The diaphragm is a domed sheet of muscle which separates the chest from the abdomen. Leading to the stomach, the esophagus passes through an opening or hiatus in the diaphragm. If the tissue surrounding the hiatus is weakened by obesity, trauma, heavy lifting, aging, or even some medications, part of the stomach may protrude through the hiatus up into the chest cavity, causing a hiatal hernia.
Symptoms of Hiatal Hernia include:
A physical exam will include a complete medical history and discussion with Dr. Finley about the severity of the problem—whether it is limiting your lifestyle and in what ways, and what medications you have tried. Diagnostic tests include Esophageal Motility, EGD—a test that measures the strength of the esophageal sphincter, and occasionally, a 24-hour pH test.
If surgery is necessary:
If medical therapies are not effective, minimally invasive procedures are extremely effective for treating hiatal hernias and gastro-esophageal reflux disease. Using tiny incisions through which instruments are inserted into the abdomen, the hernia is sewn up and the upper portion of the stomach is wrapped around the hiatus where the esophagus connects with the stomach. This strengthens the muscles in the area and prevents food and acid from splashing back up into the esophagus.
The repair is accomplished usually in less than an hour, and the patient is able to leave the facility in less than 23 hours. Recuperative time is a matter of days, although a slightly restricted diet is the norm for approximately two weeks after surgery.