A hiatal hernia happens when part of your stomach pushes through the diaphragm into your chest. This occurs due to increased pressure in the abdomen. While small hernias usually don’t cause symptoms, larger ones can lead to problems like acid reflux, chest pain, and difficulty swallowing.
What Is a Hiatal Hernia?
A hiatal hernia is a condition where part of the stomach bulges into the chest cavity through an opening in the diaphragm. The diaphragm is a muscle that separates the chest from the abdomen.
Pressure from things like obesity, coughing, or pregnancy can cause a hiatal hernia.
- Symptoms of Hiatal Hernia:
- Heartburn
- Abdominal bloating
- Chest pain
- Nausea and vomiting
- A bitter taste in the mouth
- Discomfort in the stomach or chest
When Do You Need Surgery?
Small hiatal hernias, less than 5 cm (about 2 to 3 inches), usually don’t need surgery. These can be managed with lifestyle changes like diet and weight loss, along with medication. However, if the hernia grows larger, surgery may be necessary.
Hernias over 7 cm can cause severe symptoms like heartburn, chest pain, and shortness of breath. If untreated, they can lead to complications like obstruction or strangulation, which are serious. These larger hernias typically need surgery.
Types of Hiatal Hernia:
- Type 1 (Sliding Hiatal Hernia): The most common type, where the stomach slides into the chest. This type often causes mild acid reflux, which can be controlled with medication and lifestyle changes. Surgery is usually not needed unless symptoms worsen.
- Type 2 (Paraesophageal Hiatal Hernia): Part of the stomach pushes through the diaphragm, but the connection between the stomach and esophagus stays in place. This type usually does not require surgery unless it causes problems.
- Type 3 (Mixed Hiatal Hernia): This is a more complicated hernia where both the stomach and the esophagus move into the chest. Surgery is needed as it can cause more serious problems.
- Type 4 (Large Hiatal Hernia): This is the most serious type. The stomach, along with other organs like the spleen or pancreas, may move into the chest. Surgery is always required for this type due to the risk of complications.
How Is a Hiatal Hernia Treated Surgically?
If a hernia is large or causing severe symptoms, surgery may be necessary. Here are the common types of surgery:
- Open Surgery: This older method requires large cuts to push the stomach back into place and seal the hole in the diaphragm. It may take longer to heal and can leave large scars.
- Laparoscopic Surgery: This is a modern, minimally invasive procedure. Small incisions are made, and a camera is used to guide the surgery. Recovery is faster, and there is less scarring.
- Robotic Surgery: Similar to laparoscopic surgery but with the help of robotic tools. This method also involves small cuts and allows for precise repairs with quicker recovery.
Conclusion
Small hiatal hernias can often be managed with lifestyle changes and medications. Larger hernias, especially those over 7 cm, can cause serious symptoms and require surgery.
Types of surgery include open surgery, laparoscopic surgery, and robotic surgery, with each having its own advantages.
If you have symptoms of a hiatal hernia, seek medical help from our medically acclaimed professional Dr. Rick Ngo at Texas Hernia & Surgical Specialists or call us at (888) 365-1544 to book an appointment.