Hiatal Hernia

WHAT YOU SHOULD KNOW:

A hiatal hernia is a condition that causes part of your stomach to bulge through a hiatus (hole) in your diaphragm. The part of the stomach may move up and down, or it may get trapped above the diaphragm.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Your esophagus, stomach, blood vessels, or nerves may get injured during surgery. You could also have trouble breathing, get infected, or have a lot of bleeding after surgery. You may also feel bloated after meals. Even after surgery, you may get another hiatal hernia.

  • If a hiatal hernia is not treated, you may develop gastroesophageal reflux disease (GERD). This may lead to ulcers and bleeding in the esophagus. The hiatal hernia may also slide into your chest, get trapped, and not slide back into your abdomen. The trapped stomach may die if its blood supply is cut off. You may also have sudden severe chest pains and problems swallowing. This may lead to other serious medical problems.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Diet:

You may not be able to eat solid foods for a period of time. You may be allowed to drink water, broth, apple juice, or lemon-lime soda pop. You may also suck on ice chips or eat gelatin. As you improve, you may be given soft foods to eat or thickened liquids to drink. You may be placed on a full diet as your swallowing gets better. A dietitian may talk to you about your feeding and nutrition. If you continue to have trouble swallowing, a swallowing therapist may teach you a safer way to swallow. The swallowing therapist will also help you learn which foods and liquids are safe to eat and drink.

An IV

is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

You may need any of the following:

  • Antacids: These medicines decrease stomach acid that can irritate your esophagus and stomach.

  • Histamine type-2 receptor blocker: This is also called an H2-blocker. It stops acid from being produced in the stomach.

  • Promotility agents: These medicines cause the sphincter, between the bottom part of the esophagus and the stomach, to contract (tighten) more. A sphincter is a ringlike muscle that opens and closes an opening in your body. These medicines may cause miscarriages and should not be taken by pregnant women.

  • Proton pump inhibitor: This is also called a PPI. It blocks acid from being made in the stomach.

Tests:

You may need any of the following tests:

  • Telemetry is continuous monitoring of your heart rhythm. Sticky pads placed on your skin connect to an EKG machine that records your heart rhythm.

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

  • Esophageal manometry: This test measures the pressure within the esophagus and stomach.

  • Esophageal pH monitoring: A small probe is placed inside the esophagus and stomach to check the pH of your stomach acid. The pH measures how much acid is in your stomach. This test also measures the amount of acid that goes into the esophagus.

  • Imaging tests:

    • Barium swallow: This test is an x-ray of your throat and esophagus, the tube connecting your throat to your stomach. This test may also be called a barium esophagram. You will drink a thick liquid called barium. Barium helps your esophagus and stomach show up better on x-rays. Follow the instructions of your caregiver before and after the test.

    • Endoscopy: This test uses a scope to see the inside of your digestive tract. A scope is a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers may find problems with how your digestive tract is working. Samples may be taken from your digestive tract and sent to a lab for tests. Small tumors may be removed, and bleeding may be treated during an endoscopy.

    • Upper GI x-rays: During an upper GI series, an x-ray machine is used to take pictures of your stomach and intestines (bowel). You may be given a chalky liquid to drink before the pictures are taken. This liquid helps your stomach and intestines show up better on the x-rays. An upper GI series can show if you have an ulcer, a blocked intestine, or other problems.

Treatment:

Surgery may be done when your medicines cannot control your symptoms or other problems are present. Your caregiver may also suggest surgery depending on the type of hernia you have. Surgeries may include the following:

  • Putting your herniated stomach back into its normal location or fixing your esophagus problem.

  • Making the hiatus smaller and anchoring your stomach in your abdomen.

  • Fundoplication: Fundoplication is a surgery that wraps the upper part of the stomach around the esophageal sphincter to strengthen it. A sphincter is a ringlike muscle that opens and closes an opening in your body.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hiatal Hernia (Inpatient Care)

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