Hiatal Hernial

In the condition known as hiatus (or

hiatus) hernia, the opening of the
diaphragm through which the esophagus
passes becomes enlarged, and part of
the upper stomach tends to move up
into the lower portion of the thorax.

Signs & Symptoms

heartburn:

chest pain or burning,

nausea, vomiting or retching (dry heaves)
burping.
waterbrash, the rapid appearance of a
large amount of saliva in the mouth that is
stimulated by the refluxing acid.

Assessment & Diagnosis Findings

A physical exam for hiatal hernia is
similar to that for heartburn, with two
additions: X-rays may be ordered to
show the hernia, and if anemiais a
concern, a blood sample may be
taken to check your red blood cell
count.

A hiatal hernia can be diagnosed with a

specialized X-ray study that allows
visualization of the esophagus and stomach
(barium swallow) or with endoscopy (a test
that allows the doctor to view the hernia
directly). An esophageal manometry test
(pressure study) may also be performed in
which the strength and muscle coordination
of the esophagus is measured while
swallowing. A pH test can also measure the
acid levels in the esophagus.

Medication
Antacids

that neutralize stomach

acid. Over-the-counter antacids, such as
Gelusil, Maalox, Mylanta, Rolaids and Tums,
may provide quick relief.
Medications to reduce acid
production. Called H-2-receptor blockers,
these medications include cimetidine
(Tagamet HB), famotidine (Pepcid AC),
nizatidine (Axid AR) and ranitidine (Zantac
75). Stronger versions of these medications
are available in prescription form.

Medication
Medications

that block acid production

and heal the esophagus. Proton pump
inhibitors block acid production and allow
time for damaged esophageal tissue to heal.
Over-the-counter proton pump inhibitors
include lansoprazole (Prevacid 24HR) and
omeprazole (Prilosec OTC). Stronger versions
of these medications are available in
prescription

Medical Management
Management for a hiatal hernia
includes frequent, small feedings that
can pass easily through the
esophagus. The patient is advised not
to recline for 1 hour after eating, to
prevent reflux or movement of the
hernia, and to elevate the head of the
bed on 4-8-inch (10 to 20-cm).

Thank You