Laparoscopic Hernia Repair Article

Hiatal Hernia

Whenever an internal part of a body pushes into a place where it does not belong it is said to be a hernia.

There is an opening in the diaphragm called the hiatus. The diaphragm is the muscular wall which divides the chest cavity from the abdominal cavity. The esophagus or food tube goes through the hiatus where it then attaches to the stonach. When a person has a hiatal hernia, the stomach bulges up through the hiatus and goes up into the chest cavity. The two main types of hiatal hernias are sliding and paraesophageal which means that it is next to the esophagus.

In the sliding hiatal hernia, the stomach and portion of the esophagus which joins the stomach slide up throught the hiatus into the chest cavity. The sliding hiatal hernia is the more common of the two types of hernias.

While the paraesphageal hernia is the less common of the two types of hernias, it presents more of a problem. With this type of hernia, the stomach and the esophagus stay in their normal positions, but a portion of one's stomach squeezes through the hiatus. This then puts the portion of the stomach next to the esophagus. The bad thing about having this type of hernia is that the stomach can have its supply of blood shut off. Therefore, it becomes "strangled".

People with a hiatal hernia often have GERD or gastrointestinal reflux disease. Even though there seems to be a link, not everyone who has GERD has a hiatal hernia, and not everyone who has a hiatal hernia has GERD. The pain of a hiatal hernia can mimic the pain of a person having a heart attack. That is why it is very important to get the proper testing so that the proper diagnosis can be made.

Causes of Hiatal Hernias

In many instances the cause of a hiatal hernia is not known. Some are born with a weakness while other get a hiatal hernia after having had an injury to a certain part of the body. It is suspected that an increase of pressure in the abdomen or a substantial gain of weight may all lead to the development of a person getting a hiatal hernia.

Risk Factors

There is an increased occurrence of hiatal hernia in people over fifty. They are also more likely to occur in overweight people, especially women. Smokers also seem predisposed to hiatal hernias.

Diagnosis

A hiatal hernia is usually diagnosed with a specialized X-ray that allows for the visualization of the esophagus or with endoscopy.

Treatment

If people do not experience any symptoms then no treatment is needed. However, as stated above, surgery is usually recommended for the paraesophaeal hernia. GERD should be treated with diet and with medication. Chest pain should be evaluated.

Surgical Intervention

If there is a chance that the hernia is becoming stangulated, then surgery may be the answer that is necessary to reduce it and put it back in its original location. This can be performed as a laparoscopic procedure. This can be performed without having to cut the patient open. It cuts down on pain, scarring and there is more rapid recovery time.