The opening in the diaphragm through which the esophagus reaches into the abdominal cavity is also called diaphragmatic hiatus. When this opening becomes weaker due to any kind of problem, the upper part of the stomach pushes through and reaches the chest backwards. In this case, a hiatus hernia has occurred and if you suffer from it you must know how to live and deal with it.
Instead of eating regular three meals per day you must try to eat about six times day and lower quantities of food in order to protect the stomach that has already moved from its place. Before going to sleep never eat or drink anything for about one or two hours. Avoid bending towards after you have had you're meal and avoid foods causing heartburn. Also try to avoid alcohol and in case of heartburn use an antacid drug. Always sleep with head and shoulders on an incline and never sleep with clothes that might constrict your body especially in the stomach area. You must immediately stop smoking and avoid any activity causing abdominal strain. If you follow these instructions properly, you will get to be able to live with the hiatus hernia.
Other important tricks and advices must also be taking seriously if you want to worry even less about you hiatus condition. When you plan of having dinner in a restaurant learn which foods are potential triggers of heartburn and avoid them. A diet against heartburn also includes avoiding food that might potentially trigger an acid reflux. The acid reflux from the stomach into the esophagus is another important symptom of hiatus hernia and may cause disturbing heartburn.
Patients suffering from heartburn must avoid drinking alcohol as much as possible as it is a very important trigger of acid reflux. In rare cases if you pay attention to some vital tricks about alcoholic beverages, you may be allowed to drink small amounts of alcohol without fearing you will suffer heartburn crises.
Smoking is known to affect patients with hiatus hernia as it immediately stimulates the gastric acid production and leads to a weakening or relaxation of the inferior esophageal sphincter. If this occurs, the stomach content is allowed to get back into the esophagus and produce damages to its mucosa.
Beside all the advices below, you must carefully monitor the triggers of your personal heartburn conditions and avoid them permanently. Some products may be responsible also for the severity of the heartburn and for your body's reaction. Other foods may on the contrary be able to offer you relief.
There are two major types of hiatus hernia: the sliding hernia occurs when both the gastroesophageal junction and the upper part of the stomach slide back into the chest cavity. They can remain permanently inside the chest or only slide upwards during the swallowing process, when the esophagus contracts and shortens due to contraction pulling on the stomach. When the swallowing is completed, the junction falls back in the abdomen.
The second type of hiatus hernia is the Para esophageal one when the junction remains at its place but the upper part of the stomach is squeezed beside the esophagus and up into the chest. The most common complications of this type of hernia are incarceration and strangulation.
The occurrence of hiatus hernia can be caused by several factors like weightlifting, abdominal injuries with lesions of the diaphragmatic hiatus, high pressure inside the abdominal cavity due to coughing, vomiting or bowel movements, pregnancy, obesity, tight clothes or constipation.
Most of the sufferers from hiatus hernia have no symptom manifestations; some of them still, can experience heartburn, regurgitation, vomiting, and gastroesophageal reflux disease, sour or bitter taste inside the mouth, often belching or hiccups, chest pain radiation. Other possible symptoms in case of hiatus hernia are increased chest pressure, bloating after meals, abdominal pressure and discomfort, discomfort and pain in the esophageal or stomach area, difficulties during swallowing, gas and unexplained dry cough.
The most frequently associated conditions with the hiatus hernia are the erosive esophagiis due to the acid contents of the stomach refluxed into the esophagus and the Though Barrett's esophagus also connected to the gastroesophageal reflux disease.
The most used technique to diagnose a hiatal hernia is the Barium X-ray when the patient swallows liquid containing barium which covers the esophageal and stomach walls making them visible for the X-rays. Another technique is the upper endoscopy allowing the doctor to visualize esophagus, stomach and duodenum; it is performed with a thin and flexible lighted tube. Another testing for detecting the existence of heartburn symptoms is the Bernstein Test. Also called acid perfusion test, it is used in combination with other functional techniques like the barium X-ray to determine the existence of gastroesophageal reflux caused by a hiatus hernia.
Patients with no clinical manifestation require no treatment. The ones with medium changes need lifestyle changes and medication to control the condition and only the ones with severe symptoms and eventual complications require surgical intervention.