Hiatus Hernia Definition By Medical
Before entering the hiatus hernia definition, it’s good we understand the term hernia itself. Hernia is the weakening of muscle tissue around the body, especially in the abdominal area (abdomen), which causes the internal organs in the surrounding body is pushed or sticking through the weakened tissue.
The hiatus hernia occurs when a portion of the stomach is pushed up into the diaphragm (the chest and abdominal cavity muscles). The diaphragm has a hole (hiatus) that functions to connect the esophagus (pipe / duct food) and stomach. When there is weakness, the stomach will stick out through this hole until it reaches the diaphragm, even down to the chest cavity.
In most cases, a small hiatus will not cause any symptoms, but when the size begins to enlarge, hiatus hernia can cause food and gastric acid to rise to the esophagus.
Hiatus Hernia attacks many people aged over 50 years, in which the muscles of the body begin to relax and weaken. According to the Esophageal Cancer Awareness Association, more than half of the elderly aged 60 will develop this disorder.
The Cause of Hiatus Hernia
The cause of muscle weakness resulting in a hernia is still not known with certainty. But age is a risk factor that is closely associated with hiatus hernia. As we get older, the muscle strength of the diaphragm will further weaken, so the risk for hiatus hernia will increase.
Some other factors that can trigger a hiatus hernia, are:
- Born with a hiatus size that is larger than the size in general.
- Experiencing cuts or tears in the diaphragm area.
- Continuous pressure on muscle tissue around the hiatus, for example when pushing while urinating, coughing, vomiting, or lifting heavy loads.
There are two main types of hiatus hernia:
- Sliding hiatal hernia – a hernia that moves up or down, or that enters or leaves the chest area (this type is the most common).
- The para-oesophageal hiatus hernia, ie, when a portion of the stomach is pushed up through the hiatus located on the side of the esophagus.
Symptoms of Hiatus Hernia
A small hiatus hernia does not always show symptoms as well as a large hiatus hernia. Some of the major hiatus hernia symptoms commonly felt by sufferers include:
- Burning sensation in the chest due to acid rise to the esophagus (heartburn)
- Difficult to swallow
- Hard to breathe
- Pain in the chest or abdominal area
- Feel very full after eating
- Vomiting blood, or
- Remove the dark stools that indicate bleeding in the digestive tract.
Diagnosis of Hiatus Hernia
In some cases, a small hiatus hernia has no symptoms or disturbances so the sufferer may not be aware of having this condition. A hiatus hernia may be detected only when the patient tests for other disorders. The doctor may ask questions that relate to symptoms that have been felt or other things that are related to the condition of the patient.
In addition to an interview or anamnesa, the doctor may proceed with the examination, such as:
- Blood test to detect anemia
- Medical imaging of the body, such as CT scan and X-ray.
- Endoscopy to detect inflammation by inserting a flexible tube equipped with a camera and light into the throat, throat to the abdomen.
- Esofagram to get a clear picture of the esophagus, stomach, and upper gastrointestinal tract on X-ray results. The clear picture is produced by the lime liquid drunk before the examination. This liquid contains a barium that will coat the upper gastrointestinal tract for easy viewing.
- Manometry to measure pressure and movement in the esophagus by inserting the catheter through the nose, esophagus to the abdomen.
Treatment of Hiatus Hernia
Treatment of hiatus hernia is usually intended to relieve symptoms. Here are some treatment recommendations if the patient experiences symptoms such as heartburn and reflux (acid reflux).
- Drugs to reduce acid production, such as cimetidine, nizatidine, famotidine, and ranitidine.
- Antacids to neutralize acid from the stomach.
- Drugs to inhibit acid production and cure tissue in the esophagus, such as omeprazole and lansoprazole.
The surgical procedure may be suggested in cases of hiatus hernia that are not improved by administration of drugs. In addition, a very large case of hiatus hernia may also have to be treated with surgery. The surgery is performed to pull the stomach back to its original position with the aim of shrinking the opening (hiatus), reconstructing the muscle rings on the hiatus to return strong, or lifting the hernia. Some common methods of surgery are:
- Toraktomi – Method of operation by making a single slice on the chest wall.
- Laparotomy – Method of operation by making a single slice on the abdomen.
- Laparoscopic – Method of operation performed with the help of the monitor to determine the exact location of the abnormality that occurred.
In addition, the symptoms of hiatus hernia can also be appeased by taking several steps, such as:
- Avoid foods that can trigger heartburn, such as chocolate, citrus / sour fruits, onions, tomato-based foods, and spicy foods.
- Get used to eating in small portions throughout the day compared to eating in large portions. At night, a good meal is at least 2-3 hours before bedtime.
- Avoid alcoholic beverages
- Raise the side of the head of the mattress as high as 15 cm if going to sleep.
- Quit smoking.
- Lose weight for those who are overweight and obese.