Understanding The Treatment Options For Hiatal Hernias

A hiatal hernia is a protrusion of your stomach through the opening in your diaphragm, known as the hiatus, which then overlaps with your oesophagus. Stomach acid is then able to flow up through the oesophagus. This type of hernia makes it difficult and often painful to swallow, and as sufferers can develop an aversion to eating, they can become deficient in some nutrients if the condition is left untreated. Heartburn is a common symptom of a hiatal hernia, and the condition is also associated with oesophageal narrowing due to the delicate tissue of the oesophagus being repeatedly exposed to stomach acid, which can cause scar tissue to develop.

Hiatal hernias can be diagnosed using an upper gastrointestinal series, and your gastroenterologist will recommend a course of treatment based on the findings and the severity of your symptoms. Here's an overview of the three main treatment options for this type of hernia:

Lifestyle Changes

There are a number of foods and drinks that can make the symptoms associated with hiatal hernias worse. Your gastroenterologist can refer you to a dietician for detailed information on the foods you should avoid. Sufferers often have their own trigger foods, which you can identify by keeping a food diary, but caffeine and fried foods are common triggers. You can also make simple changes to your routine to try and lessen the amount of acid that travels backward through your oesophagus. For example, use a bed wedge when you go to sleep to keep your head and chest slightly elevated, and avoid bending over when you've just eaten a meal.

Medication

Strong antacids can be prescribed to neutralise your stomach acid, while proton-pump inhibitors can be used to lessen the amount of acid your stomach makes, which means there's less chance of the small amount that is produced travelling along your oesophagus. Additionally, alginates can be taken to help prevent your oesophageal tissue being damaged. Finding the drug combination that works best for you can take a bit of trial and error, but your doctor will work with you to minimise your symptoms as much as possible.

Surgery

Hiatal hernias can be successfully repaired using a surgical procedure called Nissen fundoplication. This is a minimally invasive surgical approach that combines robot-assisted and keyhole techniques. The goal is to narrow your hiatus just enough to prevent your stomach from protruding through it and allowing acid to escape into your oesophagus. The surgeon will use computer software to control a robotic arm that has surgical tools attached to it. The robotic arm is inserted into your abdomen through a few small incisions and has the advantage of allowing your surgeon easy access to the diaphragm without having to resort to open surgery. This type of surgery is often less traumatic and recovery can be faster, but you should fully discuss the pros and cons with your surgeon before deciding to go ahead with any type of robotic surgery.

A hiatal hernia can severely impact your quality of life, but the right treatment can leave you pain free and able to enjoy meals once again. So don't just put up with your symptoms; schedule an appointment with your doctor to discuss your options.