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A sliding hiatal hernia is a type of hernia in which part of the stomach, along with the gastroesopahgeal junction, protrudes up through the hiatus, the hole in the diaphragm which allows the esophagus to connect with the stomach. Normally, the diaphragm separates the contents of the chest from the contents of the abdomen, but in a hiatal hernia, the stomach intrudes into the chest cavity. This condition is actually extremely common, and many people have it and experience no symptoms. For people who do experience symptoms, there are some treatment options available.
Most commonly, people with a sliding hiatal hernia experience some heartburn and they may also have gastroesophageal reflux disease (GERD). In some patients, the stomach is permanently herniated into the chest, while in others, the stomach is pulled up through the hiatus when the patient swallows and the muscles contract. The condition is known as a “sliding” hiatal hernia because the stomach literally slides up through the hiatus in a sliding hiatal hernia.
Often, this condition goes unidentified, because the patient does not experience symptoms, or the symptoms are so mild that the patient does not complain. In other cases, a medical imaging study reveals the issue. Surgery may be recommended to address the issue if the patient experiences severe or debilitating symptoms, with the goal of the surgery being to anchor the stomach in the abdomen and keep it there.
Patients who are considering surgery for this type of hiatal hernia may want to ask about the risks and potential complications of the surgery. It is also a good idea to inquire about anticipated healing time, including the amount of time which may be required for a hospital stay. Patients with sliding hiatal hernias may also find it helpful to know about what may happen if they do not receive surgery. The surgeon should also be able to provide information about his or her success rate with patients who present with a sliding hiatal hernia.
In another type of hiatal hernia, a para-esophageal hiatal hernia, the gastroesophageal junction stays in place, and part of the stomach slips up through the hiatus so that it lies next to the esophagus. This rarer form of the hiatal hernia is a serious problem, because the area of the stomach which herniates can be cut off from its blood supply, resulting in tissue death. In this case, surgery is required to correct the problem before complications emerge.
I saw my doctor after I developed severe pain near my diaphragm. I started vomiting. I hadn’t had a bowel movement in days.
He discovered that I had a strangulated hernia, and I needed surgery right away. I got laparoscopic surgery. He made five small incisions in my abdomen, and he inserted the laparoscope through them. It showed him my organs on a monitor. He told me that this type of surgery has less risk of infection, less scarring and pain, and less recovery time.
I did recover quickly. I was able to walk around the very next day. I didn’t have to restrict my diet, but I was told not to do any heavy lifting or hard labor for three months.
My friend had always wanted to have lots of children. She ended up having five. During her years of childbearing, she developed extreme heartburn and gastroesophageal reflux disease. It caused her a lot of discomfort, because she could not take medication for it while pregnant.
After she had her fifth child and had her tubes tied, she decided to ask her doctor for some heartburn medication. He suspected she might have a sliding hiatal hernia, because her abdominal pressure had been greatly increased from all of those pregnancies.
He made her swallow some barium for an x-ray. The barium let him see the esophagus. She did have a hiatal hernia, but he told her the best thing to do was to treat the gastroesophageal reflux disease, since she had no dangerous symptoms.