Hiatal hernia is a condition that affects people of all ages but is far more common in the elderly, particularly those that are 50 years and above. It also affects about 12-20% of pregnant women. A small hiatal hernia isn’t usually a cause for alarm. You may not know you have it unless a physician discovers it while trying to check for another condition. However, a large hiatal hernia can cause problems when it presents with symptoms like Gastroesophageal Reflux Disease (GERD), which leads to heartburn. Hiatal hernia can be so severe that it leads to shortness of breath. This is why it is important to know the ways to go about it in the comfort of your home.
In this post, you will learn the meaning of hiatal hernia, the types, causes, risk factors, symptoms, preventions, and some natural ways by which hiatal hernias can be cured. So, sit back, and enjoy!
Table of Contents
What is Hiatal Hernia?
A hiatal hernia is a condition that occurs when the upper part of the stomach protrudes through the diaphragm to the chest cavity.
The diaphragm is a thin dome-shaped muscle that separates the chest cavity from the abdominal cavity. In the diaphragm, there is a small opening known as the hiatus. This opening allows the esophageal tube to transfer food down to the stomach. What happens in a hiatal hernia is that abdominal contents that should primarily be in the abdominal cavity will protrude through this opening and enter the chest cavity.
Types of Hiatal Hernia
There are two main types of hiatal hernias. They are:
Sliding Hiatal Hernia (Type I)
Sliding hiatal hernia is when the lower portion of the esophagus (esophageal junction) and the upper part of the stomach protrude up and down through the hiatus of the diaphragm into the chest cavity and the abdominal cavity.
Sliding hiatal hernia is the most common type of hernia accounting for about 90% of Hiatal hernias that affect people. They are usually mild and don’t show symptoms. When discovered, they may not require any intervention because they are usually small. However, some people, usually a small percentage may present with symptoms.
Para-esophageal Hiatal Hernia (Type II)
The para-esophageal hernia is the second type of hiatal hernia. It is less common accounting for about 12% of people with hiatal hernia. In this type, the stomach, together with the abdominal structures squeezes through the hiatus of the diaphragm and stays adjacent to the esophagus which is located in the chest region. Rather than move up and down as seen in sliding hiatal hernia, it may get stuck, get squeezed, and lead to complications.
The two other types of hiatal hernias are a subset of the previous ones. They are:
Type III Hiatal Hernia
Type III hernia is a type of hiatal hernia that comprises both types I and types II hernia. In this case, the features of the previous hernias are seen.
Type IV Hiatal Hernia
This happens when other abdominal structures herniate through the esophageal hiatus of the diaphragm into the chest cavity.
Causes of Hiatal Hernia
The exact cause of the hiatal hernia is not known. When the muscles surrounding the hiatus of the diaphragm weaken, it can lead to the development of a hiatal hernia. Hiatal hernia can either be congenital (from birth) or caused by persistent pressure exerted on the diaphragm. When the intra-abdominal pressure is higher than the tensile strength of the diaphragm, there will be a weakness of the diaphragm and this will lead to a hiatal hernia. This pressure can further cause injury to the diaphragm. The following can cause overexertion of the diaphragm:
Straining When Moving the Bowels
When you strain when passing out your stool, it may cause pressure on the diaphragm and lead to a hiatal hernia. The hard stool is the major reason that causes straining during bowel movement. Some causes of the hard stool are a low-fiber diet, inadequate drinking of water (dehydration), and lack of exercise.
Trauma can also cause a hiatal hernia. When an injury is inflicted on the diaphragm, usually by an accident, fall, or a blunt object that strikes with low to high velocity, there can be a direct development of a hiatal hernia.
When you are about to lift a heavy object, if you suddenly strain or force yourself while performing the task, you could get a hiatal hernia.
Persistent coughing can also increase intra-abdominal pressure, and cause hiatal hernia. Also, if the diaphragm is weak, persistent coughing can force the abdominal organs through the hiatus of the diaphragm into the chest cavity where it connects to the esophagus. A condition is known as the hiatal hernia.
Vomiting is an involuntary reaction that causes a forceful evacuation of abdominal contents through the mouth. When this action is repeated, it can cause a build-up of intra-abdominal and cause a hiatal hernia.
Risk Factors of Hiatal Hernia
As we get older, the risk of developing hiatal hernia increases. This is because the muscles of the body get weaker, including the diaphragm. People that are 50 years and above have a higher risk of developing hiatal hernia than those below.
Being overweight and obese puts an extra strain on the abdominal muscles, and causes them to become weaker, thereby making them susceptible to developing a hiatal hernia. Accumulation of excess fat, therefore, increases the risk of having it.
The gender of a person can also affect the chances of getting a hiatal hernia. Hiatal hernia is more common in women than in men.
Women who are pregnant frequently develop a hiatal hernia. Hiatal hernia affects about 15-20% of pregnant women. Abdominal organs may occasionally protrude through the diaphragm as a result of the growing fetus pushing them upward. Therefore, pregnant women have a higher chance of developing hiatal hernia than those who are not.
Nicotine present in cigarettes and all other tobacco products weakens the abdominal wall. This can cause the abdominal contents to protrude into the chest cavity. Therefore, smokers are at higher risk of developing hiatal hernia than non-smokers.
Symptoms of Hiatal Hernia
Most people that present with symptoms of hiatal hernia have symptoms that are similar to the symptoms of Gastrointestinal Reflux Disease (GERD). The following are some of the symptoms of a hiatal hernia.
- Bad breath
- Pain in the chest or abdomen
- Regurgitation of foods
- Hiccups that are usually difficult to stop
- Shortness of breath
- A bitter or acidic taste felt at the back of the throat
- Feeling of fullness after eating only a small portion of food
- Irritation of the gum causes them to become tender and bleed
Complications Of Hiatal Hernia
The following are some of the complications of hiatal hernia:
A strangulated hernia is a state of medical emergency because when this happens, the stomach moves into the chest cavity and becomes trapped. This can cause the blood supply to the stomach to be cut off and become strangled.
Sepsis is the body’s extreme response to an infection. When the strangled hernia is not treated, it can become necrotized and sepsis can also develop.
When there is continuous regurgitation of food and stomach acid from the stomach into the chest cavity, the esophagus which is the passageway will be eroded. This leads to scarring of the esophagus. If optimum and immediate care isn’t given at this time, there is a high chance of the affected person developing esophageal cancer.
Hiatal hernia can cause bleeding in the stomach and the esophagus(esophagitis). The bleeding can present symptoms like blood in the stool, bloody vomit, cyanosis, and anemia. All these symptoms indicate that there is a hemorrhage in the affected person internally.
Prevention of Hiatal Hernia
The following are the ways by which hiatal hernia can be prevented
Smokers are four times at risk of having hiatal hernia when compared with non-smokers. As earlier said, the nicotine present in tobacco products is dangerous to the abdominal walls. Aside from developing a hiatal hernia, smoking is hazardous to the overall health of an individual. It is therefore very important to quit smoking.
Regular exercise especially the ones that target your abdomen and your diaphragm is crucial in preventing hiatal hernia. performing these exercises will help to strengthen the diaphragm. An example of this is the breathing exercise.
What you eat plays an important role in preventing hernia. We must avoid foods that are too acidic as they can weaken the diaphragm. Furthermore, try eating several smaller meals daily rather than eating a few large meals. This is because heavy food can increase intra-abdominal pressure, which can lead to a hiatal hernia. In addition, ensure your food are rich in fibers so that you can easily pass your stool without straining your abdominal muscles. Eat more vegetables and take fruits so that you won’t feel too heavy when you eat. This information is very useful both in the prevention and treatment of hiatal hernia.
Maintain A Healthy Weight
As we have earlier seen that being overweight and being obese increases the risk of developing a hiatal hernia. We must regularly check our weight to ensure that we are fit. The measures mentioned above (regular exercise, healthy eating) and other factors can help to reduce excess weight. A person must maintain a normal BMI of 18.5-24.9. Anything above that must be quickly addressed.
Avoid Wearing Tight Dresses
Another way by which we can prevent hiatal hernia is to avoid wearing tight dresses. When a dress is too tight, it causes constriction of the abdomen and increases intra-abdominal pressure. This can lead to a hiatal hernia. You should wear free dresses and avoid tight belts.
Natural Remedies For Hiatal Hernia
The following are the natural ways by which hiatal hernia can be treated
Drinking lukewarm water helps to relax the diaphragm and prevent the continuous opening of the hiatus. This water must be taken early in the morning, and immediately after waking up. After drinking the water, try to stand on your toes, and suddenly drop on your heels. Try the exercise severally. By doing this, the weight of the warm water helps to pull down the stomach from the chest cavity, thereby returning it to the right position.
People suffering from hernia often experience pain in the abdominal region. Ice helps to ease this pain and provide relief. When applying the ice, you must ensure the ice doesn’t come in contact with your skin. You can wrap it around a towel before finally placing it on the skin. The ice also helps to reduce inflammation and ease bloating.
Practice Good Sleeping Posture
If you are diagnosed with a hiatal hernia, you should practice good sleeping posture. This is because you are prone to having symptoms of Gastroesophageal Reflux Syndrome (GERD). To prevent the regurgitation of foods and drinks, the head of your bed should be elevated by 4-8 inches as opposed to lying down without any support.
Diluted Apple Cider Vinegar
Dilute a few drops of raw apple cider vinegar in warm water and drink daily before you eat. The acetic acid present in apple cider vinegar helps to create an improvement in the digestive environment and helps to prevent stomach contents from regurgitating into the chest cavity. Apple cider vinegar also has anti-inflammatory properties such as polyphenols that help to ease symptoms of hiatal hernia that includes heartburn, irritation of the stomach, etc.
Abdominal massages help to ease discomfort being felt as a result of a hiatal hernia. It also helps to strengthen the abdominal muscles and give them the capacity it needs to hold the abdominal organs in place. This prevents the abdominal organs from trying to push through the hiatus of the diaphragm into the chest cavity.
Relax and apply gentle pressure to the abdominal region and target the upper part because the diaphragm lies.
What you eat is very important when you are diagnosed with a hiatal hernia. You must try as much as possible to avoid foods that will increase your intra-abdominal pressure. An example of this will be foods that are heavy and difficult to digest. These foods can also cause you to become overweight, which is a risk factor for hiatal hernia. you must eat food that is high in fiber and stay away from fatty foods. Some examples of foods to eat include vegetables, fruits, sweet potatoes, whole grains, beans, etc.
The above measures should improve the symptoms felt, and even help in reducing or reversing the hiatal hernia. However, if there are no improvements a few days after trying these measures, it is very important to report to your doctor for expert management.