Hiatal Hernia Treatment in Gurgaon, India
What is Hiatal Hernia?
A Hernia is a medical condition that refers to the protrusion of an internal organ or tissue through a weakened area in or around the abdominal region. A hiatal hernia is a type of hernia that occurs when part of the stomach pushes through the diaphragm’s opening (the hiatus) into the chest. While hiatal hernias can occur in any age group and gender, people aged 50 years and above are at an increased risk.
The diaphragm normally helps keep stomach acids in the stomach. When a hiatal hernia occurs, this mechanism can become impaired, leading to acid reflux, heartburn, and other gastrointestinal problems. There are two primary types of hiatal hernias: sliding hiatal hernia and paraesophageal hiatal hernia.
What are the Symptoms of Hiatal Hernia?
The symptoms of a hiatal hernia can vary depending on the size and type of the hernia. In severe cases, a large hiatal hernia may lead to more serious symptoms, including difficulty breathing or chest tightness. Common hiatal hernia symptoms include:
Acid reflux or heartburn
Chest pain or discomfort
Difficulty swallowing (dysphagia)
Regurgitation of food or sour liquid
Hoarseness or a sore throat
Nausea
Bloating & excessive burping
What are the Causes and Risk Factors of Hiatal Hernia?
While the exact cause of a hiatal hernia can vary from person to person, several factors may increase the probability of developing the condition. The condition occurs when the stomach bulges up into the chest through the diaphragm, which separates the chest from the abdomen. Various factors can contribute to this condition, and some individuals may be more prone to developing it due to certain lifestyle habits or biological characteristics.
Understanding these causes and risk factors can help in early detection and in making informed decisions about lifestyle changes, dietary adjustments, and medical treatments to prevent or manage a hiatal hernia. Below are some of the leading causes and risk factors associated with the progression of a hiatal hernia:
As individuals age, the muscles and tissues of the diaphragm weaken and may become less able to maintain the integrity of the opening through which the esophagus passes. This weakening can make it easier for the stomach to push through the diaphragm and cause a hiatal hernia. Older adults are more likely to experience this condition due to the natural aging process and the gradual breakdown of connective tissues.
Excess body weight, particularly in the abdominal region, increases pressure within the abdomen. This added pressure can push the stomach upward into the chest, increasing the likelihood of a hiatal hernia. People with obesity are at a higher risk, especially if they also experience other conditions like acid reflux or gastroesophageal reflux disease (GERD).
Pregnancy can increase the risk of developing a hiatal hernia, as the growing fetus puts extra pressure on the abdomen. Additionally, hormonal changes during pregnancy may lead to the relaxation of the diaphragm muscles, increasing the chance of the stomach moving upward into the chest cavity.
Heavy Lifting and Straining
Frequent or intense straining, such as during heavy lifting, constipation, or coughing, can increase intra-abdominal pressure. This pressure can contribute to the development of a hiatal hernia by pushing the stomach through the diaphragm. People who engage in heavy physical activity or experience chronic coughing or vomiting are more vulnerable to this condition.
Smoking weakens the muscles in the esophagus and diaphragm, which may contribute to the formation of a hiatal hernia. Additionally, smoking is a known risk factor for conditions like chronic cough and gastroesophageal reflux disease (GERD), both of which can increase the risk of a hiatal hernia.
Genetics and Family History
Certain studies suggest genetic factors may play a role in the progression of a hiatal hernia. If you have a family history of the condition, you may be at higher risk. Certain inherited characteristics, such as a more elastic diaphragm, can make some individuals more prone to developing a hernia.
Certain surgeries, especially those involving the abdomen or esophagus, may increase the risk of a hiatal hernia. For instance, after an abdominal surgery, scar tissue or changes to the muscle structure can make it easier for the stomach to slide through the diaphragm opening.
Certain Health Conditions
Certain medical conditions, such as connective tissue disorders, can lead to weakened tissues in the diaphragm, making it more susceptible to hiatal hernia. Conditions like asthma, chronic obstructive pulmonary disease (COPD), or other conditions that lead to frequent coughing may also contribute to increased pressure on the abdomen, raising the risk of developing a hiatal hernia.
When to Consult the Doctor for Hiatal Hernia Treatment?
Get in touch with a general surgeon for hiatal hernia treatment if your symptoms do not improve with OTC medicination or get worse with time. While many people with a small hiatal hernia may not experience symptoms or require immediate treatment, it’s essential to seek a doctor’s consultation if any symptoms worsen or cause significant discomfort. Timely intervention can help prevent complications and improve your quality of life. Here are some key signs that indicate it’s time to consult a doctor for your hiatal hernia treatment:
Persistent Heartburn or Acid Reflux
If you are frequently experiencing heartburn or acid reflux, and over-the-counter medications (such as antacids) aren’t providing relief, it’s time to consult a doctor. Persistent acid reflux can lead to more serious conditions, such as esophagitis, Barrett’s esophagus, or other complications.
Difficulty Swallowing (Dysphagia)
If you notice that it’s becoming increasingly difficult to swallow food or liquids, you may be experiencing symptoms of a hiatal hernia affecting your esophagus. Difficulty swallowing (known as dysphagia) can be a sign of the hernia pressing on the esophagus or other digestive issues that require medical attention.
If you are experiencing chest pain or tightness, especially after meals, it’s important to seek immediate medical advice. Although chest pain can be associated with acid reflux or a hiatal hernia, it can also indicate more serious conditions such as heart disease. It’s essential to rule out any potential heart-related issues.
If you are experiencing unexplained weight loss or significant changes in your appetite or digestion, it may signal complications related to a hiatal hernia. For example, a large hiatal hernia can interfere with digestion, leading to weight loss or difficulty absorbing nutrients.
Frequent nausea or vomiting, particularly if it’s associated with severe pain, can be a sign that a hiatal hernia is causing a blockage or complications like strangulation, where part of the stomach becomes trapped. This situation requires urgent medical attention.
Regurgitation of Food or Liquid
If you find that food or liquid is coming back up into your mouth after swallowing, it’s a sign of reflux. This can occur when a hiatal hernia disrupts normal digestion. If this symptom becomes frequent or severe, it is important to seek medical help.
In rare cases, a hiatal hernia can lead to strangulation, where part of the stomach becomes trapped in the diaphragm, cutting off its blood supply. This is a medical emergency and requires immediate attention. Symptoms of strangulation include severe abdominal pain, nausea, vomiting, fever, and a rapid heart rate.
Symptoms Tend to Get Worse
If you’ve made lifestyle changes to manage your hiatal hernia, such as altering your diet or avoiding trigger foods, but your symptoms continue to worsen, it's a good idea to consult a doctor. There may be a need for stronger medications or even surgical intervention.
How is Hiatal Hernia Diagnosed?
The general surgeon typically diagnoses hiatal hernia through a combination of medical history, physical examination, and diagnostic tests such as:
Endoscopy (Hiatal hernia endoscopy)
A flexible tube with a camera is inserted into the esophagus to examine the stomach and diaphragm for hernia formation.
This imaging test can help visualize the stomach and esophagus to detect any abnormalities.
This test measures the pressure inside the esophagus to assess the swallowing function.
Ambulatory acid probe test
This test measures the amount of acid in the esophagus to determine the severity of reflux.
What are the Different Types of Hiatal Hernia Treatment?
Hiatal Hernia treatment involves a combination of surgical and non-surgical methods. Depending on the severity of the hernia and how it impacts your daily life, various treatment options are available to help alleviate discomfort and improve general health. The doctor may recommend lifestyle modifications, medicine prescription, or in severe cases, surgical intervention. Hiatal hernia treatment aims to provide relief and ensure the condition doesn't progress to more serious issues. In this section, we will explore the different types of hiatal hernia treatment available to help you make an informed decision about managing your condition.
Non-Surgical Hiatal Hernia Treatment
For many individuals, non-surgical treatments are sufficient to manage the symptoms of a hiatal hernia, especially if the hernia is small and the symptoms are manageable. These treatments focus on reducing the severity of symptoms like acid reflux and heartburn and improving overall digestion.
Several medications are used to control the symptoms of a hiatal hernia, particularly when acid reflux or GERD is a major concern. These include:
Antacids: Over-the-counter medications like Tums or Maalox can neutralize stomach acid and provide quick relief for heartburn and indigestion.
H2 blockers: These medications (e.g., ranitidine, famotidine) reduce the production of stomach acid and are useful for long-term relief from acid reflux.
Proton pump inhibitors (PPIs): Drugs like omeprazole or lansoprazole are more potent than H2 blockers and work by inhibiting acid production, providing significant relief from acid reflux symptoms.
Prokinetics: These medications help improve the movement of food through the digestive tract, which can help with swallowing and reduce reflux.
Lifestyle and Dietary Changes
Incorporating a high-fiber diet and reducing fatty or acidic foods can help ease the symptoms of acid reflux. Eating foods that are gentle on the stomach, such as lean proteins, vegetables, and whole grains, can support digestion. Making certain lifestyle changes can significantly reduce symptoms and prevent the condition from worsening. Some key adjustments include:
Eating smaller meals: Large meals can increase abdominal pressure and worsen reflux. Eating smaller, more frequent meals can help prevent this.
Avoiding trigger foods: Foods such as spicy dishes, citrus fruits, chocolate, caffeine, fatty foods, and alcohol can worsen acid reflux, so it’s important to avoid these.
Not lying down after eating: Allow at least 2–3 hours after eating before lying down to prevent reflux from occurring.
Maintaining a healthy weight: If you’re overweight, losing even a small amount of weight can reduce abdominal pressure and alleviate symptoms of a hiatal hernia.
Elevating the head of the bed: Raising the head of the bed by 6–8 inches can help prevent acid from flowing back into the esophagus while sleeping.
Avoid excessive strain: Avoid certain activities like heavy lifting or chronic coughing that can increase intra-abdominal pressure. Engaging in stress-reducing activities, such as yoga or meditation, can also help reduce pressure on the abdomen.
Surgical Hiatal Hernia Treatment
While many people can manage a hiatal hernia with non-surgical treatments, there are cases where surgery is required. Surgery may be necessary if symptoms are severe, do not respond to medication, or if there are complications, such as the stomach becoming strangulated.
Open Hiatal Hernia Repair Surgery
This traditional surgery involves making a large incision in the abdomen to access the hernia. The surgeon will then reposition the stomach back into its correct place and repair the diaphragm. The opening in the diaphragm may be tightened to prevent the hernia from recurring. While effective, this method typically requires a longer recovery time and a higher risk of complications compared to minimally invasive techniques.
Laparoscopic Hiatal Hernia Repair Surgery
Laparoscopic hiatal hernia repair surgery is a minimally invasive procedure used to treat hiatal hernias. This surgery involves the use of small incisions, a camera (laparoscope), and specialized surgical tools to repair the hernia.
The goal is to move the stomach back into its proper position in the abdomen and to repair or tighten the diaphragm opening that allows the hernia to form. Laparoscopy for hiatal hernia repair is performed in the following steps:
Anesthesia: The patient is placed under general anesthesia, meaning they will be asleep throughout the procedure for a smooth surgery experience.
Small Incisions: The surgeon makes several small incisions (typically 3 to 5) in the abdomen. These incisions are much smaller (almost the size of a keyhole) than the one used in traditional open surgery.
Insertion of the Laparoscope: A laparoscope (a thin tube with a camera) is inserted through one of the incisions to provide the surgeon with a clear view of the hernia and the surrounding area.
Repairing the Hernia: The surgeon uses specialized tools inserted through the other incisions to gently move the stomach back into its correct position within the abdomen. During the procedure, the surgeon will typically use a mesh to reinforce the diaphragm and prevent the hernia from returning.
Closing the Incisions: Once the repair is complete, the surgeon removes the laparoscope and instruments, and the small incisions are closed with sutures or surgical glue.
Recovery: The patient is monitored in a recovery area as they wake from anesthesia. Most patients can go home the same day or the day after the surgery, depending on the individual’s recovery progress.
Robotic Hiatal Hernia Repair Surgery
In some cases, robotic surgery may be used for more precise control during the procedure. This technique involves the surgeon using a robotic system to guide the surgery with enhanced visualization and control. Like laparoscopic surgery, robotic repair is minimally invasive, offering the same benefits of quicker recovery, reduced pain, and smaller incisions. The precision of robotic surgery may be particularly useful for complex cases.
This is a specific surgical procedure often performed during a hiatal hernia repair, especially for those with severe acid reflux (GERD). The surgeon wraps the top of the stomach around the esophagus to help prevent acid reflux. It is often done using laparoscopic techniques and is effective for those who have both a hiatal hernia and significant acid reflux.
Advantages of Laparoscopic Hiatal Hernia Repair Surgery
Laparoscopic hiatal hernia repair offers several key benefits over traditional open surgery, making it a popular choice for both patients and surgeons:
The small incisions used in laparoscopic surgery are much less invasive than the larger incision required in open surgery. This leads to smaller scars and less disruption to surrounding tissues.
Patients typically experience a shorter recovery time with laparoscopic surgery. Many are able to return to normal activities within a week or two, compared to several weeks with open surgery.
Because the procedure is less invasive, patients generally experience less post-operative pain. This means fewer pain medications are required, and there is a lower risk of complications related to pain management.
The smaller incisions reduce the risk of infections compared to the larger incision in traditional surgery.
Many patients undergoing laparoscopic surgery can go home the same day or within 24 hours, whereas traditional surgery may require a longer hospital stay.
The laparoscope provides the surgeon with a high-definition view of the hernia and surrounding tissues, allowing for greater precision during the procedure.
The minimally invasive nature of the surgery means there’s less trauma to the body overall, which can result in fewer complications and a quicker return to normal activities.
Risk and Complications of Untreated Hiatal Hernia
If left untreated, hiatal hernia complications can arise, especially in larger or more severe cases. These complications include:
Esophagitis: Inflammation of the esophagus caused by acid reflux.
Strangulation: If part of the stomach becomes trapped in the diaphragm, it can lose blood flow, leading to tissue death and requiring emergency surgery.
Barrett’s Esophagus: A condition where the lining of the esophagus changes, increasing the risk of esophageal cancer.
Chronic Bleeding: Small tears in the esophagus or stomach may lead to bleeding, which could be life-threatening if left untreated.
What are Hiatal Hernia Prevention Tips?
While it may not always be possible to prevent a hiatal hernia, you can reduce your risk by following these prevention tips:
Maintain a healthy weight to reduce pressure on the abdomen.
Avoid large meals, especially before bedtime.
Don’t lie down immediately after eating.
Practice stress management techniques to avoid excessive strain on your body.
Wear loose-fitting clothes to reduce pressure on your abdomen.
Avoid smoking and limit alcohol consumption.
Advanced Laparoscopic Hiatal Hernia Repair Surgery by Top General Surgeons in Gurgaon
Artemis Hospitals offers advanced Hiatal Hernia treatment, including laparoscopic Hiatal Hernia repair surgery. The hospital is equipped with cutting-edge technology, which ensures a high success rate. Our team of highly skilled general surgeons performs complex minimally invasive surgeries with almost no complications. Patients benefit from minimally invasive techniques that reduce post-operative discomfort and promote faster recovery.
To book an appointment with a General Surgeon at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 9599285476. You can also schedule an appointment through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Reviewed by Dr. Manu Chaudhary
Attending Consultant- General & Minimally Invasive Surgery
Artemis Hospitals
Frequently Asked Questions (FAQs)
Can a Hiatal Hernia go away on its own?
No, a Hiatal Hernia does not heal naturally. It may remain stable or enlarge over time but may require medical intervention for long-term health benefits.
When is Surgery Necessary?
Surgery for a hiatal hernia is usually considered in the following cases:
Severe symptoms that do not respond to medication or lifestyle changes.
Complications such as strangulation, where part of the stomach is trapped in the diaphragm and loses its blood supply.
Chronic acid reflux or GERD causes damage to the esophagus or leads to conditions like Barrett’s esophagus.
Difficulty swallowing, which may indicate that the hernia is causing a blockage or esophageal dysfunction.
What is the surgical time for laparoscopic Hiatal Hernia surgery?
Laparoscopic Hiatal Hernia surgery OT time typically ranges from 30 minutes to 2 hours, depending on the severity of the condition, the surgical expertise of the surgeon, and the type of Hiatal Hernia.
Is laparoscopic Hiatal Hernia repair surgery painful?
No, the patient is given general anesthesia before the procedure for sedation. However, there may be mild pain and discomfort after the surgery as the effect of the anesthesia wears off.
Will there be scars after my laparoscopic Hiatal Hernia surgery?
Laparoscopic Hiatal Hernia repair surgery offers almost negligible scarring as the size of the incision resembles a keyhole.
Can a small hiatal hernia cause symptoms?
Yes, even a small hiatal hernia can cause symptoms such as heartburn or acid reflux, especially when lying down.
Is hiatal hernia surgery safe?
Yes, hiatal hernia surgery, including laparoscopic and robotic methods, is generally safe with a low risk of complications.
How long does it take to recover from hiatal hernia surgery?
Recovery time depends on the type of surgery, but most patients recover in about 1-2 weeks for laparoscopic procedures and up to 6 weeks for open surgery.
Can a hiatal hernia come back after surgery?
While rare, a hiatal hernia can recur after surgery, especially if there are underlying lifestyle factors contributing to the condition.
What is the ICD-10 code for hiatal hernia?
The ICD-10 code for hiatal hernia is K44.
Is it possible to prevent acid reflux with a hiatal hernia?
Yes, dietary changes and lifestyle modifications can help manage acid reflux symptoms associated with a hiatal hernia.
What’s the difference between a sliding and paraesophageal hiatal hernia?
A sliding hiatal hernia is the most common type, where part of the stomach and esophagus slides upward. A paraesophageal hiatal hernia is rarer and involves part of the stomach becoming trapped above the diaphragm.
Is hiatal hernia surgery covered by insurance?
Most insurance plans cover hiatal hernia surgery, but coverage varies depending on the terms and conditions set by the insurance provider. To know more, get in touch with us to get a cost estimate and book an appointment with the top general surgeons in Gurgaon.
