Hiatal Hernia (Causes, Symptoms, Diagnosis, Treatment)
What is Hiatal Hernia?
Hiatal hernia is a very common condition where the top of your stomach bulges through an opening in your diaphragm and into the chest cavity. The diaphragm has a little opening (esophageal hiatus) through which your esophagus (food tube) passes before it connects to your stomach.
In the case of a hiatal hernia, the stomach pushes up through that opening and causes discomfort. Paraesophageal hernia (less commonly occurring, 5%) is more dangerous.
This abnormality happens when your esophagus and stomach remain where they should be, but part of your stomach squeezes up through the hiatus and sits next to your esophagus causing discomfort.
Your stomach can get squeezed and lose blood supply, so it’s generally called a strangulated hernia.
Types of Hiatal Hernia:
There are two main types of Hiatal hernias:
They can also be categorized into these 4 types:
Type I –
Sliding Hiatal Hernia: This is the most common type and represents 95% of all Hiatal hernias.
They are not very dangerous(but, not to be taken lightly) and can be cured via chiropractic care/adjustments(Synergy Wellness NYC), medications, or in some severe occurrence, surgery is the last resort.
Type II, III, IV –
Paraesophageal Hiatal Hernias: Rarely occurs and represents 5% of the total hiatal hernia cases. These are some really serious situations and can be very discomforting to the individual and can cause immense pain.
Cause of Hiatal Hernia:
The causes of Hiatal hernia are not entirely known and cannot be specified. It is very unique to each individual. Doctors have a list of reasons that can cause this condition which is mostly due to pressure, a trauma in that area, and mechanical causes.
A hiatal hernia occurs when the muscle tissues holding the stomach weaken and allows it to bulge up through the diaphragm. It’s not always clear what causes Hiatal Hernia. But a hiatal hernia might be caused by:
1. Age-related changes in your diaphragm:
With age the muscles holding the stomach and the diaphragm loosens and can cause the stomach to slip out of position.
2. Poor posture during workout: This is one of the most common and leading causes of Hiatal Hernia in young people. Irregular breathing while having improper posture forces the hernia to slip through the esophageal hiatus. A condition called scoliosis would further complicate a hiatal hernia.
3. Traumatic injury to the area or blows to the abdomen.
4. Post-surgery trauma in certain cases.
5. Obesity and large body size.
6. Being born with an unusually large esophageal hiatus.
7. Intense pressure on the surrounding muscles: coughing, vomiting, straining during a bowel movement, pregnancy, exercising or lifting heavy objects/weight lifting.
Symptoms of Hiatal Hernia:
Hiatal hernia signs and symptoms are very confusing. Most of the time it is misdiagnosed as something else and that can be very irritating. It can bother you if not treated properly.
1. Heartburn: This is caused due to Acid reflux. It is a burning sensation in your chest, usually after eating, which might be worse at night or while lying down.
2. Regurgitation of food or liquids into the mouth: Very popularly known as GERD(Gastroesophageal reflux disease). It is a condition where the stomach contents leak backward into the esophagus (food pipe). GERD can irritate the food pipe.
3. Difficulty swallowing Chest or abdominal pain: Hiatal Hernia can cause a blockage of food while swallowing causing pain in the abdomen and in the worst case may result in choking.
4. Feeling full soon after you eat and a lot of belching
5. Shortness of breath.
6. Vomiting of blood or passing of black stools: Gastrointestinal bleeding.
These are some of the symptoms that Doctors around the world have listed which may or may not indicate a Hiatal Hernia. If you have noticed some of the following symptoms it is highly recommended to get help from your doctor.
There are some studies that go deeper into the symptoms of Hiatal Hernia. Altering the stomach’s position can cause the hernia to squeeze the neighboring vagus nerve. The vagus nerve stimulates the release of hydrochloric acid. This might cause over or under-secretion of hydrochloric acid.
Researchers from the University of Michigan Medical School found cases where, sometimes, Hiatal hernias were responsible for heart palpitations. It is caused due to stimulation of the vagus nerve.
Diagnosis of Hiatal Hernia:
A hiatal hernia is discovered during a test or procedure that is done to determine the causes of heartburn, chest pain, or upper abdominal pain. It can be done mostly by an imaging test that checks for problems in the upper GI tract which includes your mouth, throat, esophagus, and stomach.
Common ways to detect Hiatal Hernia:
1. A barium swallow(esophagogram) Upper GI tract imaging test:
The X-ray of your upper digestive system can show the hernia after a barium swallow. This is one of the very popular methods to check the cause of your heartburns.
2. Upper endoscopy:
A thin, flexible tube with a camera (endoscope) goes down your throat, to examine the inside of your esophagus and stomach to check for any inflammation.
Cure for Hiatal Hernia:
Treatment for a hiatal hernia is a little tricky because of its multiple types. There are many sorts of occurrences and everyone needs a different procedure to get the fix.
In some instances, it has been noted that the patient does not need any treatment. 85% of hiatal hernia cases are asymptomatic. And in other cases, it’s so bad that surgery is the only way out.
So, do you need to worry?
Well, as I said, it’s very tricky. Hiatal hernia due to its multiple types is followed by multiple cases and different cures.
Most of the patients lie in between the parameter of curable by chiropractic care withouit medication or surgery to curable only via surgery. Let’s have a look at all of them:
In many cases, the hiatal hernia maneuver has shown to be very effective and does wonders for patients.
The hiatal hernia maneuver is a technique where the chiropractic physician physically slides the hernia to its actual position under the hiatus.
Dr. David Kulla of Synergy Wellness Chiropractic & Physical Therapy has been treating thousands of patients successfully with the hiatal hernia maneuver done by hand.
Dr. Kulla also has a patent on a self help (currently working on FDA approval) device for hiatal hernia. Physicians have found the Hiatal Hernia maneuver to be more satisfactory for the patients as it keeps them away from medication and surgery.
For many, medication doesn’t work. The maneuver is a little uncomfortable but has been documented to be very successful with over a 95% success rate treating sliding type 1 hiatal hernias. The only caveat here is that Hiatal Hernia maneuver can only be used in Type I and some II Hiatal Hernias.
Medication is also one of the very popular treatment options for Hiatal Hernia. They don’t actually cure your hiatal hernia but may help you with acid reflux and heartburn.
It’s a temporary solution and can only be treated by either surgery or chiropractic care. Make sure you consult your physician in case of heartburn or acid reflux. If you experience heartburn and acid reflux, your doctor may recommend:
Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids, and Tums, may provide temporary relief. These can be harmful in the long run because they have side effects.
Medications that block acid production and heal the esophagus. These medications(e.g.- omeprazole), known as proton pump inhibitors, are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal.
In the worst case scenario surgery is the only option, which has an estimated 90% success rate, but that rate lowers significantly 5 years post surgery. Still, about 30% of people will have reflux symptoms return.
Due to its return, it’s still not considered to be a permanent solution and sometimes may need chiropractic attention to keep the hernia in check.
Once you have surgery you cannot have the hiatal hernia maneuver done. Surgery tends to be the last option for patients who aren’t helped by medications to relieve heartburn and acid reflux or have some other complications like severe inflammation or narrowing of the esophagus.
Laparoscopy or fundoscopic surgery: It is a type of surgical procedure that allows a surgeon to access the inside of the abdomen and pelvis without having to make large incisions in the skin.
This is one of the least invasive techniques and is safer. Surgery should always be considered as a last resort.
If you suffer from a hiatal hernia and are visiting the new york city come visit us in manhattan, New York.
Don’t forget to call first 212-533-4900 or BOOK HERE. > www.SynergyWellnessNy.com