LARGE HIATAL HERNIA

MY SYMPTOMS are: –

– Severe heartburn

– Regurgitation

– Cough

– Breathlessness

– Chest pain

– Fullness after eating

I CONTACTED Dr Ashish Vashistha, SENIOR DIRECTOR, HOD DEPARTMENT OF SURGERY & ROBOTICS MAX HOSPITAL SAKET NEW DELHI who is the BEST HERNIA SURGEON IN DELHI  Explains About Hiatal Hernia.

He explained about Hiatal Hernia –

A Hiatal Hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. A hiatal hernia might be caused by:

• Age-related changes in your diaphragm.
• Injury to the area, for example, after trauma or certain types of surgery.
• A congenital defect, born with a very large hiatus.
• Constant and intense pressure on the surrounding muscles. This can happen while coughing, vomiting, straining during a bowel movement, exercising, or lifting heavy objects.

Dr Ashish Vashistha, BEST HERNIA SURGEON IN DELHI  Explains About Types of Hiatal Hernia:-

Hiatal Hernias are classified into 4 types:

• Type I: The sliding type, represents more than 95% of hiatal hernias. This type occurs when the GEJ is displaced toward the hiatus.

• Type II: A paraesophageal hiatal hernia, which occurs when part of the stomach migrates into the mediastinum parallel to the Oesophagus

• Type III: A paraesophageal hernia combined with a sliding hernia, where both the GEJ and a portion of the stomach have migrated into the mediastinum

• Type IV: The stomach and an additional organ, such as the colon, small intestine, or spleen, herniate into the chest.

Dr. Ashish Vashistha, BEST HERNIA SURGEON IN DELHI  Explains About the Evaluation :-

EVALUATION-

Endoscopy is an essential step in evaluating GERD and a suspected hiatal hernia in patients being considered for surgery.

Manometry rules out primary motility disorders such as achalasia, which can mimic reflux symptoms. Patients with primary motility disorders often require a partial fundoplication rather than a Nissen.

Dr. Ashish Vashistha, BEST HERNIA SURGEON IN DELHI  Explains About Its Treatment:-

TREATMENT-

Implementing lifestyle changes such as:-

• Eating smaller meals,
• Eating earlier in the evening,
• Avoiding foods that trigger heartburn,
• Waiting to lie down after eating,
• Losing excess weight,
• Quitting smoking,
• Elevating the head of your bed

Medicines-

• Antacids that neutralize stomach acid. Antacids may provide quick relief.
• Medicines to reduce acid production. These medicines are known as H-2-receptor blockers.
• Medicines that block acid production and heal the Oesophagus. These medicines are known as proton pump inhibitors. They are stronger acid blockers than H-2-receptor blockers and allow time for damaged oesophageal tissue to heal.

SURGICAL TREATMENT– laparoscopic / Robotic Fundoplication

· Surgery to repair a hiatal hernia is usually performed through small incisions during which the stomach and any other surrounding tissue are pulled down from the chest cavity and back into the abdomen. The surgeon will also make the opening in your diaphragm smaller and may reconstruct an Oesophageal valve to treat reflux.

· The procedure is called a fundoplication. This name refers to the upper part of your stomach, which is called the fundus. During the procedure, your surgeon wraps the fundus around your lower esophagus and attaches it with surgical staples or stitches. This tightens the muscle that separates the two organs (lower oesophageal sphincter).