Hiatal Hernia

A hiatal hernia is when a portion or all of the stomach migrates through a hole in the diaphragm up into the chest.  In very large hiatal hernias, other organs like intestine can go through this hole as well.  Symptoms could include heartburn or gastroesophageal reflux, difficulty swallowing where food can get stuck when a person swallows or regurgitation or vomiting.  Although there are serious reasons for shortness of breath, some patients with large hiatal or paraesophageal hernias can also experience shortness of breath.  If you have shortness of breath, more seioius conditions should be evaluated for by your doctor.  There are multiple symptoms that patients can experience and these can be discussed with your surgeon so you should follow-up with a surgeon who specializes in the diagnosis and repair of these.

Prior to surgery, there are several tests that your surgeon may order prior to surgery.  They may order an endoscopy to evaluate the esophagus and stomach, an upper gi (upper gastrointestinal or esophagram) where a person swallows liquid contrast to evaluate the esophagus and stomach, the size of the hiatal hernia, if it is a sliding hiatal hernia and if there is reflux.  Sometimes your doctor may order a pH test which tests for acid in the stomach or esophageal manometry which tells your doctor how well the esophagus functions.  There are laparoscopic and robotic laparoscopic techniques to repair hiatal and paraesophageal hernias.  If you feel you have a hiatal or paraesophageal hernia or you know you have one, you should be evaluated by a surgeon who performs surgeries for them who can discuss the options with you.