Hiatal Hernia a protrusion of stomach into the chest: Symptoms, Causes and Risk Factors
The protrusion of a portion of the stomach up through the oesophageal hiatus of the diaphragm into the pleural cavity of the chest is known as hiatal hernia.
This condition usually causes respiratory difficulties. The condition is either congenital or acquired.
In a small hiatal hernia, there are hardly any symptoms, the small hiatal hernia is usually detected by doctors during the examination of the patient. In a large hiatal hernia, the stomach tends to backflow its content including gastric juices into the esophagus causing heartburn.
Types of hiatal hernia:
Hiatal hernia is mainly of two types:
- Sliding hiatal hernia, which is the most common type of hiatus hernia in which the hernia moves up and down and in and out of the chest.
- Para-esophageal hernia, this type of hernia is rare and is also known as rolling hernia. In this type of hernia, a part of the stomach is pushed up next to the esophagus the stricture in the diaphragm.
Symptoms:
The symptoms caused due to backflow of the stomach content are the following:
- Heartburn along with pain in the chest and burning.
- Nausea
- Vomiting and sometimes retching (make the sound and movement of vomiting)
- Sour eructations (A sour taste in the mouth)
- Belching
- Excessive salivation in the mouth as reflex due to acidity.
- Asthma
- Repeated infection of the lungs causing pneumonia and bronchitis
- Coughing spasm due inhalation or aspiration of gastric acid
- Pain while swallowing food
- Aggravation of symptoms after food.
- Symptoms are better or may resolve either by sitting up or lying down.
- Acidic or sour taste in the mouth
- Sore throat
- Sweating
- Raspy voice
- Difficulty to pass bowel
- Feeling heaviness and a sense of general discomfort due to gas.
Causes:
The hiatal hernia results mainly due to the weakness of muscle tissue of the diaphragm allowing the stomach to protrude from the oesophageal hiatus. The exact cause of hiatal hernia is not known, but the following reasons are considered as its causes:
- Weakness and changes in the diaphragm due to age.
- Injury or trauma
- Congenital or by birth
- Persistent pressure on the surrounding muscles either while coughing, vomiting, straining while passing stool, lifting heavy objects or doing vigorous weight lifting exercises.
Risk factors:
The following are the risk factors for hiatal hernia:
- Obese people are at higher risk
- Heavy weight lifters
- People having a chronic cough
- People having chronic constipation
- People above fifty years.
- Pregnant women are at higher risk.
Complications:
The following are the compilations caused because of long term untreated hiatal hernia:
- Gastro-oesophageal reflux disease
- Oesophageal stricture
- Barrette’s esophagus or cancer of the esophagus
- Strangulated hernia.
- Oesophageal ulcer
Lifestyle tips to manage hiatal hernia:
The following steps can be followed to prevent aggravation of symptoms and lead a normal life with a hiatal hernia:
- Eat small and frequent meals
- Avoid lying down at least 3 hours after having food.
- Try to avoid food and drinks that make the symptoms worse
- Walk regularly
- While lying down try to keep your head a bit risen by placing an extra pillow.