Hiatal hernia patients are well aware of the discomfort, heaviness, bloating and burning sensation they experience after eating certain foods. This condition caused by hiatal hernia can be truly disabling in some circumstances. A hiatal hernia occurs when the upper part of the stomach slips through the diaphragm and is located in the chest.
In general, the presence of a hiatal hernia is associated with gastroesophageal reflux disease (GERD), a condition characterized by the presence of abnormal exposure of acidic stomach contents into the distal esophagus.
Identifying and remedying the hernia
The fundamental and very specific symptom of GERD is heartburn, which is described as a retrosternal burning or stinging sensation that ascends from the pit of the stomach into the throat.
Secondly, especially in advanced cases of the disease, patients may experience food moving up into the mouth (regurgitation). This leads our patients to describe a sensation of bad taste in the mouth and breath, belching after ingestion, etc.
Epigastric pain is another typical associated symptom. If this pain is very intense, it can sometimes be mistaken for a myocardial infarction. Finally, if the esophageal involvement is significant, patients may present dysphagia (difficulty in passing food), vomiting, anemia, etc.
Other less frequent atypical symptoms include cough, chronic laryngitis, dysphonia, recurrent pneumonia, asthma, dental erosions, etc.
Can it be corrected naturally?
Dr. Priego Jiménez, a specialist in General and Digestive System Surgery, explains that the treatment of GERD is basically medical by means of a pharmacological treatment based on proton pump inhibitors (omeprazole, esomeprazole…). Other less effective drugs would be histamine 2 receptor antagonists (ranitidine and famotidine) and antacids.
Surgery would be indicated in those patients who experience:
- Lack of symptom control despite medical treatment.
- Patients who, despite successful management, the need for lifelong medication, with the economic and side effect implications associated with medications, prefer to opt for surgical treatment.
- Development of complications of GERD such as Barrett’s esophagus and esophageal peptic stricture.
The surgical intervention is called fundoplication and is performed laparoscopically. This technique consists in making a kind of scarf with the gastric fundus around the esophagus, to create a high pressure zone and thus prevent the acid from continuing its ascent into the esophagus.
Can it be prevented?
The treatment of GERD involves the implementation of a series of hygienic-dietary measures, for example:
- It is advisable to eat a healthy and balanced diet, with a greater number of meals (5-6 per day), but in smaller quantities.
- Avoid going to bed immediately after meals. It is advisable to wait at least 2-3 hours after eating.
- Raise the head of the bed by 10-20 cm. Ideally, the use of articulated beds is recommended, although it can also be achieved by placing wooden blocks on the legs or by using several pillows.
- Avoid increased intra-abdominal pressure such as heavy meals, obesity (it is advisable to lose weight), constipation, heavy lifting, chronic coughing, avoiding stressful situations, pregnancy…
- Stop smoking.
- Avoid taking those drugs that decrease the tone of the lower esophageal sphincter and therefore favor gastroesophageal reflux, such as anticholinergics, calcium antagonists, tricyclic antidepressants…
If you want to find a solution to your hiatal hernia problem remember to follow the advice of Dr. Priego Jiménez, who also recommends avoiding the consumption of alcohol, coffee, tea, chocolate, foods with excess fat (fried foods), citrus fruits, vinegar, tomato, spices, pepper, onion, etc., since, as with the drugs previously described, they will reduce the pressure of the lower esophageal sphincter and will favor reflux.