Pathophysiology

Modifiable
Non-Modifiable
 There were no modifiable factors that
presented with the patient  Age
 Gender

Exertion of Pressure

Upward Movement of Pressure

Reaches the diaphragmatic opening

Risk Factors Compromises the integrity of the

diaphragmatic opening
Disease Process
Pressure overcome the muscle strength
Types of Hiatal Hernia

Complication The fundus of the stomach

slips through
Signs and Symptoms

Rolling Hiatal Hernia

Stricture portion of the

stomach

Tissue injury

Scar

Decreasing functioning Gastrointestinal Obstruction

of the stomach bleeding
Decrease diaphragmatic
Decreasing digestion of food Blackening of the stool expansion
in the stomach (Melena)
Decreasing respiratory effort
Fatigue
Shortness of breath
There are several risk factors that can increase the likelihood of developing a hiatal hernia. Some of these risk
factors are modifiable, meaning that they can be changed, while others are non-modifiable, meaning that they
cannot be changed.
Modifiable Risk Factors:
1. Obesity or being overweight
2. Smoking
3. Poor posture
4. Heavy lifting
5. Straining during bowel movements
6. Chronic coughing
7. Eating large meals or lying down after eating
8. Poor diet or overeating
9. Lack of exercise
10. Chronic constipation
Non-Modifiable Risk Factors:
1. Age - hiatal hernias are more common in people over the age of 50
2. Genetics - having a family history of hiatal hernias may increase the risk of developing one
3. Gender - hiatal hernias are more common in women than men
While some of these risk factors cannot be changed, lifestyle modifications such as losing weight, quitting
smoking, and avoiding heavy lifting or straining during bowel movements can help to reduce the risk of
developing a hiatal hernia or worsening an existing one. Other treatments for hiatal hernias may include
medications to reduce acid production, surgery to repair the hernia, or lifestyle modifications to manage
symptoms.

The exact pathophysiology of hiatal hernia is not fully understood, but it is believed to involve a combination of
factors. Here is the Theory based pathophysiology or disease process of Hiatal Hernia;
Exertion Pressure - Exertion pressure refers to the pressure that is exerted on the abdominal contents during
activities that increase intra-abdominal pressure, such as coughing, sneezing, lifting, or straining. This exertion
pressure can cause the stomach to push upward against the diaphragm. Upward Movement of Pressure - As
the exertion pressure increases, the stomach may start to move upward through the diaphragmatic opening
(hiatus) into the chest cavity. Reaches the Diaphragmatic Opening - When the stomach reaches the
diaphragmatic opening, it may start to put pressure on the surrounding tissues and organs. Compromises the
integrity of the diaphragmatic opening - The pressure from the stomach can weaken the muscles and
ligaments that hold the diaphragmatic opening closed, compromising its integrity. Pressure overcome the
muscle strength - the pressure from the stomach may overcome the strength of the muscles and ligaments,
causing the stomach to herniate (protrude) through the opening into the chest cavity. So since the pressure in
the stomach may overcome the strength it leads to a two process

Lower portion of the esophagus slips through - The lower portion of the esophagus may slip through the
diaphragmatic opening and into the chest cavity along with the stomach and follows by upper portion of the
stomach slips through that leads to the one of the types of Hiatal Hernia, Sliding Hiatal Hernia. The other
process lead to Greater curvature of the stomach slips through – the remaining or the other part of the
stomach protrudes through the hiatus and compress the surrounding structures and leads to the one of the
types of Hiatal Hernia, Paraoesophageal Hiatal Hernia.

Hiatal hernia can manifest in a variety of ways, depending on the severity and type of hernia. Here are some
common manifestations of hiatal hernia:
1. Heartburn: This is the most common symptom of hiatal hernia. It is characterized by a burning
sensation in the chest that typically occurs after eating or when lying down.
2. Regurgitation: Regurgitation is the feeling of stomach acid or food coming back up into the mouth.
It can be accompanied by a sour or bitter taste.
3. Dysphagia: Dysphagia is difficulty swallowing, which can be caused by the herniated portion of the
stomach obstructing the passage of food through the esophagus.
4. Chest pain: Chest pain can occur as a result of the hernia putting pressure on the diaphragm or
the esophagus.
5. Shortness of breath: Hiatal hernia can cause shortness of breath due to the pressure on the
diaphragm and the displacement of the lungs.
6. Nausea and vomiting: These symptoms can occur when the hernia causes obstruction of the
stomach or when there is reflux of stomach contents into the esophagus.
It is important to note that not everyone with a hiatal hernia will experience symptoms. In some cases, the
hernia may be discovered incidentally during diagnostic testing for another condition. If you experience any of
these symptoms, it is important to talk to your healthcare provider to determine the underlying cause and
appropriate treatment.