Hiatus Hernia
A condition where part of the stomach pushes up through the diaphragm into the chest cavity.
Overview
A hiatus hernia occurs when part of the stomach pushes up through the diaphragm opening (hiatus) into the chest. Small hernias often cause acid reflux and heartburn, while large ones can cause swallowing difficulty and, rarely, dangerous twisting of the stomach. Many are managed with medication, but persistent or large hernias benefit from surgery.
Causes
- Weakening of the diaphragm opening with age
- Raised abdominal pressure (obesity, pregnancy, straining)
- Chronic cough
- Congenital predisposition
Risk Factors
- Age over 50
- Obesity
- Smoking
- Chronic straining or heavy lifting
- Pregnancy
Symptoms
Diagnosis
- Upper GI endoscopy
- Barium swallow study
- Esophageal manometry (for large hernias or before surgery)
- 24-hour pH study (to assess reflux)
Treatment Options
Surgical Treatment
When symptoms persist despite medication, or the hernia is large, laparoscopic repair is highly effective. The stomach is returned to the abdomen, the diaphragm opening is tightened (with mesh for large defects), and an anti-reflux wrap (fundoplication) is added to control acid reflux. Dr. Bhagat performs these keyhole repairs with excellent symptom relief and fast recovery.
Recovery
Laparoscopic repair typically involves a 1–3 day hospital stay and a graded soft diet for a few weeks. Most patients return to normal activity within 2–3 weeks and experience lasting relief from reflux.
Prevention
- Maintain a healthy weight
- Avoid large, fatty meals late at night
- Stop smoking
- Manage chronic cough and constipation
- Avoid heavy lifting and straining
Frequently Asked Questions
Does every hiatus hernia need surgery?
Will surgery cure my acid reflux?
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