Hiatal hernia

What is it?

A hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity. The diaphragm separates the thoracic cavity from the abdominal cavity. The esophageal hiatus is the opening in the diaphragm through which the esophagus passes from the thoracic to the abdominal cavity.

Classification

There are different types of hernia:

• Rolling hernia is when a part of the stomach pushes (protrudes) up through the hole in the diaphragm next to the oesophagus. The most serious complication may be a reduction in the blood supply to the stomach.
• Sliding hernia is the most common type. It is when the stomach intermittently slides up into the chest through a small opening in the diaphragm.. The gastroesophageal junction pushes towards the upper abdomen, also leading to reflux problems. In some people with a hiatal hernia, it refluxes into the lower esophagus which sets off nervous reflexes that can cause a cough or even spasm of the small airways within the lungs people.
• Hiatal hernia has the characteristics of both types of hernias, previously described.

Epidemiology

Among adults, the chance of having an inguinal hernia increases with age, and inguinal hernias can appear at the age 50 and are most common in people ages of 75 to 80.
An esophageal stricture is an abnormal narrowing of the esophagus, a tube-like structure that connects your throat to the stomach. This condition is more common in senior people and is caused by factors such as organic deterioration, constipation and the continuous repetition of movements such as swallowing.
However, regardless of age, obese people are more subject to this condition, while it is a rare disease in children..

Causes

There can be different causes  of hernia:

• Abdominal trauma;
• Congenital issues;
• intra-abdominal pressure  caused by obesity;
• Cigarette smoking;
• Sedentary lifestyle;
• Constipation;
• Chronic cough.

Symptoms

In some cases hernia can be completely asymptomatic. In the other cases, the most common symptoms are:

• Reflux
• Difficulty digesting or swallowing
• Chest pain and burning sensation;
• Acid reflux;
• Bitter taste in mouth;
• Hypersalivation;
• Hoarseness;
• Ulcer;
• Anemia;
• Tightness in the stomach;
• Tightness in the chest;
• Nausea or vomiting.

Diagnosis

• The most common way to diagnose a hiatal hernia is a X-ray with contrast medium;
• Other tests used are gastroscopy or digestive endoscopy.

Pharmacological therapy

Very often hiatal hernias are treated pharmacologically. The most commonly used drugs for its treatment are the following:

• Antacids for heartburn;
• Proton pump inhibitors for reflux and heartburn;
• H2 blockers, which reduce hydrochloric acid secretion.

Surgery

If the symptoms and the size of the hernia are severe, surgery must be performed with a laparoscopy, with side effects that can persist for 3-4 weeks such as swollen abdomen, belching, meteorism and swallowing difficulties.

Natural remedies

There are several natural remedies to treat hernia:

• Fennel has a deflating action on the stomach and intestines;
• Figs reduce the production of gastric acid secretion.
• Angelica reduces secretion of hydrochloric acid in the stomach;
• Gentian stimulates digestive function by increasing saliva production and promoting both stomach acid and digestive enzymes production.

Diet

Diet can play an important role in controlling the symptoms of hiatal hernia:

• Avoid all carbonated drinks;
• Avoid hot and irritating meals for the gastric mucosa;
• Do not go to bed immediately after meals;
• Eat much pineapple that has digestive actions;
• Eat apples and bananas that play a protective action for the gastric mucosa;
• Avoid large meals. Eat little but often.
• Avoid all hard or fibrous foods that are not chewed enough that can irritate the gastric mucosa;
• Prefer toasted bread;
• Do not drink a lot with meals;
• Consume fish rich in omega 3, with anti-inflammatory action;
• Avoid coffee and chocolate;
• Avoid milk and derivatives;
• Avoid salami and red meat;
• Avoid acidic foods such as citrus fruits, tomatoes, lemons, grapefruit, blueberries;
• Avoid fries and stews;
• Avoid alcohol;
• Avoid spicy foods and sauces;
• Eliminate butter or cream;
• Eliminate dried fruit;
• Avoid salty and very sugary foods.