A hiatus hernia is a condition in which the cardiac sphincter becomes enlarged, allowing a part of the stomach to pass into the thoracic cavity.
Upper stomach and the gastroesophageal junction are SLIDING HERNIAS (TYPE I) displaced upward into the thorax. The gastroesophageal junction stays below the diaphragm but all or part of the stomach pushes through in to the thorax.
Trauma Congenital muscle weakness Relaxation of ligaments or skeletal muscles Increased intra abdominal pressure Middle aged or elderly people
Loss of function of the esophageal sphincter Reflux of unneutralized gastric juices in to the esophagus Inflammation of the lower esophagus
Pathophysiology continues
Heartburn after large meals and during night. Heartburn and pain beneath the sternum after meals; on physical exertion / when bending forward or sudden change of posture. Regurgitation of food several hours after meals. Dysphagia
M E D I C A L
S U R G I C A L
Avoid foods which stimulate gastric secretion. E.g. Alcohol, caffeine & carbonated beverages Antacids at 1 and 3 hours after meals and at bedtime. Avoid anticholinergics. Upright position while taking food. Elevation of head end or low fowlers position during sleep to minimize regurgitation. Avoid heavy lifting and sharp forward bending. Avoid bedtime snacks, spicy foods, alcohol, caffeine and Smoking.