Hiatal hernia lump in throat

A hiatal hernia is a bulge or swelling of the diaphragm, the muscle that separates the chest and abdomen.

Hiatal hernias often develop when the diaphragm separates from its usual position, leading to the chest and abdomen being pushed together. This usually happens in older adults.

It can also happen in babies and children.

What causes a hiatal hernia?

The cause of a hiatal hernia is often unknown. Sometimes it can be triggered by a muscle strain, a bulging of the diaphragm, or by the stomach sticking out through a weak area.

What are the symptoms of a hiatal hernia?

The symptoms of a hiatal hernia can vary depending on the size and cause.

If a hiatal hernia is caused by a muscle strain, you may have:

  • Heartburn
  • A bulge in the upper part of the abdomen
  • Difficulty swallowing
  • Difficulty breathing
  • Chest pain

If a hiatal hernia is caused by stomach contents pushing through a weak area of the diaphragm, you may have:

  • Nausea
  • Bloating
  • Weight loss
  • Abdominal swelling or weight gain

How is a hiatal hernia diagnosed?

Your doctor will take a medical history and perform a physical exam. They’ll look for signs of a hernia and order tests to confirm a diagnosis.

You may need an upper endoscopy to examine your esophagus and stomach. During the procedure, the doctor inserts an endoscope, a tube with a camera on the end, into your mouth or nose. They’ll look for any signs of a hernia.

They may also use an ultrasound or CT scan to examine your abdomen.

How is a hiatal hernia treated?

Hiatal hernias can be treated with surgery or by using a tube to drain stomach contents.

Surgery

Most surgery for a hiatal hernia is done laparoscopically, through a small incision made in your lower back. During the procedure, your surgeon will make several cuts on your belly.

Your surgeon will then remove the bulging tissue or part of the stomach. They’ll then close the cuts using stitches, sutures, or staples.

Drainage

A drainage tube will be inserted through your upper abdominal wall to drain stomach contents. This tube will be left in place for several days or weeks.

What is the long-term outlook?

Surgery can often cure a hiatal hernia. But sometimes it can recur, especially if the hernia is left untreated.

Your doctor may recommend long-term use of a proton pump inhibitor, such as omeprazole (Prilosec), to prevent the hernia from becoming larger. Or your doctor may recommend surgery to make the hernia smaller.

What is the difference between a hiatal hernia and a stomach hernia?

A hiatal hernia and a stomach hernia are both conditions caused by the stomach bulging through a weak spot in the diaphragm.

Both types of hernia are rare.

Both are potentially serious conditions that can cause complications, such as:

  • Infection
  • Bowel obstruction
  • Stomach perforation
  • Bowel perforation
  • Nausea and vomiting

How to prevent a hiatal hernia?

You can help prevent a hiatal hernia by making changes to your diet and lifestyle.

Reducing your risk is important because a hiatal hernia can lead to life-threatening complications.

The American Society of Colon and Rectal Surgeons recommend that people avoid:

  • Alcohol
  • Smoking
  • Caffeine
  • Caffeine-containing foods and drinks
  • Certain foods, such as those high in sodium

Try to avoid eating or drinking these foods for a few hours before your appointment.

Your doctor can tell you more about how to reduce your risk of developing a hiatal hernia or stomach hernia.

What is the link between a hiatal hernia and heartburn?

A hiatal hernia causes heartburn, which is a burning sensation in the chest.

A hiatal hernia causes heartburn because the stomach bulges into the hole in the diaphragm. This can lead to stomach acid moving into the chest and creating a burning sensation.

There is also a chance that the stomach bulge can push stomach contents into the windpipe, which can lead to a lung infection.

People with a hiatal herniation are at increased risk of developing:

  • Bacterial infections of the lower respiratory tract, including pneumonia
  • Pulmonary hypertension
  • Pulmonary embolism
  • Chronic coughing
  • Lung cancer

Heartburn and hiatal hernia

What is the link between a hiatal herniation and GERD?

A hiatal herniation can cause reflux of stomach contents into the esophagus. This can lead to a condition called gastroesophageal reflux disease (GERD).

GERD is a group of symptoms that affect the lower part of the esophagus and the stomach. Symptoms can include:

  • Chronic cough
  • Gastroesophageal reflux
  • Regurgitation
  • Feeling full after eating small amounts
  • Belching
  • Food sticking in the throat

Symptoms of GERD may get worse with physical activity, especially coughing or straining.

Some people may have GERD without a hiatal herniation. In these cases, the symptoms may be due to GERD occurring in the upper part of the esophagus.

Talk with your doctor if you have any of these symptoms. They may recommend an upper endoscopy or a gastroscopy.

A gastroscopy is an examination of the upper part of the esophagus. It can help diagnose GERD.

A gastroscopy uses a thin, flexible tube with a camera on the end called an upper endoscope. The camera allows your doctor to see the lining of the esophagus and stomach. It can also be used to take tissue samples of the lining.

Your doctor will recommend the best treatment for your condition.

What are the possible complications of a hiatal herniation?

A hiatal herniation can affect the function of the diaphragm. This can lead to complications, including:

  • Sporadic pneumonia
  • Severe esophagitis
  • Barrett’s esophagus
  • Gastroesophageal reflux disease (GERD)
  • Tracheoesophageal fistula

Spontaneous perforation of the stomach into the chest cavity is also a complication.

Outlook

A hiatal herniation and GERD can both lead to heartburn and other symptoms.

But some people only have hiatal hernias, while others only have GERD.

If you’ve had both, you may not have any symptoms at all. However, symptoms can appear from time to time if you have more than one of the conditions.

A hiatal herniation and GERD can be treated with lifestyle changes and medications.

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