Hiatus hernia: what is it?

The most common lesions of the digestive system are hiatus hernias. We speak of a hiatus hernia when the upper part of thestomach rises in the chest.

In normal times, theesophagus crosses the muscle of the diaphragm through an orifice called the hiatus – which gives its name to the hiatus hernia – and is connected in its lower part to the stomach. In the case of a hiatus hernia, the stomach rises through the hiatus, and its upper part is therefore found above the diaphragm.

There are two types of hiatus hernias. When the junction between the esophagus and the stomach (called the gastroesophageal junction) goes up in the chest with a portion of the stomach, the hiatus hernia is called by sliding. This is the case for 90% of hiatus hernias.

In the second case, we speak of a rolling hiatus hernia. The gastroesophageal junction (also called cardia) remains in its place, but a portion of the stomach rises, compressed by the diaphragm, and is found next to the esophagus. In very rare cases, a mixed hernia may appear: it will be a combination of the two types of hiatus hernias.

Hiatus hernia: benign in most cases

A hiatus hernia in itself is not a serious injury, but it does require follow-up to prevent rare complications.

Slip hiatus hernia is asymptomatic in most cases. In the 10 to 15% of cases where it is not, it is the cause of reflux gastric and stomach pains. His diagnostic is often done by chance.

The diagnosis is more difficult in the case of a sliding hiatus hernia, and the symptoms more frequent. From pains chest, discomfort in breathing, pneumonia frequent, chronic cough, ulcers, abdominal pain and bloating can be felt. Bleeding from the hernia can also induce anemia.

In rare cases of acute complications and if the hernia is large (considered large when it exceeds 2 inches), the stomach may constrict and the gastric wall may become necrotic. These cases represent 2 to 5% of hiatus hernias by rolling and require hospitalization.

Stress, age or being overweight promote the appearance of hiatus hernias

The causes of hiatus hernia can be numerous and difficult to isolate. A stomach injury, a birth defect with a larger than normal hiatus, or being overweight can be the cause of the hernia. the stress, the change in the diaphragm with age or the fact of regularly wearing too tight clothes, such as corsets, can also be triggering or aggravating factors.

The surgery is not necessarily indicated since it is possible to live with a hiatus hernia without its quality of life being affected. When the symptoms are mild, such as mainly reflux, drug treatment will be preferred. To relieve symptoms, it is also recommended to split your meals, that is to say to eat small amounts in several times during the day, to avoid tobacco, alcohol, caffeine and food too acids, adopt a healthy lifestyle if the patient is overweight, avoid wearing tight clothing at the level of theabdomen, not to lie down after eating, or to elevate your head to sleep.

Surgery is advised by the doctor as a last resort, if drug treatment has not worked, or if the hiatus hernia is large or has serious risks or complications.