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Hiatal Hernia In A Nutshell
“A hernia occurs when an organ or tissue squeezes through an opening in the muscle or tissue that holds it within its cavity. In some cases, the intestines may protrude through a weakened area in the abdominal wall.”
– Dr Ganesh
Hernias occur primarily in the abdominal region, especially in the upper thigh, belly button, and groin areas. Most hernias are not immediately life-threatening but often do require surgery to prevent potentially dangerous complications.
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The most common symptom of a hernia is a bulge or lump in the affected area. For example, in the case of an inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet.
The lump might disappear when you are lying down, and it is likely more prominent when you are standing up, bending down, or coughing. You might also experience some pain and discomfort in the area surrounding the lump.
In some types of hernias, such as Hiatal hernias, specific symptoms may be observed, such as heartburn, trouble swallowing, and chest pain. In many cases, hernias have no symptoms, and you may not know you have a hernia unless it shows up during a routine check-up or a medical examination for an unrelated problem.
Dr Ganesh: “It’s important to recognise the signs of a hernia and to see a doctor if you suspect that you have one. An untreated hernia won’t go away by itself. A doctor can assess your hernia and recommend a suitable treatment plan for your condition.”
A hiatal hernia may develop over time, as was the case with a 61-year-old patient in Austria who had an ongoing problem with black and tarry stools.
Her condition presents the possibility of an untreated hiatal hernia, developing into gastrointestinal bleeding over the years due to a bleeding ulcer in the lower oesophagus, and why early medical intervention could be vital in managing this condition.
In some instances, whether in children or adults, hernias may cause life-threatening complications. It is recommended that you seek emergency care if you experience nausea, vomiting, fever, or sudden pain. Early medical care can minimise symptoms.
However, surgery is the only way to treat a hernia effectively. There are different types of surgeries available for hernia repairs, and our surgeon can advise on which one is best suited to your condition.
The prognosis for hernia repair surgery is generally good but can depend on the nature of the hernia, your symptoms, and your overall health. In some cases, the hernia may recur following repair.
A hiatal hernia refers to a condition where the upper part of the stomach and oesophagus protrude past the opening (also known as hiatus) in the diaphragm into the chest cavity. This results in the stomach bulging through the diaphragm, which may lead to reflux symptoms, lung complications, and pain.
This condition is observed to occur more frequently in patients over the age of 50.
While there are no known causes for hiatal hernia, studies have shown that people who experience injuries to the abdomen or chest may be prone to experiencing this condition.
This could potentially be due to the damage leading to weakness in the muscle tissue, allowing the stomach to push through the diaphragm when pressure is exerted.
Other causes of Hiatal hernias may be linked to forceful coughing, heaving from vomiting, straining during bowel movements and carrying of heavy objects.
Hiatal hernias have also been linked to risk factors such as obesity, ageing, and smoking.
There are two types of Hiatal hernias:
Sliding Hiatal Hernias are the most common type of Hiatal hernias. The condition occurs when the bottom of the oesophagus, also known as the gullet, and the top of the stomach protrude through the hole (hiatus) in the diaphragm. The diaphragm is a muscle that separates the lungs from the abdomen. This results in the hernia sliding into and out of the chest through the hiatus.
Fixed Hiatal Hernia, also known as a paraesophageal hernia, is a different type of hiatal hernia that is less common.
A portion of the stomach pushes past the diaphragm in a fixed hernia and remains fixed in the location, resulting in a bulge. In such cases, the fixed hiatal hernia may obstruct the blood flow to the stomach, causing a possible risk or medical emergency.
Patients with hiatal hernia may not immediately present any symptoms. For those that do, common symptoms may include:
An obstructed hernia may lead to a blockage in the blood flow to the stomach, which can be a serious issue. You are advised to seek medical attention if you experience long periods of vomiting, pain or observe blood in your stools or black stools.
While it may seem that the symptoms of hiatal hernia are similar to that of other gastrointestinal diseases, it is difficult to diagnose the condition without further investigations.
If you are experiencing frequent bouts of the symptoms mentioned above, consider scheduling an appointment with a medical professional for a proper diagnosis.
Patients with a hiatal hernia can experience GERD. Gastroesophageal Reflux Disease (GERD) occurs when the stomach acid contents are regurgitated to the oesophagus, leading to symptoms such as heartburn.
However, it is possible to have developed a hiatal hernia without GERD or GERD without a hiatal hernia.
If you suspect that you may have a hiatal hernia, you are advised to seek medical advice for a proper diagnosis of your condition.
Diet can play an essential role in controlling the major symptoms of a hiatal hernia, such as heartburn and acid reflux commonly seen in patients.
Once diagnosed with a hiatal hernia, one will have to be very careful about their diet to ensure that the symptoms do not worsen.
To help improve your condition and avoid aggravating your hernia, changing your diet may help. You may consider:
Hiatal hernias are usually diagnosed through a gastroscopy. In this procedure, our doctor will insert an endoscope, a long flexible tube fixed with an imaging device to view the walls of your stomach and oesophagus.
This investigation allows our doctor to identify signs of abnormalities in your oesophageal walls and stomach lining and detect possible conditions, and take samples for investigation if necessary.
Our doctor will also be able to see if your stomach is pulled up above your diaphragm, leading to a hiatus.
A hiatal hernia does not go away without surgery. While lifestyle changes can help reduce the chances of triggering the symptoms of a hiatal hernia, such as acid reflux, patients are eventually recommended to seek surgical treatment if diet and medication do not relieve the symptoms.
Laparoscopic Nissen Fundoplication Surgery is one of the recommended treatments for this condition. This surgery tightens and reinforces the lower oesophageal sphincter (LES), which helps prevent acid from being regurgitated into the oesophagus.
In the procedure, the upper part of the stomach is wrapped around the exterior of the lower oesophagus to strengthen the sphincter. It is also observed to be highly successful and help improve the patient’s lifestyle in the long run.
Hiatal hernias do not go away without surgery. However, for patients who experience mild symptoms of heartburn and acid reflux, they may be prescribed medication to manage the condition before surgery is recommended.
Medications such as antacids, H2-receptor blockers, and proton pump inhibitors are some of the options that our doctor may prescribe to help lower or neutralise the effects of stomach acid on your oesophageal walls, giving it more time to heal.
If the condition continues to worsen or becomes more frequent, surgery will be the option to treat hiatal hernia.
For Char Bucci, her 30 years of suffering from severe heartburn were fixed in one hour following a hiatal hernia surgery.
Using the Laparoscopic Fundoplication technique to treat her hiatal hernia, the doctor made incisions less than an inch compared to a 12-inch-long incision in the abdomen in open surgeries. This also ensured that Char was able to recover faster and get back to living her life.
Dr Ganesh: “Laparoscopic Nissen Fundoplication is one of the recommended treatments that we suggest to patients who have experienced long and severe bouts with GERD or Hiatal hernias. It is minimally invasive so patients can generally expect a quicker recovery time and with a lower risk of complications.”
Nissen Fundoplication can be performed either as an open surgery or laparoscopically.
In both types of procedures (whether open or laparoscopic), a Nissen Fundoplication involves wrapping the upper part of the stomach around the lower oesophagus.
This tightens the sphincter around the lower oesophagus, and makes it less likely that acid will flow back up the oesophagus.
This procedure serves to tighten and reinforce the lower oesophageal sphincter (LES) and has a high success rate in helping patients recover and prevent recurrence in the long run.
After your surgery, it is common to experience discomfort around the surgical site and even the shoulder. Our surgeon will prescribe medication to help ease this discomfort as you recover.
Tending to your wound will require extra care. You are advised to carefully follow our surgeon’s instructions to prevent complications or infections during your recovery.
Open surgery often requires a longer recovery process than laparoscopic surgery. Your surgeon will let you know when you can return to your regular routine.
Following the surgery, you will be able to move around normally, but you may be advised to avoid any strenuous activity. Additionally, you should avoid carrying and lifting heavy objects during this recovery period. This is to prevent adding stress and strain to the wounds and the operative site.
You will likely be required to eat slowly and chew your food more thoroughly before you swallow, after surgery.
Most people can expect to spend 2-3 days in the hospital after laparoscopic hiatal hernia surgery. During this time, pain medication and soft foods will be prescribed.
After being discharged from the hospital, it is important to avoid lifting heavy objects or straining during bowel movements. Recovery times vary from person to person, but most people can expect to return to their normal activities within 4-6 weeks.
Dr Ganesh at G & L Surgical Clinic strives to prioritise his patients’ recovery and comfort. Having had adequate experience in performing hernia removal surgeries for numerous patients for many years in Singapore.
Furthermore, the staff at G & L Surgical Clinic have been thoroughly and adequately trained to make your experience a comfortable and hassle-free one. Whether you intend to undergo our hernia treatments, procedures or other medical services in Singapore, you can rest assured that you will be properly and sufficiently cared for by trained professionals.
Organise a consultation with our surgeons for further assistance on hernia treatments in Singapore.
What are the warning signs of hiatal hernia?
While heartburn and nausea are some symptoms of hiatal hernia, more severe signs that may need immediate medical attention are shortness of breath, vomiting of blood and passing of black stools.
Why Do I Feel Moderate Pain That Intensifies Throughout The Day?
Hernias can cause pain for a variety of reasons. A hernia occurs when an organ or tissue protrudes through a weak spot or hole in the muscle or surrounding tissue that holds it in place. The protrusion of the organ or tissue can put pressure on the surrounding tissue and cause discomfort or pain. The pain may be constant or intermittent and may be worse when you are physically active or when you are standing or sitting for long periods of time. Hernia pain may also be exacerbated by coughing, sneezing, or straining during bowel movements.
Does Exercise Aggravate Hiatal Hernia?
Exercise can be beneficial for those that suffer from a hernia but certain activities that put pressure on the abdomen such as weight lifting may cause more pain.
Will The Pain Eventually Subside If I Stop Strenuous Activities?
It is not uncommon for hernia pain to fluctuate or come and go. However, if the hernia is not treated, the pain is likely to persist and may even worsen over time. Hernias can become larger and more uncomfortable as the protrusion of the organ or tissue puts additional pressure on the surrounding tissue.
What Is The Difference Between GERD And A Hiatal Hernia?
GERD is a severe form of acid reflux where stomach acid flows backwards into the oesophagus. Long-lasting GERD can cause hiatal hernia as it weakens the muscles in the abdomen, resulting in the upper stomach bulging out (hiatal hernia).
Due to my work, I got a hernia on my inner thigh and had to see a doctor to get it treated. I found Dr Ganesh online and I am so glad that he is a very patient and caring doctor.
He understood the challenges I faced and proposed that I do hernia repair as the hernia was getting worse. Within a week, I got the procedure scheduled and he helped me to get the hernia repaired. Now, I am back to work and feeling normal with no pain.
Dr Ganesh also gave me good advice to make sure I don’t trigger the condition again. Thank you to all the nurses at G&L Surgical too. All of you are so nice and always smiling, it gave me a great assurance that I am in good hands.
Dr Ganesh is a kind and caring doctor. I had a hernia after childbirth for quite some time but never thought much of it.
However, I noticed that the hernia started to grow larger and I was feeling discomfort from it. It was getting quite painful and I was worried it’s something serious.
I found Dr Ganesh online and scheduled an appointment with him on the day. He assessed that I have an umbilical hernia and recommended that I undergo a hernia repair. As it turns out, fixing the hernia is not a major surgery and I am now back to work with no more bulges on my belly.
I feel much better thanks to him. Thank you to the G&L Team for doing great work!
I had a hernia near my hip and was recommended to Dr Ganesh through a mutual friend. What surprised me most was that Dr Ganesh was unlike any doctor that I have met. My impression of a specialist is that they will always recommend that I undergo surgery but to my surprise, his advice was the opposite. He did an assessment and advised that I did not require a hernia repair as the hernia is still fairly small at the time.
I followed his advice and managed to avoid triggering the pain for about 2 months. However, as I started getting active at the gym, I noticed the hernia was getting larger again and the same discomfort was returning so I went back to visit Dr Ganesh again.
This time around as the hernia is much larger, I had to opt for the hernia repair. Honestly, it wasn’t too bad since I trusted in his skills. The entire procedure was quick and seamless and within a week, I am already back to work.
My absolute gratitude to Dr Ganesh and his team for displaying professionalism, efficiency and assurance that allowed me to be at ease throughout my entire treatment. Your dedication to your work is definitely a blessing and you are truly an amazing doctor!
I had an incisional hernia on the scar above where I had my appendix removed some years ago. It started to bother me and hurt so I came across Dr Ganesh’s clinic online. He’s a friendly doctor and super patient, and had no issues explaining to my husband and I all those questions that we have gathered from reading online.
Turns out it wasn’t as serious as the horror stories we read online but my hernia would definitely need to be repaired.
His team was very fast and booked me in for the procedure within a week. Everything went smoothly and my husband was very pleased that Dr Ganesh was very reassuring. Right before the surgery, Dr Ganesh noticed that he was very worried and even got the staff to grab a cup of coffee for my husband.
I am so grateful to this team for being so kind and thoughtful. If you are even looking for a doctor that cares, this is where you should go. Thank you G&L Clinic!
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