References:
- Lecturer (Pascua)
The herniation of a part of the stomach through the diaphragmatic hiatus into the thorax due to an incompetent or abnormal opening of the diaphragm. There are two types:
- Sliding (Type I) Hiatal Hernia: the upper stomach and the gastroesophageal junction are displaced.
- Paraesophageal Hiatal Hernia: all parts of the stomach are displaced.
- Signs and Symptoms: (similar to the signs of GERD)
- Pyrosis when gastric contents are regurgitated into the esophagus.
- Dysphagia and odynophagia
- Feeling of fullness in the chest area
- Hemorrhaging, obstruction, and strangulation in severe cases
- Diagnostic Examination:
- X-ray studies are confirmatory for hiatal hernia.
- Barium swallow may also be used.
- Management:
- Diet: small, frequent meals
- Lifestyle:
- Avoid lying after eating for at least one hour to prevent reflux or recurrence of hernia.
- Elevate the head of the bed by four to eight inches.
- Surgery: Nissen Fundoplication (Gastric wrap-around), same as GERD.