When you swallow, food will enter the stomach through the esophagus. The esophagus will carry food through an opening called the hiatus into the stomach. A hiatal hernia occurs when the upper part of the stomach pushes through this opening and into the esophagus. Mild hernias generally don't cause much trouble, and they may not even be felt. However, more severe hernias can push food and stomach acid into the esophagus, causing a burning sensation in the chest, belching, difficulty swallowing, or chest pain. If you have been diagnosed with a hiatal hernia, there are many options for dealing with it.
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Method 1 of 3: Diagnosing a Hiatus Hernia
Step 1. Ask your doctor about an esophageal exam
If you experience a burning sensation in your chest, burping, difficulty swallowing, or chest pain that may be due to a hiatal hernia, ask your doctor to check it out. To confirm the symptoms are indeed caused by a hiatal hernia, and not simply acid reflux, the doctor will need to look inside the stomach. The doctor may perform an esophageal exam. In this test, you must drink a thick solution that contains barium. This solution will coat the upper gastrointestinal tract in the body. Next, X-rays will be taken, and because of the presence of barium, the resulting images of the esophagus and stomach will be clearer.
In a hiatal hernia, there will be an enlargement at the junction between the esophagus and the stomach
Step 2. Have an endoscopic examination
The doctor may also perform an endoscopic examination. In this examination, a small cable equipped with a camera and light (endoscope) is inserted through the throat into the esophagus and stomach. This tool will check for inflammation or abnormal changes in the tissue that indicate the stomach is pushing toward the esophagus.
Step 3. Get a blood test
To check for complications from a hiatal hernia, your doctor may check your blood. Acid reflux and symptomatic hiatal hernias can cause bleeding if the tissue is inflamed or irritated, and even ruptured blood vessels. Excessive bleeding can lead to anemia and a low red blood cell count. The doctor will take a small blood sample and send it to a laboratory to determine the red blood cell count.
Method 2 of 3: Changing Your Lifestyle
Step 1. Quit smoking
A hiatal hernia can cause acid reflux symptoms, so the first step in its treatment is to prevent acid reflux, reduce stomach acid production, and improve esophageal emptying. This can be done by reducing risk factors and changing lifestyle. Smoking can make your hiatal hernia symptoms worse. Research shows that smoking relaxes the sphincter, the group of muscles that surrounds the lower end of the esophagus, so the stomach can push it. Sphincter pressure is useful to prevent the contents in the stomach from rising back up.
Quitting smoking can be difficult. So talk to your friends, family, and doctor if you're seriously considering it. They can provide motivation and direction on treatment options to help you, such as medications, nicotine patches, nicotine gum, and other healthier options
Step 2. Avoid certain foods
Certain foods can cause stomach irritation and increased production of stomach acid. Over time, this will affect the sphincter and result in acid reflux and hernias. To prevent and control your symptoms, avoid or limit your intake of the following foods:
- Chocolate
- Onions and garlic
- Spicy food
- Fatty foods such as fried foods
- Orange fruit
- Tomato food
- Alcohol
- Peppermint or spearmint
- Carbonated drinks like soda
- Dairy products such as milk and ice cream
- Coffee
Step 3. Eat healthier foods
Apart from avoiding certain foods, there are also foods that can help you control the symptoms of a hiatal hernia. Try to include healthier options for the stomach, such as lean meat, skinless chicken, low-fat red meat, ground turkey instead of ground beef, and fish. Low-fat cuts of beef include sampil, gandik, or hasluar. Low-fat pork chops include deep hash. You can also improve your diet by:
- Bake or burn your food instead of frying it.
- Remove the fat layer on the meat during cooking.
- Try to avoid using spicy seasoning in cooking.
- Eat low-fat dairy products, such as low-fat yogurt instead of ice cream.
- Steaming vegetables with water instead of broth.
- Limit the use of butter, oil, and cream sauces. Use cooking spray instead of oil when frying.
- Choose low-fat or nonfat foods, rather than fatty foods.
Step 4. Consider the effects of other diets
You need to consider several other things related to food while trying to treat a hiatal hernia. Read the ingredients or ingredient list when you buy groceries. If you are in doubt whether a food product is triggering symptoms, consider this before eating and compare your condition after eating. Also, try to eat smaller portions throughout the day, rather than eating large portions. That way, your stomach will digest it easier and not secrete as much stomach acid as if you eat large portions.
Do not eat too fast, because the effect is similar to eating large portions
Step 5. Reduce the pressure in your stomach
Increased abdominal pressure can increase the pressure on the sphincter, resulting in acid reflux or hernia. To reduce pressure in the stomach, try not to strain during bowel movements. If you strain during bowel movements or have difficulty passing stools, add fiber-rich foods such as fruit and cereals to your diet. Try not to lift heavy objects as this will put pressure on your stomach and make your symptoms worse or cause a hernia.
Also try not to lie on your back or side after eating. When your stomach is full, lying down will only increase the pressure in that area
Step 6. Lose weight
Being overweight or obese can cause problems associated with a hiatal hernia. Research shows that being overweight is a risk factor for a hiatal hernia. Try walking for about 30 minutes after eating to aid digestion and lose weight. Research shows that walking for 30 minutes after eating will lose more weight in one month than walking 1 hour after eating.
- Gradually increase the intensity of your exercise. Do cardio exercises like running, jogging, jumping, and cycling to help burn more fat and calories.
- If you exercise and change your diet to help treat your hernia, you're more likely to lose weight.
Method 3 of 3: Using Drugs
Step 1. Use over-the-counter medications
There are various types of drugs that you can use to help treat the symptoms of a hiatal hernia, such as Promag, Mylanta, and Magasida which can be used before, during, or after meals to neutralize stomach acid. These drugs are available in the form of tablets, chewable tablets, or suspensions. You can also take H-2 receptor blocking drugs such as Zantac and Pepcid, which block receptors in the stomach and reduce acid production. The time it takes this drug to take effect is 30-90 minutes and can last up to 24 hours. You are advised to drink it before breakfast in the morning.
- The mechanism of action of proton pump inhibitors such as Nexium and Prilosec is similar to that of H2 receptor blockers, namely by blocking the glands that produce stomach acid. Take this medicine 30 minutes before breakfast in the morning.
- All of the above drug options can be purchased without a prescription. Whatever medicine you choose, remember to always follow the instructions for use on the packaging.
- If symptoms persist, contact a doctor. A higher dose of prescription medication may be needed to relieve your symptoms.
Step 2. Understand the need for surgery
Although most patients with hiatus hernias can manage it with medication and lifestyle changes, there are certain cases that require surgery. If there are complications from acid reflux, such as bleeding, ulcers, or complications in the airways, such as asthma, aspiration pneumonia, or chronic cough due to a hiatal hernia, your doctor may recommend surgery.
Incarcerated hernia is a case of hernia that causes the stomach to be pushed to the side of the esophagus and not into it. Some patients with this hernia experience disturbances in gastric movement or blood flow, resulting in perforation and tissue death. Perforation causes a high mortality rate. To prevent this, surgeons will generally recommend surgery after the diagnosis is made
Step 3. Ask your doctor about the type of surgery
To treat a hiatal hernia, there are three types of surgery that may be needed. One of them is the nissen fundoplication. In this procedure, the top of the hull will be stitched 360 degrees. A hiatus that passes through the esophagus will also be addressed. You may also need to have a Belsey fundoplication, which is a 270-degree suturing at the top of the stomach to reduce flatulence and difficulty swallowing.
- You may also need to have hill repair surgery. In this action the upper part of the stomach before the esophagus will be pulled back into the abdomen, so that the antireflux mechanism can be strengthened. Some surgeons then tie the stomach down to prevent it from pushing up again.
- The choice of action is determined by the expertise and comfort of the surgeon doing it.
Step 4. Get to know the operation further
The most common surgical procedure used to treat a hiatal hernia is laparoscopy. The surgeon will use a camera cable to view the hernia and another cable to perform the operation. This procedure leaves less scars, and better results, as well as a faster recovery period than regular gastric surgery. The surgeon will make 3-5 small incisions in your abdomen. A thin camera wire called a laparoscope is inserted through one of these incisions, while surgical equipment is inserted through the other.
- The laparoscope is connected to a video monitor in the operating room. The surgeon will treat the problem in the stomach while watching the condition on the monitor.
- This operation is performed on the patient under general anesthesia, so you will fall asleep and feel no pain. This operation usually lasts for 2-3 hours.
