Hiatal Hernia

Some people with hiatal hernia may not show any symptoms while others may show symptoms which closely resemble that of gastroesophageal reflux disease (GERD). The following are the symptoms of hiatal hernia:

• Heartburn
• Chest pain
• Frequent burping
• Backflow of stomach acid into the food pipe or the throat
• Bad breath
• Bitter taste in the mouth
• Bloating 
• Stomach pain
• Burning sensation in the throat
• Pain while swallowing

Since most of these symptoms are also seen during a heart attack, a person needs to seek a medical professional as soon as the symptoms start appearing. 

There is no specific cause for hiatal hernia but researchers believe that it can occur due to increased pressure in the abdominal cavity. The pressure in the abdominal cavity can build-up due to the following reasons:

• Excessive coughing
• Heavy weight lifting
• Physical strain
• Continuous vomiting
• Excessive straining during constipation

There are certain tests which are helpful in diagnosing hiatal hernia in a person:

• Chest X-ray: Chest x-rays help in diagnosing the size and position of hiatal hernia in a person.
• Endoscopy: A specific kind of endoscopy, called the esophagogastroduodenoscopy or the EGD, is done using an endoscope. An endoscope is a thin tube with a camera attached to one end. During this endoscopy, the tube is inserted to look into the food pipe (oesophagus), the stomach and the initial part of the small intestine (duodenum).
• Barium swallow test: In this test, the patient is asked to swallow liquid barium, which flows through the stomach and intestine. Since the barium appears opaque on an X-ray, the organs appear clear on the X-ray films. 
• Oesophageal manometry: In this test, a tube is inserted through the nostril into the oesophagus (food pipe) to check for muscle strength. A weak muscle in the oesophagus leads to acid reflux in the throat.
• pH test: This test is done to check the presence of acid reflux in the food pipe (oesophagus).

You can not predict if and when you may get a hiatal hernia, but you can certainly work on reducing the risk factors for hiatal hernia. Some of the preventive steps you can take are:

• Eat smaller quantities of food in order to avoid acid reflux.
• Quit smoking as tobacco irritates the digestive system and can lead to GERD.
• Avoiding certain food items like tomato sauce and citrus fruits which are acidic in nature and can irritate the lining of the food pipe (oesophagus).
• Maintain your weight to avoid putting pressure on your abdominal cavity.
• If you are constipated, do not put excessive strain on your bowels as you may herniate or even bleed through your anus. You can take laxatives or stool softeners to relieve constipation.
• Eat more fibre to keep the bowels healthy.
• Do not lift heavy objects or weights, especially if you are over 50 years old.
• Do not wear tight belts, tummy tuckers or shapers as they can put a lot of pressure on your abdomen.

The treatment of hiatal hernia is initially done with the help of medicines to reduce symptoms. If the patient does not respond to the drug therapy, surgery is the next option for them.