The diaphragm is a muscle that separates the thoracic zone from the abdominal zone. It has an important respiratory function, since it enables the expulsion of Aíre of the lungs. The diaphragam has a small hole (hiatus) through which the spherophag passes before joining the stomach.

Hiatus hernia is a small bulge in the stomach that occurs because the east pushes up to pass through the hole and enter the thorax.

Under normal conditions, gastric acid flows down, however, a hiatus hernia can allow acid to rise through the esophagus, causing the annoying gastroesophageal reflux.

Prevalence

It is estimated that between 20% and 30% of the population suffers hiatus hernia. The symptoms described by patients are acidity, difficulty swallowing and breathing, bad breath, dry cough, as well as nausea and vomiting, among others.

The causes are multiple, but genetic predisposition is the most important (congenital defect).
The risk of hiatus hernia increases with age, being more common in patients over 50 years.

Factors such as obesity, constipation or repetitive vomiting cause an increase in abdomen pressure that can weaken the diaphragmatic muscle and with it the appearance of hernia.

Tobacco, ascites or suffer of bronchitis are also triggered factors.
The patient's care that presents symptoms that can suspect a hiatus hernia, a series of diagnostic tests are carried out:

 

• Blood analytics
• High digestive endoscopy with biopsies
• Digestive endoscopy gastrointestinal traffic
• Phmetry
• Esophageal manometry.

Some patients do not agree the symptoms, so it does not need treatment, but they should do periodic reviews.

When there are symptoms, the patient must follow a treatment that includes postural and hygienic-dietary measures that improve their general condition.
These include avoiding tobacco, alcohol, coffee, make light meals, as well as measures such as raising the headboard of the bed to avoid the rise of gastric acid.

Antacids can also be administered (protons pump inhibitors or anti H2).
Surgery is indicated when there is no response to treatment, or in the case of giant hernias that condition the protrusion or bulging of other abdominal viscera, as well as in cases of barret esophagus, ulcers and/or bleeding.

Laparoscopic melt is the Gold Standar technique for surgical treatment of hiatal hernia and gastroesophageal reflux. A minimally invasive technique, which consists in returning the stomach to the abdominal cavity and making a “tie” in the upper gastric portion to avoid reflux.
This surgical technique is performed and considerably medieating and significantly improves the postoperative in terms of pain and recovery time.

Remember

 

It is estimated that between 20% and 30% of the population suffers hiatus hernia.

Genetic predisposition the most important cause (congenital defect).

There are therapeutic and surgical measures, depending on the seriousness of the case.

This technique considerably improves postoperative in terms of pain and recovery time.