A hiatal hernia is a condition in which the upper part of the stomach slides into the chest cavity. The stomach should be in the abdominal cavity, protruding upward through the gap in the diaphragm muscle, which is the muscle that separates the chest cavity from the abdominal cavity.
Hiatus hernia is mostly experienced by people aged over 50 years, where the muscles in the body begin to relax and weaken.
If the protruding part is small, a hiatal hernia is generally harmless. But when it gets bigger, food and stomach acid can back up into the esophagus and cause a burning sensation in the chest.
Causes of Hiatal Hernia
A hiatal hernia occurs because the muscle that separates the abdominal cavity and chest cavity, namely the diaphragm muscle, becomes weak, causing part of the stomach to enter the chest cavity. Although the cause of the weakening of the diaphragm is not known for certain, there are several factors that are suspected to be the trigger, including:
- Great pressure on the abdominal cavity and continuously. For example, in people who suffer from chronic cough, constipation, or in their work often lift heavy objects.
- Injury to the diaphragm. These injuries can occur due to trauma or the effects of certain surgical procedures.
- Is pregnant.
- Having a disease that causes fluid to accumulate in the abdomen (ascites), such as cirrhosis.
- Suffering from diabetes.
- Born with a large gap in the diaphragm.
In addition to the trigger factors above, certain conditions can also increase a person's risk of experiencing a hiatus hernia, including being 50 years old or older, being obese, and having a smoking habit.
Hiatal Hernia Symptoms
Hiatus hernia with a protruding part is still small does not always show symptoms. Symptoms of a new hiatus hernia appear when the hernia enlarges and causes stomach acid to rise into the esophagus. Symptoms that can be felt include:
- Burning sensation in the chest (heartburn)
- Often burp
- Bitter or sour taste in the throat
- Difficult to swallow
- Short breath
If vomiting occurs that is red or black like coffee, and dark stools such as asphalt can indicate bleeding in the digestive tract. Immediately visit the nearest health facility.
Hiatal Hernia Diagnosis
There are several tests that a doctor can do to diagnose a hiatal hernia, including:
- X-ray of the upper gastrointestinal tract (fOMD X-ray), to determine the condition of the esophagus, stomach and upper intestine more clearly.
- Gastroscopy or upper gastrointestinal binoculars, to see the condition of the esophagus and stomach from inside the mouth, and see whether there is inflammation.
- Esophageal manometry, to measure the strength and coordination of the muscles of the esophagus during swallowing.
- Acid level measurement test, to determine the level of acid in the esophagus.
- Gastric emptying test, to measure the length of time food leaves the stomach.
Hiatus Hernia Treatment
Hiatal hernias that do not cause symptoms can recover without special treatment. In mild conditions of hiatus hernia, simple treatment at home can be done to relieve the symptoms of a hiatal hernia. Handling it can be done by:
- Stop smoking and always maintain an ideal body weight.
- Eat small portions and more often.
- Do not lie down or lie down after eating, at least 2-3 hours after eating.
- Use a higher pillow.
- Avoid foods or drinks that can make symptoms worse, such as spicy foods, chocolate, tomatoes, onions, coffee, or alcohol.
- Do not wear clothes or belts that are too tight, which can increase the pressure on your stomach.
If the above does not reduce the complaint or even worsens, the gastroenterologist can give ulcer medication, either neutralizing stomach acid (antacids) or reducing stomach acid production, such as ranitidine., famotidine,omeprazole, or lansoprazole.
In more serious conditions, a surgical procedure will be performed to treat a hiatal hernia. This procedure is performed to return the stomach to the abdominal cavity and shrink the gap in the diaphragm. The operation can be done by open surgery by making an incision in the chest wall, or by a laparoscopic technique, which is done with the help of special equipment such as a camera tube.
Complications of hiatal hernia
If not treated properly, a hiatal hernia can lead to inflammation or injury to the lining of the esophagus (esophagus), or stomach. This can cause bleeding in the digestive tract.