Hiatal Hernia

Hiatal Hernia

  • Overview
  • Appointments
  • Symptoms
  • Diagnosis
  • Treatments
  • Locations
  • Doctors

    • What is a hiatal hernia?

    A hiatal hernia occurs when the upper part of your stomach has protruded up into your chest, pushing through the little opening (or hiatus) in your diaphragm (which separates your abdomen from your chest).

    Most of the time, hiatal hernias are so small they might not be felt at all. But if the hernia is a bit larger, it could force the opening in your diaphragm to become larger and your entire stomach and other organs are in danger of sliding up into your chest.

    A hiatal hernia can also put undue pressure on your stomach by squeezing or twisting it. This pressure can make your stomach retain acid, which can then flow up into your esophagus. You could develop chest pain, gastroesophageal reflux disease (GERD), heartburn and have trouble swallowing or even breathing. The acid may also cause ulcers within the stomach that can bleed and lead to acute or chronic anemia (low blood counts).

    There are a few different kinds of hiatal hernias. Type I hernias, or sliding hiatal hernias, are the smallest and most common variety. These hernias cause your stomach to slide through a small opening in the diaphragm, and up into your chest. These often do not require an operation or treatment.

    Much less common than these are Types II, III, and IV hernias, or paraesophageal hernias. These occur when a part of the stomach protrudes into the chest adjacent to the esophagus. That part of the stomach is “trapped” above the diaphragm and can’t slide back down again. While these hernias are far less common, they can be more dangerous, since they cause more serious symptoms, and because the blood flow to your stomach can be compromised.

    What are the risk factors for a hiatal hernia?

    Those over the age of 50, pregnant women and the obese are at higher risk. A hiatal hernia can also be triggered by insistent pressure on the hiatus muscles caused by coughing, vomiting, severe straining during bowel movements, lifting heavy objects and excessive physical exertion.

    Appointment Information

    To discuss a potential hernia treatment or surgery, contact the Surgery Call Center at (734) 936-5738.

    What are the symptoms of a hiatal hernia?

    Hiatal hernias, especially Type I hernias, do not usually cause symptoms. They may, however, be associated with the following: burping, heartburn, nausea, vomiting, and/or regurgitation into the esophagus.

    A paraesophageal hernia, or Type II, III, or IV hernia, may cause more severe symptoms. These can include:

    • Abdominal/chest pain
    • Abdominal bleeding (which can be indicated by blood in vomit, red or black stool, anemia or a blood test indicating loss of blood)
    • Change in voice
    • Early satiety (or becoming full after only eating a small amount of food)
    • Occasional trouble swallowing (especially solid food)
    • Shortness of breath or trouble breathing after eating
    • Acid reflux
    • Regurgitation or a sensation of food “sticking”

    How is a hiatal hernia diagnosed?

    Along with a complete exam and detailed medical history, your surgeon may use one or more diagnostic tests to determine the best course of treatment.

    • Barium Swallow / Upper GI study: This requires that you swallow a small amount of contrast material, or liquid barium, which coats the lining of your esophagus so that X-ray images can be taken. If you have trouble swallowing, this procedure can help to locate any areas in your esophagus that may have narrowed, also known as strictures.
    • Chest X-rays: Electromagnetic energy produces images of internal tissues, bones and organs.
    • CT-Scans: These scans make up a series of images of the inside of your body taken from different angles.
    • Upper Endoscopy (EGD): An endoscope is threaded through your mouth and then into your esophagus, allowing your surgeon to actually see your upper digestive tract, which includes your esophagus, stomach, and duodenum, or the first part of your small intestine. If needed, a tissue sample can be removed during this procedure.

    How is a hiatal hernia treated?

    Hiatal hernias don’t always require treatment beyond regular monitoring and medications. Under certain conditions, however, treatment will be necessary. Those conditions include: chronic anemia; chronic pain; complications by gastroesophageal reflux disease; complications by esophagitis; danger of strangulation; inability to vomit; recurrent pneumonia or other infections. The following treatments are available for those with hiatal hernias.

    Minimally invasive surgery can effectively diminish the size of a hernia, as well as reduce the opening in the diaphragm, thereby preventing strangulation. During this procedure, surgeons will insert a tiny video camera into your abdomen. They’ll be able to view images projected onto a monitor, which will allow them to complete the procedure with greater control and finesse. The purpose of this surgery is to restore the stomach into your abdomen and close down the hole in the diaphragm. Minimally invasive surgery is associated with a quicker recovery and faster return to function than traditional open repair. Your doctor will determine if you are a candidate for this approach

    Locations
    • General Surgery Clinic | Chelsea Professional Office Building 14650 E Old US Highway 12 Ste 201
      Chelsea Multispecialty Clinic
      Chelsea, MI 48118-1801       Get Directions
    • General Surgery Clinic | Taubman Center 1500 E Medical Center Dr
      Floor 2 Reception C
      Ann Arbor, MI 48109-5331       Get Directions

    Doctors

     Search for a U-M Health doctor     Andrew Ching-Hung Chang, MD

    Andrew Ching-Hung Chang, MD

    Professor

    Thoracic Surgery, Surgery

    Justin Brigham Dimick, MD

    Justin Brigham Dimick, MD

    Professor

    Surgery

    Chigozirim Ekeke, MD

    Chigozirim Ekeke, MD

    Assistant Professor

    Thoracic Surgery

    Jonathan Ford Finks, MD

    Clinical Professor

    Surgery

    Hope Tiffany Jackson, MD

    Hope Tiffany Jackson, MD

    Clinical Associate Professor

    Surgery

    Grace Jane Kim, MD

    Clinical Professor

    Surgery

    Kiran Hari Lagisetty, MD

    Kiran Hari Lagisetty, MD

    Clinical Associate Professor

    Thoracic Surgery, Surgery

    Jules Lin, MD

    Professor

    Thoracic Surgery, Surgical Critical Care, Surgery

    Sean Michael O'Neill, MD

    Sean Michael O'Neill, MD

    Clinical Assistant Professor

    Surgery

    Nabeel R Obeid, MD, FACS, FASMBS

    Nabeel Robert Obeid, MD

    Clinical Associate Professor

    Surgery

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