November 5, 2010

Acid Reflux Hernia

A hernia is generally defined as the displacement or protrusion of an organ through a hole or into a cavity.? There are two types of hernias related to acid reflux – Sliding Hiatal Hernia and Para-Esophageal Hiatal Hernia.

Sliding Hiatal Hernia

Sliding Hiatal Hernias are the most common.? They occur when the muscle at the junction between the esophagus and the stomach – the lower esophageal sphincter – becomes too relaxed.? This allows the diaphragm to become displaced and a portion of the stomach to pass into the lower esophagus.

Roughly half of people with a Sliding Hiatal Hernia don’t suffer symptoms.? If symptoms do occur they are identical to Gastroesophageal Reflux Disease, and can include heartburn, acid reflux, regurgitation and frequent belching and hiccups.

Treatments can include over the counter antacids or prescription drugs; a change in diet that involves eating smaller, more frequent meals, or eliminates foods like citrus, alcohol, caffeine, garlic, mint, or any other foods that would cause heartburn; quitting smoking; eliminating tight clothing which can cause pressure on the stomach resulting in reflux; and taking care not to lie down too quickly after eating.? If symptoms are severe, surgery may be necessary and would involve pulling the stomach down and tightening the opening to the stomach, which would prevent recurrence.

Para-Esophageal Hiatal Hernia

Para-Esophageal Hiatal Hernias are slightly more severe than Sliding Hiatal Hernias.? They occur when a portion of the stomach becomes displaced and ends up next to the esophagus.? This condition can be problematic as a result of complications associated with it.? Strangulation can occur when blood can’t get to the affected area, resulting in tissue death.? It can also put pressure on the esophagus, causing food to lodge there after swallowing.? Ulcers can also form from damage caused by food stuck in the esophagus or stomach acid.

Most Para-Esophageal Hiatal Hernia’s aren’t symptomatic, but if there are, symptoms can include nausea, chest pain and pressure, vomiting, abdominal discomfort, and trouble swallowing.

The complications due to an untreated hernia can become severe, so early surgical intervention is the most successful treatment for Para-Esophageal Hiatal Hernia.

Diagnosing Hiatal Hernia

A doctor can diagnose a Hiatal Hernia many ways; however a few tests are used regularly.? An upright chest x-ray can be performed.? This would reveal any obvious abnormalities to the esophagus and stomach.? A barium x-ray involves digesting barium, a thick solution that is visible under x-rays.? Or, an upper endoscopy could also be performed, which involves a physician inserting a lighted tube to search for problems in the esophagus and upper stomach.

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