Hiatal Hernia

Types

According to Dr Purnendu Bhowmik, the best hernia Surgeon in Kolkata, the different types of hernia are:

• Type I: It is also called the sliding hernia and is the most common type of hiatal hernia (95%). The gastroesophageal junction, in people with a sliding hernia, moves above the diaphragm. The stomach stays in its original position while the fundus (the upper part of the stomach next to cardia) remains just below the gastroesophageal junction.
• Type II: This hiatal hernia is characterized by a part of the fundus protruding from the hiatus while the gastroesophageal junction remains in its usual position.
• Type III: This is a combination of the first and second types, with the gastroesophageal junction and the fundus sticking out through the hiatus.
• Type IV: Type IV hiatal hernia is characterized by herniation of the stomach along with the spleen, colon, small bowel, and pancreas through the esophageal hiatus. This type of hernia is relatively rare, representing only about 5%–7% of all hernias. It can lead to severe complications.

Symptoms

Most of the small hernias do not show any sign of their presence. However, the large hernias can be associated with the following symptoms, says Clinica Health’s best hernia doctor in Kolkata.

• Belching
• Heartburn
• Nausea
• Chest pain

Large hernia symptoms can worsen upon lifting heavy objects, leaning forward, lying down, and during pregnancy. In some rare cases, the portion of the stomach that herniates into the chest cavity may get strangulated, causing:

• Severe chest pain
• Obstruction of oesophagus
• Difficulty in swallowing (dysphagia)

If you experience these symptoms, consult a hernia specialist doctor in Kolkata as soon as possible.

Risk Factors of Hiatal Hernia

• Obesity
• Smoking
• Age 50 or older
• Women have a higher chance of developing hiatal hernia

Hernia Diagnosis

Tests to diagnose hiatal hernia include –

• Barium swallow – A person will be provided with a liquid to drink that shows up on an X-ray. The drink allows the doctor to get a better look at the oesophagus and stomach.
• Endoscopy – A doctor inserts a long, thin tube with a camera attached, called an endoscope, down the throat to see the insides of the oesophagus and stomach.
• Oesophageal manometry – A doctor inserts a tube down a person’s throat to check the pressure in the oesophagus while they swallow.
• pH test – The test aims to measure the acid levels in a person’s oesophagus.

Complications

• Bleeding and anaemia
• Reduced blood flow to the stomach
• Severe GERD
• Difficulty swallowing
• Barrett’s oesophagus (oesophageal damage due to acid reflux)
• Oesophageal Cancer
• Lung problems or pneumonia

Hernia Treatment options

Hernia treatment in Kolkata depends on its type. Most people don’t experience symptoms of a hiatal hernia and hence don’t require treatment. If a person suffers from acid reflux, a doctor may prescribe the following medications –

• Antacids to reduce stomach acid
• Proton pump inhibitors or H-2 receptor blockers to reduce the production of acid in the stomach
• Prokinetics to make the oesophageal muscle that keeps stomach acid from backing up into the oesophagus stronger. They also facilitate the working of oesophageal muscles and help the stomach to empty itself.

The following lifestyle changes can also help manage acid reflux symptoms –

• Limit fatty foods
• Stop smoking
• Eat small meals
• Avoid junk food and alcohol
• Avoid exercising immediately after eating
• Elevate the head of your bed
• Sit up after you eat
• Maintain a healthy body weight
• Avoid tight-fitting clothes

Suppose a person suffers from a para esophageal hernia. In that case, surgery is necessary to stop the stomach from getting strangulated, says Clinica Health’s best hernia surgeon in Kolkata. A Hernia doctor will also prescribe surgery if sliding hernias bleed or become large, strangulated, or inflamed The most common hiatal hernia surgery in Kolkata is laparoscopic surgery. Laparoscopic hernia surgery involves making a few small (5 to 10 millimetre) cuts in the belly. A surgeon then inserts a laparoscope tool with a light and a camera attached through these incisions. The camera relays pictures of the inside of the patient to a monitor to guide the surgeon’s movements and help them repair the hernia. The surgeon pulls the stomach back into the abdominal cavity and wraps the upper part of the stomach around the lower portion of the oesophagus, creating a tighter sphincter to avoid reflux of food and acid. This minimally invasive procedure poses less risk of infection and causes less pain and scarring. Recovery after laparoscopic surgery is also faster than traditional surgeries. One can go back to their regular activity in 2 weeks. Laparoscopic fundoplication: Currently, the fundoplication is the standard procedure performed by the best laparoscopic hernia treatment in Kolkata. This technique involves mobilization of the distal oesophagus, lessening the associated hiatus hernia, followed by either partial or complete fundoplication around the oesophagus.