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SCHEDULE:
Monday - Friday
10:00 am - 6:00 pm
Saturday
10:00 am - 1:00 pm
Sunday closed
Pacific Time
Office Address:
Jose Clemente Orozco #2468, Consultorio 407
Plaza Medical, Zona del Río.
Tijuana, Baja California.
Local: (664) 634.2014
From USA: (619) 446.6769
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General Surgery:
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About 50% of all people with hiatal hernias do not have any symptoms. For the other approximate 50% of individuals with hiatal hernias who do have symptoms, heartburn is the most common symptom. Knowing how to control the heartburn through diet is important.
Studies have shown that the opening in the diaphragm, where the esophagus connects with the stomach, acts as an additional sphincter around the lower part of the esophagus. Normally the hiatus and the lower esophageal sphincter (LES)--the muscle connecting the esophagus with the stomach--line up with each other to keep stomach contents from backing up into the esophagus. It is believed that a hiatal hernia can weaken the (LES) and cause reflux. The hiatal hernia results in the retention of acid and other stomach contents above the opening (hiatus) and can result in this being easily refluxed into the esophagus.
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A few quick tips about eating with a hiatal hernia:
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Eat smaller, more frequent meals, instead of larger meals. |
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Don't eat for at least two hours before bedtime. |
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Sit up for at least one hour after eating. |
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Don't bend over right after eating. |
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Avoid foods that can trigger heartburn (acid reflux) symptoms |
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Avoid alcohol. |
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Symptoms of Hiatal Hernias
About 50% of all people with hiatal hernias do not have any symptoms.
For the other approximate 50% of individuals with hiatal hernias who do have symptoms, the following may occur:
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Heartburn (which is worse when bending over or lying down shortly after eating). |
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Regurgitation (backflow of stomach contents into the back of the throat. |
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Vomiting. |
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Gastric reflux (backflow of stomach contents into the esophagus). |
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A sour or bitter taste in the mouth. |
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Frequent belching. |
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Frequent hiccups. |
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Chest pain radiating from below the breastbone (the sternum). |
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Feeling of pressure in the chest. |
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A bloated feeling after eating. |
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Abdominal discomfort. |
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Abdominal pressure, especially soon after eating. |
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Discomfort or pain in the stomach. |
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Discomfort or pain in the esophagus. |
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Gas. |
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Unexplained coughing. |
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Difficulty swallowing. |
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Causes of Hiatal Hernias
There are a number of contributing factors that can cause hiatal hernias:
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Sudden physical exertion, such as when weight lifting. |
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Abdominal injury that causes a hole or tear in the diaphragm. |
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Increased pressure in the abdominal cavity caused by constant hard coughing, vomiting, straining during bowel movements. |
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Obesity. |
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Pregnancy. |
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Tight clothing around the abdomen. |
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Constipation. |
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Diagnosing Hiatal Hernias
Each of these procedures can be used to diagnose a hiatal hernia.
The procedure used most often to detect evidence of a hiatal hernia is barium x-rays. With the barium x-rays, the patient drinks a liquid that contains barium, which will coat the walls of the esophagus and stomach. X-rays are then taken, which can then show if there is a hiatal hernia.
The Upper Endoscopy allows the doctor to examine the inside of the patient's esophagus, stomach, and duodenum (the first part of the small intestine) with an instrument called an endoscope, a thin flexible lighted tube. With this procedure the doctor will be able to see if there is a hiatal hernia.
The Bernstein Test attempts to reproduce symptoms of heartburn.
It is usually done along with other tests dealing with esophageal functions. This test is also called the acid perfusion test. It isn't used alone to diagnose a hiatal hernia, but used in combination with barium x-rays can help determine if an associated condition also exists: Gastroesophageal Reflux Disease (GERD).
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Treating Hiatal Hernias
For approximately 50% of individuals with a hiatal hernia, symptoms are not present. For those who do experience symptoms, it is usually caused by heartburn, or acid reflux. Many individuals with a hiatal hernia also have gastroesophageal reflux disease, or GERD. For them, their doctors may prescribe a treatment plan that is similar to the treatment for GERD.
For those individuals who don't have any symptoms, they don't require any treatment for their hiatal hernia. For others, lifestyle changes and medications will control their symptoms. It is only for a minority of patients who experience severe symptoms of reflux despite lifestyle changes and medications, or who develop complications such as stricture, bleeding or an obstruction, will surgery be considered.
The following are some of the treatment options for a hiatal hernia:
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Lifestyle changes for a hiatal hernia. |
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Diet modification. |
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Not smoking. |
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Avoiding alcohol. |
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Preventing acid reflux during the day. |
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Preventing acid reflux at night. |
Medication, which include:
Antacids
H2 Antagonists
Proton Pump Inhibitors.
If surgery is needed:
During hiatal hernia repair surgery, the stomach and lower esophagus are placed back into the abdominal cavity, and the hiatus (the opening in the diaphragm where the esophagus and stomach join) is tightened. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication) to reduce acid reflux.
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