Paraesophageal Hiatal Hernia

Nature and Symptoms

Also known as hiatus hernia, paraesophageal hiatal hernia is a protrusion of the stomach into the thorax due to a tear or weakness in the diaphragm. This condition is often called the ‘great mimic’ because its symptoms resemble many other disorders, such as heartburn, shortness of breath, or even chest pains, which can be mistaken as heart attack.

While hiatus hernia can occur anytime as a result of some factors, it affects mostly middle-aged people and is more common in developed countries. This is likely a result of unhealthy diets, higher rates of obesity, and less physically active lifestyles.

Causes

Paraesophageal hiatal hernia is caused by several factors including diet, heredity, weight, lifestyle, and habits. Pregnancy and obesity can push the top of the stomach upwards, leading to hiatal hernia. Other physical causes include violent vomiting (especially when forced out as in anorexics), hard sneezing or coughing, heavy lifting, and straining during defecation.

A lack of fiber in the diet causes constipation and straining during defecation. This increases intra-abdominal pressure to the stomach which can result in hiatus hernia. Unhealthy lifestyles such as excessive drinking,smoking, and stress may also contribute to the condition.

Risks

Occasional mild discomfort and feelings of bloating or acid reflux are common, and need no urgent medical attention.

However, an enlarged hernia can pose two major threats – incarceration and strangulation. Incarceration is where the hernia is tightly stuck and repeatedly squeezed beside the esophagus, causing intense pain. Strangulation is more serious and life-threatening, because the hernia is in a position to cut off air circulation and blood supply. In rare cases, the hernia can lead to esophageal injury and even cancer.

Treatment and Prevention

In less serious cases, doctors advise patients to elevate the head of the bed and avoid lying down when full. Medications may be prescribed for stress, acid reflux, and constipation.

Hiatus hernia can be prevented through healthy habits and proper nutrition. Consumption of high-fiber foods prevent constipation and reduce risk of hiatal hernia. Avoid coffee, alcohol, and cigarettes. When lying down, elevating the head and torso can alleviate symptoms. Weight loss is advisable in overweight individuals. Physical activities should exclude heavy lifting. Most of all, individuals should relax and avoid stressful situations.

These practices will alleviate the condition and help one to avoid extreme solutions, which can include surgery.

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