Hiatus hernia is common gastrointestinal disorder, caused due to herniation of gastric mucosa and lower part of oesophagus within the chest cavity through esophageal hiatus of diaphragm causing reflux oesophagitis and characterised by heartburn,substernal and dysphagia.
Hiatus hernia is congenital condition but sometimes it can be acquired.
Acquired causes are muscular weakness especially seen in old people due to muscular degeneration.
In conditions like pregnancy,ascites,abdominal tumour due to increased intra-abdominal pressure. Obesity is one of the cause for Hiatus hernia due to decreased elasticity of crus.
Hiatus hernia is common in middle age,common in females.
Clinically Hiatus hernia is characterised by pain around the substernal region,which may radiate to shoulder,burning sensation(heartburn). Pain is worse on stooping,lying down soon after meals,heavy meals,hot drinks,spicy food,alcohol. Pain is better by sitting upright,intake of antacids.
water brash-regurgitation of food into mouth,which is worse on bending or stooping,sour eructations. Dysphagia(difficult in swallowing)-sensation of food sticking in substernal region,hiccoughs due to precordial distress.
Complications of Hiatus hernia are strangulation,oesophageal ulceration,severe bleeding,perforation.
Management of Hiatus hernia is very important,first to modify the cause;weight reduction if obeses;maintain upright position after meals;small frequent meals;dont sleep immediately after meals;eat dinner early to avoid sleeping immediately after meals;sleep in propped posture;avoid tea,coffee,tea,avoid heavy weight lifting.
If condition is severe advice for surgery.