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Hiatal hernia: The result of overeating?

If you believe there are no serious side effects to eating too much, too fast, we have news for you. The number of hiatal hernias directly linked to the amount and the way we eat is on the rise. To learn more about this painful condition, which is more common in women than men, checked in with Dr. David Edelman, general surgeon at Doctors Hospital in Coral Gables, Florida.

Hiatal Hernia

Hiatal hernias related to eating habits What is a hiatal hernia?

Dr. David Edelman: A hiatal hernia is a widening of the diaphragm muscle opening that separates the chest from the abdominal cavity. When you eat or drink, food goes from the mouth, down the esophagus, through the diaphragm and into the stomach. Eating too fast and too much, causes the esophagus to distend, which, over time, stretches the opening in the diaphragm, leading to a hiatal hernia.

Symptoms of a hiatal hernia What are the signs and symptoms of a hiatal hernia?

Dr. David Edelman: Hiatal hernias are common. They are present in about five percent of the population. Hiatal hernias often present themselves as heartburn or acid reflux disease, which are common problems affecting women of all ages. The problem develops when acid in the stomach backs up into the esophagus. Heartburn is initially treated with medication taken by mouth. However, if medications do not control the heartburn, surgery may be necessary.

Obesity increases risk of hiatal hernias Is any group of women more predisposed to the problem than another?

Dr. David Edelman: Obesity is a contributing factor to hiatal hernias since the increase in weight on the abdomen pushes on the stomach and causes the acid to back up. Pregnancy has a similar effect and is a major reason why this condition is more frequent in women. Genetics is another common cause, so is caffeine (from coffee and sodas) and tobacco intake. Heartburn, GERD (gastroesophageal reflux disease), reflux and hiatal hernia are similar names for the same condition.

Self-care for hiatal hernias What are the steps a woman should take if she thinks she’s suffering from a hiatal hernia?

Dr. David Edelman: First, start and follow that diet you’ve been delaying. Eat sensibly and smart. Make your portions smaller and eat less fat, drink less coffee and soda. Stop smoking if you have not done so already. It’s okay to take over-the-counter medications like Tagamet, Pepcid or Prilosec OTC. If these measures are not effective, then make an appointment to see your physician or gastroenterologist.

Diagnosing hiatal hernias How is the problem detected by a doctor?

Dr. David Edelman: Your doctor may order an X-ray known as an Upper GI or may have a gastroenterologist perform a telescopic exam of the stomach known as a gastroscopy. Sometimes a CAT scan of the abdomen will demonstrate a hiatal hernia. A sonogram or CAT scan is sometimes used because there are other causes of abdominal pain.

Treatment for hiatal hernia How are hiatal hernias treated?

Dr. David Edelman: Twenty years ago, the surgery was done using a large incision in the upper abdomen. It was painful and resulted in a four to six week recovery. In the 1990s, laparoscopic surgery was introduced and the surgical recovery was dramatically shortened. At the same time, newer medications hit the market, which were better able to control the symptoms of heartburn and problems associated with GERD.

Then, in early 2000, biologic surgical mesh was introduced and was added to repair the tear in the diaphragmatic muscle in patients with GERD. The biologic mesh enhanced the operation and made the long-term results better. As the body recognizes the material as natural tissue, the graft communicates with the body, signaling surrounding tissue to grow across the scaffold. This action supports the healing process by attracting cells and nutrients to the area. The body begins to use the scaffold to heal the tear in the muscle. Over time, the biologic graft completely remodels into strong, fully vascularized tissue. As a result, patients experience a quick and efficient recovery period, typically returning to their normal, daily activities within two to three weeks of the surgery.

Although laparoscopic surgery utilizing biologics can offer exceptional results for any woman who has a hiatal hernia, the procedure may not be appropriate for everyone. In many cases, medications, diet and weight loss can help to alleviate the symptoms of heartburn. Nevertheless, surgery has consistently shown to be the most effective treatment for repairing a hiatal hernia. It’s recommended that you see a gastroenterologist or a laparoscopic surgeon familiar with the treatment of heartburn before you consider medication or surgery for this condition.

Preventing hiatal hernias Is there any way to prevent this problem from happening?

Dr. David Edelman: The simple answer is no. The more acceptable answer is to eat properly and exercise regularly. Anyone can have this condition, but it is always healthier to be in good shape, mentally and physically.

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