Most people tolerate PPIs well and side effects are uncommon. When they do occur, they're usually mild and can include headaches, diarrhoea, feeling sick or constipation. To minimise any side effects, your GP will prescribe the lowest possible dose of PPIs they think will be effective.
A stronger dose may be needed. Surgery is usually only recommended for a sliding hiatus hernia hernias that move up and down, in and out of the chest area if the problem fails to respond to lifestyle changes and medication. You may also want to consider surgery if you have persistent and troublesome symptoms, but don't want to take medication on a long-term basis. Prior to surgery, you may need further investigations to check how well the oesophagus moves manometry and how much acid is being refluxed hour oesopageal pH studies.
A procedure called a laparoscopic nissen fundoplication LNF is one of the most common surgical techniques used to treat GORD and sliding hiatus hernias. LNF is a type of keyhole surgery that involves making a series of small cuts in your abdomen. Carbon dioxide gas is used to inflate your abdomen to give the surgeon room to work in. During LNF, the stomach is put back into the correct position and the diaphragm around the lower part of the oesophagus is tightened. This should prevent any acid moving back out of your stomach.
LNF is carried out under general anaesthetic , so you won't feel any pain or discomfort. The surgery takes 60 to 90 minutes to complete. After having LNF, you should be able to leave hospital after you've recovered from the effects of the general anaesthetic.
This is usually within 2 to 3 days. Depending on the type of job you do, you should be able to return to work within 3 to 6 weeks. For the first 6 weeks after surgery, it's recommended that you only eat soft food, such as mince, mashed potatoes or soup. Avoid eating hard food that could get stuck at the site of the surgery, such as toast, chicken or steak. Common side effects of LNF include difficulties swallowing dysphagia , belching, bloating and flatulence.
These side effects should resolve over the course of a few months. However, in about 1 in cases they can be persistent. In such circumstances, further corrective surgery may be required.
If you have a para-oesophageal hiatus hernia, where the stomach pushes up through the hole in the diaphragm next to the oesophagus, surgery may be recommended to reduce the risk of the hernia becoming strangulated see complications of a hiatus hernia for more information.
Hiatus hernias that slide in and out of the chest area sliding hiatus hernias can cause gastro-oesophageal reflux disease GORD. This is where stomach acid leaks into the oesophagus gullet. This can damage the oesophagus, increasing the risk of the problems described below. Damage to the lining of the oesophagus oesophagitis caused by stomach acid can lead to the formation of ulcers.
The ulcers can bleed, causing pain and making swallowing difficult. Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD. In most cases, over-the-counter medicines called antacids or alginates are used to treat the condition. Read more about treating GORD. Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture.
An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated using a tiny balloon to dilate widen the oesophagus. This procedure is usually carried out under a local anaesthetic. Repeated damage to the oesophagus can also lead to changes in the cells lining your lower oesophagus. This is a condition known as Barrett's oesophagus. Barrett's oesophagus doesn't usually cause noticeable symptoms, other than those associated with GORD.
However, Barrett's oesophagus can increase your risk of developing oesophageal cancer. If you have persistent reflux symptoms for more than 3 weeks, you should talk to your GP because you may need some investigations. In some cases, a hiatus hernia causes part of the stomach to push up next to the oesophagus.
This is known as a para-oesophageal hiatus hernia. GORD doesn't usually occur in these cases, but there's a risk of the hernia becoming strangulated. Strangulation occurs when the hernia becomes knotted and the blood supply to the area is cut off. Emergency surgery is usually required to correct the problem.
Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hiatus hernia. Hiatus hernia See all parts of this guide Hide guide parts 1. About hiatus hernia 2. Diagnosing hiatus hernia 3. Operations around the stomach and gullet can make you more likely to get the para-oesophageal type of hiatus hernia. You are also more likely to get this type if your spine or rib cage is more curved than usual.
For example, people with scoliosis or kyphosis. There is a rare type of hiatus hernia which occurs in newborn babies, due to a congenital defect of the stomach or diaphragm. This rare type is not dealt with further in this leaflet. The hernia itself does not cause symptoms. However, if you have a hiatus hernia, the factors that normally prevent stomach acid from refluxing into the gullet oesophagus may not work so well.
The sphincter muscle may not work properly. The normal pressure of the diaphragm muscle on the oesophagus is lost. Therefore, you are more prone for acid in the stomach to go back upwards reflux into your oesophagus. The refluxed acid can cause inflammation of the lower part of the oesophagus. This can cause one or more of the following symptoms:. Some uncommon symptoms may occur.
If any of these symptoms occur, it can make the diagnosis difficult, as these symptoms can mimic other conditions. For example:. Note : many people with acid reflux do not have a hiatus hernia. Also, many people with a hiatus hernia do not have symptoms of acid reflux.
If you have a hiatus hernia it does not necessarily mean that the sphincter between the oesophagus and stomach does not work so well. It is just that having a hiatus hernia makes you more prone to having a poorly functioning sphincter and more prone to developing acid reflux symptoms. However, people with a hiatus hernia who do get reflux, on average, tend to get more severe symptoms and problems associated with acid reflux.
This may be because with a hiatus hernia any acid that gets into the oesophagus is more likely to remain in contact with the lining of the oesophagus for longer compared with people without a hiatus hernia.
See the separate leaflet called Acid Reflux and Oesophagitis Heartburn for more details. A hiatus hernia may be diagnosed if you have tests for symptoms of reflux. A special X-ray test called a barium swallow is sometimes used to confirm the presence of a hiatus hernia. Endoscopy is increasingly being used for diagnosis. An endoscope is a thin, flexible telescope which is passed down the gullet oesophagus into the stomach.
This allows a doctor or nurse to look inside. A hiatus hernia may be seen. Occasionally other tests are needed. If you have no symptoms, in most cases you do not need any treatment.
The hiatus hernia usually causes no harm. Occasionally, if you have a hernia which is at risk of complications, you may be offered surgery, even if you do not have any symptoms. If changing your lifestyle does not help, you may need medication.
Medicines which reduce the action or production of stomach acid may help. The most effective medicines are proton pump inhibitors PPIs. PPIs often used are omeprazole or lansoprazole. If these do not suit you, other pills such as ranitidine or antacids may be used. In a hiatal hernia, the stomach pushes up through that opening and into your chest.
A small hiatal hernia usually doesn't cause problems. You may never know you have one unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms. A very large hiatal hernia might require surgery. There is a problem with information submitted for this request.
Subscribe for free and receive your in-depth guide to digestive health, plus the latest on health innovations and news. You can unsubscribe at any time. Error Email field is required. Error Include a valid email address.
To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information.
If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Your in-depth digestive health guide will be in your inbox shortly.
You will also receive emails from Mayo Clinic on the latest health news, research, and care. A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It's not always clear why this happens. But a hiatal hernia might be caused by:. Hiatal hernia care at Mayo Clinic.
0コメント