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Hiatal Hernia – Symptoms, Causes, Diagnosis & Treatment

A hiatus hernia or hiatal hernia is when part of the stomach squeezes up into the chest through an opening (hiatus) in the diaphragm. A diaphragm is a large, thin sheet of muscle between the chest and the abdomen.

Symptoms:-
Heartburn
Regurgitation of food or liquids into the mouth
Backflow of stomach acid into the esophagus (acid reflux)
Difficulty swallowing
Chest or abdominal pain
Shortness of breath
Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding.

Causes:
Age-related changes in your diaphragm
Injury to the area, for example, after trauma or certain types of surgery
Being born with an unusually large hiatus
Persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects.

Diagnosis:
Usually, a hiatus hernia can be diagnosed with an X-ray test called a barium swallow and meal. The patient is made to drink a glassful of contrast and a series of X-ray films are obtained which show whether the stomach or a part of it lies above the diaphragm muscle and whether a person has a hiatus hernia. Most patients require an upper gastrointestinal endoscopy, where the doctor visually examines the oesophagus and stomach using a flexible telescope. In some cases, a CT scan may be required to find out which part of the stomach has slipped up into the chest.

Laparoscopic Hiatus Hernia Surgery :
A laparoscopic hiatus hernia surgery is a minimally invasive approach which involves specialized video equipments and instruments that allow the surgeon to repair a hiatus hernia via several small incisions, most of which are less than half centimeters in size.

The concept of this surgery remains same as in the open approach. The organs which have herniated into the chest are reduced back into the abdomen, the hernia sac is then removed and the diaphragm is repaired using either sutures or a piece of mesh and the part of the stomach is then wrapped partially or completely around the oesophagus. This will prevent the further reflux symptoms.

Benefits
The laparoscopic method requires much less cutting of the tissues.
There is significantly less pain after the operation compared to an open approach.
Patients will be able to return to normal activities faster.
Patients undergoing this approach will have fewer and smaller scars.
You will need a shorter hospitalization post surgery.
Minimal adverse complications.

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