In most cases, it is a portion of the stomach that herniates. However, with larger hiatal hernias, other organs such as the spleen, colon, pancreas or small intestine can also protrude through. A very common condition, hiatal hernias usually occur in individuals who are over 50 years old.
There are two types of hiatal hernias, and treatment will depend on which one the patient is diagnosed with:
Sliding hiatal hernia
In this case, the stomach and the part of the esophagus that joins the stomach slide in and out of the chest through the hiatus. This is the most common type of hiatal hernia.
Fixed, or paraesophageal, hernia.
This type of hernia is less common and associated with increased risk. In this case, part of the patient’s stomach pushes through the diaphragm and stays there. This could compromise the stomach’s blood supply, resulting in a life-threatening complication called strangulation.
In most cases, very small hiatal hernias are asymptomatic. When patients do experience symptoms, they are commonly heartburn, chest pain, belching, nausea, vomiting, regurgitation, and feeling overly full after meals. These signs can be present in both types of hernias, though the more severe symptoms are usually associated with paraesophageal hernias.
If the hiatal hernia is strangulated and blocking the stomach’s blood supply, symptoms will be severe and include nausea, vomiting and an inability to pass gas and empty the bowels. This is considered a medical emergency and requires immediate evaluation and emergency surgery.
What causes a hiatal hernia?
A hiatal hernia occurs when weakened muscle tissue allows the stomach to bulge up through the diaphragm. Although the exact cause is unknown, increased pressure in the stomach and age-related changes to the diaphragm may contribute to the development of this condition. In addition, weakened muscle tissue may be caused by injury to the area or persistent pressure from coughing, vomiting or straining during bowel movements.
How is a hiatal hernia diagnosed?
Hiatal hernias are often discovered incidentally during a test or procedure to determine the cause of heartburn or chest and upper abdominal pain. To provide a definitive diagnosis, our experts will perform a specialized X-ray study that allows for visualization of the defect. During this test, the patient will drink a chalky liquid containing barium that coats the upper digestive track. An X-ray is then performed, and the liquid provides a silhouette of the esophagus, stomach and upper portion of the small intestine. This allows our experts to determine if a part of the patient’s stomach is protruding through the diaphragm, causing a hiatal hernia.
In other cases, our experts will perform an endoscopy to provide a definitive diagnosis. During this exam, a thin, flexible tube with a light and video camera attached will be advanced down the throat and into the esophagus and stomach to check for inflammation and identify the presence of a hiatal hernia.
How is a hiatal hernia treated?
If the hiatal hernia is very small, the patient may be advised to follow non-surgical treatment measures to manage their symptoms. These may include avoiding triggering foods and taking medication to prevent heartburn and neutralize stomach acidity.
If conservative measures prove ineffective, or the hernia appears to be at risk for strangulation, surgery may be required to correct the issue. In these cases, our experts will perform minimally invasive laparoscopic hernia repair. They are dedicated to providing among the safest and most effective hiatal hernia surgery Los Angeles and Beverly Hills have to offer.
To begin the procedure, we will administer general anesthesia to ensure the patient’s safety and comfort. We will then make a series of minute incisions in the abdomen, near the site of the hernia. A thin scope with a camera attached will then be inserted to obtain internal visibility of the hernia and surrounding structures. From there, we will locate and repair the defect, by pulling the stomach down into the abdomen, reducing the opening of the diaphragm, reconstructing a weak esophageal sphincter and/or removing the hernia sac. In most cases, the recovery period from hiatal hernia surgery lasts one to two weeks, at which point patients can resume light activity. At six weeks, patients can resume strenuous exercise.
If you suspect you have a hiatal hernia, it is important to seek immediate evaluation at our Los Angeles Hernia Center. Untreated hernias can lead to irreversible damage and the development of life-threatening complications, so time is of the essence.
During your initial appointment, our team of surgeons will evaluate your symptoms and provide a definitive diagnosis. From there, we will compose a custom surgical plan to repair your hernia and prevent a recurrence using the most comfortable and minimally invasive techniques available. With years of experience and countless successful procedures, our surgeons have developed a reputation for delivering among the best hiatal hernia surgery Los Angeles has to offer.
We specialize in performing complete hernia surgery and repair, using the latest and most minimally invasive techniques available. Moreover, our staff is comprised of two leading hernia experts, both of whom are fully committed to providing our patients with the best hiatal hernia treatment Beverly Hills has available.
All procedures are performed in our surgical care center, which is a private alternative to a hospital setting. Because hernia repair is typically performed as an outpatient procedure, hospitalization simply is not necessary. As such, many patients prefer to undergo treatment in our state-of-the-art facility, which offers an added level of privacy, convenience, and comfort.Learn more