal reflux disease. One can experience GERD when the digestive juices from the stomach move back to the esophagus. Some common GERD symptoms include:
- Pain or discomfort in the esophagus or stomach
- Bloating
- Heartburn
- Sour or bitter taste in the back of the throat
- Belching
Even though there is some link between GERD and hiatal hernia, one condition does not cause the other. Usually, people have hiatal hernia sans GERD and vice versa. Another hiatal hernia symptom includes chest pain. It can be a sign of a heart attack; therefore one must consult your healthcare provider or visit an emergency room if one experiences any discomfort in the chest area.
Causes
Weakening in the diaphragm muscles is one of the biggest causes of hiatal hernia. It makes the stomach push up through the esophagus opening. The specific causes for the weakened diaphragm are not always clear, but the following factors may have a role in it:
- Injury from surgery or trauma
- Age-related changes in the diaphragm
- Being born with a bigger opening in the diaphragm or a large hiatus
People of all ages, regardless of their gender, may get stomach hernias. However, some factors can amplify one’s susceptibility to developing it. These include:
- Being over 50
- Pregnancy
- Increased abdominal pressure from factors like vomiting, coughing, lighting heavy objects, strenuous exercise, and straining during the bowel movements
Diagnosis
Some specific tests can help your healthcare provider diagnose the hiatal hernia.
- Endoscopy
- Barium swallow radiography
- A pH test
- Esophageal manometry
- Gastric emptying test
Treatment
Most people with stomach hernias barely get any symptoms. They may also not need treatment. But if you experience symptoms like acid reflux and recurrent heartburn, you may need some prescription treatment or surgery.
Prescription treatment
For people suffering from frequent acid reflux and heartburn, the doctor may advise the following treatment:
- Antacids to neutralize stomach acid
These can aid in quick relief. Overuse of some of the antacids can result in side effects like kidney problems and diarrhea. - H-2 receptor blockers
These help lower acid production. - Proton pump inhibitors
These are stronger acid blockers than the H-2 receptor blockers and give ample time for the damaged esophageal tissue to recover.
Surgery
In some stomach hernia cases, treatment may include surgery. It is for people who get no relief from prescription treatment or undergo complications like esophagus narrowing or severe inflammation. Surgery for the stomach hernia may demand pulling the stomach down into the abdomen and making the diaphragm opening smaller or reconstructing the esophageal sphincter. Sometimes this surgery is combined with sleeve gastrectomy surgery.
The surgery is performed via a single incision in the chest wall or laparoscopy, a minimally invasive technique. In this surgery, the surgeon will insert a small camera and special surgical tools via tiny incisions in the abdomen. So as the surgeon sees the images from inside the body on the video monitor, they will operate.
