Hiatus Hernia Part 2: Symptoms, Diagnosis, and Treatment
In part one of this series, we already discussed what a hiatus hernia is. And how easy it is to find both hiatus hernia and gastroesophageal disease (GERD) in the same patient. In this article, we will go deeper into how doctors detect and diagnose this disease. And what you can do right now to prevent hiatus hernia or improve your symptoms.
Signs and symptoms
The most common signs and symptoms of a hiatus hernia are as follows:
- Heartburn: Patients with hiatus hernia commonly have acid reflux and may be diagnosed with gastroesophageal reflux disease (GERD). Many patients with GERD have a hiatal hernia as well.
- Nausea: There’s a pressure change in the stomach and a propensity to feel nausea, and sometimes vomiting. This is more common during episodes of acid reflux.
- Increased salivation: It is associated with acid reflux as well. The mouth starts producing more saliva to counter the highly acidic environment.
- Burping: Patients usually report an increase in gas in the stomach, which is also a sign of GERD.
Diagnosing hiatal hernia
As you can see, most signs and symptoms in hiatal hernia are the same as in GERD, and most people get diagnosed by chance. In other words, patients with chronic acid reflux get X-rays or a CT scan done for any other reason, and that’s when the doctor sees the hernia image and finds out the real cause of acid reflux and associated health problems.
In some cases, standard imaging techniques might not be clear enough to make out a hiatal hernia, and your doctor might require additional imaging tests with contrast. Another procedure usually done in these patients is an endoscopy, which is useful to diagnose complications of this disease such as Barrett’s esophagus.
Treatment options to improve your symptoms
In most cases, hernias are solved after a small surgery with no major complications. But that is not the case with hiatal hernia. Most patients do not develop a dangerous condition, and surgery is not the usual treatment. What we need to do in these cases is improving the acid reflux symptoms and avoid irritating substances as a preventative measure.
The most common medications in hiatal hernia are not different from GERD. They include omeprazole and other proton pump inhibitors, and surgery is only suggested when the symptoms are not successfully controlled by any other means. In rare cases, hiatal hernias might become dangerous when the stomach becomes trapped in the thoracic cavity and starts causing vascular complications. However, in most cases, you will control your symptoms with no problems by following medical treatment and a series of lifestyle modifications:
- Instead of large meals, eat smaller portions.
- Avoid spicy food, citrus fruits, greasy food, tomatoes, and onions.
- Do not smoke and try to lose weight if you’re obese.
- Be mindful when you eat, chew appropriately, and eat slow.
- Don’t forget your routine check-ups and talk to your doctor if you have any concern.