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Hiatal Hernia Repair

Icon Endoscopy Dr Alex Craven

Understanding Hiatal Hernia

A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest cavity. The diaphragm is a muscle that helps you breathe and separates the chest from the abdomen. In a healthy body, the esophagus passes through a small opening (the hiatus) in the diaphragm to reach the stomach. However, in individuals with a hiatal hernia, part of the stomach protrudes through this opening, often leading to symptoms that affect quality of life.

Hiatal hernias are a common condition, particularly among older adults, and can cause symptoms that range from mild to severe. For many people, lifestyle changes and medications can manage symptoms. However, for those who experience chronic or severe symptoms, surgery may be recommended. Hiatal hernia repair aims to reposition the stomach and reinforce the diaphragm, reducing symptoms and helping to restore comfort and function.

Hiatal Hernia in Australia

In Australia, gastroesophageal issues like hiatal hernias are common, especially in adults over the age of 50. Though exact statistics on the prevalence of hiatal hernias specifically are limited, data shows that up to 15% of Australians may suffer from gastroesophageal reflux disease (GERD), a condition often associated with hiatal hernias. Due to increasing rates of obesity and aging populations, more Australians are at risk of hiatal hernias and their associated complications.

Symptoms of Hiatal Hernia

Hiatal hernia symptoms vary depending on the type and size of the hernia. Common symptoms include:

  • Heartburn or acid reflux
  • Regurgitation of food or liquids
  • Difficulty swallowing
  • Chest pain, often mistaken for heart issues
  • Bloating and belching
  • Shortness of breath (in more severe cases)

Some individuals with small hiatal hernias may experience no symptoms and may only discover the condition incidentally.

Causes of Hiatal Hernia

Hiatal hernias can result from several factors, including:

  • Age-related changes: Over time, the diaphragm muscle can weaken, leading to a higher risk of hernia.
  • Increased abdominal pressure: Factors such as obesity, pregnancy, heavy lifting, and chronic coughing can increase abdominal pressure, contributing to hernia formation.
  • Genetics: A family history of hiatal hernias may also increase risk.
  • Injury or trauma: Physical injuries to the diaphragm can lead to a hiatal hernia.

Diagnostic Tests for Hiatal Hernia

Diagnosing a hiatal hernia typically involves several tests to examine the esophagus and stomach, such as:

  • Upper GI Endoscopy: A camera is inserted through the throat to view the esophagus and stomach.
  • Barium Swallow: A patient swallows a barium solution that helps outline the upper digestive tract on X-rays.
  • Esophageal Manometry: This test measures the pressure and movement in the esophagus, providing details on function and muscle strength.

Complications of Hiatal Hernia

If left untreated, hiatal hernias can lead to complications, including:

  • Gastroesophageal reflux disease (GERD): Chronic acid reflux can damage the esophagus.
  • Esophagitis: Inflammation of the esophagus lining due to acid exposure.
  • Strangulation: In rare cases, the hernia can become trapped, reducing blood flow and leading to a medical emergency.

Treatments for Hiatal Hernia

The treatment of a hiatal hernia depends on the severity of symptoms:

  • Lifestyle changes: Avoiding smoking and alcohol, eating smaller meals, avoiding spicy foods, and not lying down after eating can reduce symptoms. 
  • Medications: Antacids, H2 blockers, and proton pump inhibitors can reduce acid reflux symptoms.
  • Surgery: For severe cases, or where symptoms aren’t controlled with medications, hiatal hernia repair may be recommended. Surgery involves returning the stomach to its correct position and strengthening the diaphragm to prevent future herniation. This can often be performed minimally invasively through laparoscopic techniques.

 

For more information or to book a consultation with Dr Craven, please call us on (03) 9852 3777 or email us at info@dralexcraven.com.au.

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Dr Alex Craven Provides Specialised Care In

Surgery for Obesity

Upper Gastrointestinal Surgery

General Surgery

Endoscopy

Weight and Obesity Control

Frequently Asked Questions

No, many people with hiatal hernias can manage their symptoms with lifestyle changes and medications. Surgery is usually recommended when symptoms are severe and unresponsive to other treatments.

Most patients can return to normal activities within two to six weeks, depending on the surgery type and individual health factors.

While certain lifestyle changes can reduce symptoms or the likelihood of complications, they may not entirely prevent a hiatal hernia, especially if age or genetics are factors. However, maintaining a healthy weight, avoiding heavy lifting, and eating smaller meals can reduce risk.

As with any surgery, there are risks, including infection, bleeding, and possible recurrence of the hernia. However, laparoscopic procedures are less invasive and often have shorter recovery times and lower complication rates.

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