Hiatal Hernia

What is a Hiatal Hernia?

Picture of hiatal hernia

The hiatus is the hole in the diaphragm where the esophagus pass into the abdomen to join the stomach. If the hiatus is too large then acid from the stomach floods up the esophagus causing burning of the esophagus. This is a called a sliding hiatal hernia and they are very common. Another type of hiatal hernia which is rare is called a paraesophageal hernia.

How is a hiatal hernia treated?

Most are treated medically. That is, with medication, with cessation of tobacco and alcohol and with weight reduction.

When is surgery indicated?

When medical treatment fails, when Barrett's esophageal changes are present or when it is a paraesophageal hiatal hernia.

What is the surgery for hiatal hernia?

The surgery for a hiatal hernia is called a Nissan Fundoplication. It is a procedure that tightens the opening of the esophagus into the stomach. It may be done minimally invasively by laparoscopic technique. Surgery for hiatal hernia requires hospitalization.

Medical Treatment Plan

  • Lose 10 - 20 lbs.
  • Abstain from tobacco and alcohol.
  • Low fat diet.
  • No meals after 6 P.M. in the evening.
  • Take an acid blocking medication such as over the counter Pepcid 20mg twice a day.

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