Dr. Richard Perry, MD is a general surgeon at Banner – University Medical Center Phoenix. For more information on this topic, talk with your doctor or call 602-230-CARE.
Question: What is a hiatal hernia and how is it treated?
Answer: A person’s diaphragm, a large muscle between the chest and the abdomen, has an opening called a hiatus through which the esophagus passes before connecting to the stomach. A hiatal hernia is caused when this opening becomes weakened, allowing the stomach to push through it. Why this happens is not clear, but persistent or heavy pressure on the stomach is considered a contributing factor. Other reasons include injury to the area or being born with a large hiatus.
The majority of hiatal hernias are small and people have no symptoms, but larger hiatal hernias can cause food and stomach acid to move back up into the esophagus. When this occurs, a person can experience heartburn, belching and trouble swallowing. Large hiatal hernias are typically addressed by treating the resulting heartburn or acid reflux with medications that neutralize stomach acids, or reduce or block the production of those acids.
While less common, surgery may be required to treat a severe hiatal hernia, particularly in emergency situations, when individuals do not respond well to medication, or for individuals with gastroesophageal reflux disease and hiatal hernia who need surgery to treat both conditions. Laparoscopic surgery is a minimally invasive approach during which a surgeon inserts a tiny camera and surgical tools through several small abdominal incisions and repairs the hernia while the camera transmits internal images of the body to a nearby video monitor.
Other surgical procedures for hiatal hernias include reducing the size of the opening of the diaphragm, rebuilding weakened muscles in the area, or removing the hernia sac itself. Patients with diagnosed hiatal hernias should consult with their physicians regarding the most appropriate treatment approach for their particular situation.