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Hiatus hernia

Hiatus hernia happens when stomach pushes into the chest through a diaphragm opening. This opening is called hiatus. The diaphragm is that part which separates abdomen from chest. Not much symptoms are present for this sort of hernia. The condition can lead to gastro-esophageal reflex disease (GERD). GORD is the condition when the acids in the stomach leaks into the food pipe. This is caused when the hiatus hernia prevents the proper working of the valve at the bottom of the esophagus. When such a condition occurs, the esophagus becomes susceptible of acids in the stomach. This can result in chest pain, unpleasant oral taste, dysphagia (swallowing difficulty), heartburn etc. These symptoms are generally called acid reflux symptoms.

Although hiatus hernia can affect people of any age group, it is commonly seen in middle aged people, smokers, and overweight people. A rare case of hiatus hernia that affects neonatals is also experienced.

There are 2 subcategories of hiatus hernia: sliding hiatus hernia & para-esophageal hiatus hernia. Almost 80% of hiatus hernia cases are of sliding type. In this type, the hernia moves up & down to the chest portion through the hiatus, hence the name. In para-esophageal type, the hernia pushes up through the diaphragm portion near to the esophagus. They are also called rolling hiatus hernias.

Hiatus hernias are generally diagnosed using endoscopy or by employing X-rays. In endoscopy, a thin telescope is passed through the food pipe. The telescope helps in providing a proper vision of the interior parts. Among X-rays, a special kind of X-ray test called barium swallow is used to detect the presence of hiatus hernia.

If no symptoms are present, there is no need for undergoing any treatment. If hiatus hernia causes any acid reflux symptoms, anything that pressurizes the stomach such as wearing tight clothes etc, should be avoided. For overweight persons, weight reduction techniques can be done to minimize the excess pressure in the body. Ill-habits such as smoking, alcohol consumption should be avoided.

Complications of hiatus hernia include stricture, barrett's esophagus etc.

Barrett's esophagus: It refers to the change in the lower parts of the esophagus. There is more probability for these portions to become malignant.

Stricture: Narrowing & scarring of lower section of esophagus can happen if the inflammation is prolonged.

In addition, the risk of development of esophageal cancer is slightly increased compared to the normal condition. However, this percentage is very small.