What is a Hiatal Hernia?
Your chest is separated from your abdomen by a domed sheet of muscle called the diaphragm. To reach your stomach, your esophagus has to pass through an opening, or hiatus, in the diaphragm. When the tissue around the hiatus weakens, part of the stomach may protrude through the opening into the chest cavity. This abnormality at the diaphragm hiatus is termed hiatal hernia.

A hiatal hernia is caused by a weakening of the anchoring tissues of the gastroesophageal junction to the diaphragm, perhaps due to increased pressure within the abdomen such as sometimes results from obesity or trauma. While some people are born with a hernia, factors such as heavy lifting, aging, and even some medications can cause the sphincter to weaken, allowing the stomach to push into the chest.

Symptoms

• Difficulty in swallowing
• Shortness of Breath
• Heartburn
• Feeling of fullness, including some nausea

Diagnosis
Your evaluation will include having a physical exam, completing a medical history form or questionnaire, and talking with a doctor about the problem. The doctor will want to know how severe the problem is and how it is limiting or affecting your lifestyle. You will explain any medications and lifestyle changes you have tried and whether they have been effective for your symptoms. Other complications that are resulting from your condition will also be evaluated. You will be asked to have diagnostic testing, which will include:

• Esophageal Motility
• EGD
• Occasionally a 24 hour pH

What if I need surgery?
Laparoscopic techniques are being used today to treat hiatal hernia and GERD. Your doctor will determine whether your problem is no longer responding to medical therapy. Then we will conduct a series of tests to determine if you will benefit from surgery and decide which type of repair would best suit your condition.

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