A hiatal hernia occurs when the top part of your stomach protrudes up into your chest cavity through the small opening in your diaphragm. Hiatal hernias are quite common, and many people are born with them but never have any symptoms. Being obese or overweight increases your risks for developing a hiatal hernia or experiencing more severe symptoms from the condition. Losing weight can help to prevent or reduce the symptoms of hiatal hernias.
Types
Three main types of hiatal hernias occur, which include complicated, sliding and fixed hiatal hernias, according to the University of Pittsburgh Medical Center. A sliding hiatal hernia occurs when the upper stomach portion slides into and recedes from the chest, while a fixed type stays in the chest. The most severe type is the complicated hiatal hernia, which involves multiple kinds of stomach herniation. Large hiatal hernias and complicated types are the most likely to generate symptoms and often require surgery, MayoClinic.com notes.
Identification
Although smaller hiatal hernias, including sliding or fixed types, often cause no symptoms or signs, more severe hiatal hernias can cause nausea, heartburn, gas or belching and chest pain. You might also experience pain in your stomach and esophagus, difficulty swallowing, a hoarse voice or throat irritation, or stomach and esophageal bleeding. Your doctor may need to perform one or more tests to diagnose a hiatal hernia. The most common tests performed for diagnosing hiatal hernias are barium-swallow X-rays and esophagogastroduodenoscopy, or EGD, notes the University of Maryland Medical Center.
Causes
The true cause of a hiatal hernia is unknown, but people are sometimes born with the hernia or develop the hernia when the surrounding tissues weaken. Some potential causes for hiatal hernias include abdominal injuries and repeated pressure on the supporting muscles due to vomiting, coughing and straining. People who are born with weakened muscles around the stomach or an abnormally enlarged hiatus also tend to have a hiatal hernia. Hiatal hernias are quite common in people who are older than 50 years of age, obese or smokers, notes the University of Maryland Medical Center.
Prevention/Solution
If you aren't experiencing any effects or symptoms of the hiatal hernia, your doctor may not recommend any treatment measures, notes the University of Pittsburgh Medical Center. But if you've developed severe symptoms like gastroesophageal reflux disease, or GERD, your health care provider might advise certain lifestyle changes, medications or even surgery. The most common medications used for hiatal hernias are antacids, proton pump inhibitors and other drugs that help in treating the acid reflux and heartburn caused by the hernia. In serious cases -- which are rare -- hiatal hernias require surgery to reconstruct the weakened esophageal sphincter, remove the hernia sac, reduce the size of your diaphragm opening or pull your upper stomach back down into your abdomen.
Considerations
One of the main lifestyle treatments for hiatal hernias is to lose weight, according to the University of Maryland Medical Center. Losing weight can ease your hiatal hernia-related symptoms and maintaining a healthy weight can even prevent hiatal hernias, notes the University of Pittsburgh Medical Center. Quitting smoking is also commonly recommended for people with hiatal hernias, because smoking can weaken your lower esophageal sphincter. Avoiding heartburn-triggering foods, alcohol, fatty foods, large meals and meals within three hours of bedtime can all help reduce your symptoms as well.
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