Hiatal hernia: symptoms and causes

Hiatal hernia: symptoms and causes

Hernia is one of the most common disorders in the population, especially after the age of fifty. Not everyone, however, is familiar with the hiatal hernia, a type of hernia that can prove to be very annoying or – and perhaps in this case a more dangerous and problematic condition occurs – it can be asymptomatic and, if not treated, lead to more pathologies. serious entity. 

A hernia is defined as a protrusion of an organ or tissue towards the outside of the cavity in which it is normally housed; the hiatal hernia affects the stomach, and is therefore a deformation of the stomach wall, which extends towards what is called the esophageal hiatus: a small oven in the diaphragm whose function is to allow the passage of the esophagus, in turn connected to the stomach from the cardia. The cardia is important because the gastroesophageal sphincter is located there, a valve that blocks the ascent of digested food and gastric juices upwards, up into the throat. But when the valve doesn’t work properly, a hiatal hernia can contribute to worsening gastroesophageal reflux episodes , with all the ailments that this entails. 

It should also be noted that the diaphragm also has a regulating action against the gastroesophageal sphincter, because through its pressure it favors the valve opening and closing mechanism. However, when a case of hiatal hernia occurs, the sphincter is pushed above the diaphragm by the part of the stomach that protrudes from its natural seat The diaphragm, preventing the latter from exerting the natural pressure that allows the valve to be kept tightly closed when necessary and thus prevent the rise of the gastric juices contained in the stomach. We are thus in the presence of a classic case of gastroesophageal reflux syndrome. 

Causes of hiatal hernia

As anticipated, the hernia is a disorder strongly associated with the physiological progression of time: the same is true for the hiatal hernia. Some studies have confirmed that at the basis of the development of the hiatal hernia there may also be the continuous and constant repetition of muscle movements that allow swallowing, which determines a worsening in the elasticity of the tissues, thus favoring the formation of the hernia. Precisely for this reason the hiatal hernia is very common among the elderly population: it seems that about 9 out of 10 people suffer from it after 80 years of age, but already after 50 about a quarter of the population seems to have already developed the first signs of protrusion. 

However, pregnant women and people with obesity problems also include people at risk, because strong abdominal compression is one of the secondary causes of this disorder. Even smoking, an incorrect lifestyle and a particular sedentary lifestyle can lead to the spontaneous onset of hiatus hernia, which can also appear after a strong abdominal trauma (accident, fall, beatings, etc.) or after physical exertion. particularly challenging.

Symptoms of hiatal hernia

Usually, small hiatal hernias, in the early stage, do not involve particularly important symptoms: often these are ignored entirely until the situation worsens. When the hernia becomes consistent, however, the ascent of the gastric contents into the esophagus leads to burning, acidity, heaviness, cases of regurgitation and chest pain; if left untreated, hiatal hernia, associated with gastroesophageal reflux, can cause cough and asthma, difficulty in breathing (or heavy breathing) and difficulty in swallowing, often accompanied by severe sore throats. In such cases it is therefore important to report the situation to the attending physician, who may prescribe – depending on the case – antacids, painkillers or drugs suitable for the pathology, or in the most serious symptomatological pictures, 

Even in the mildest cases, however, the hiatal hernia at the basis of gastroesophageal reflux syndrome can cause unpleasant consequences, such as halitosis (bad breath odor), abundant salivation and drool in the mouth, perception of a bad taste in the throat and mouth (tending to bitter) and alterations of the vocal timbre, such as hoarseness and aphonia. Cases of abdominal bloating and frequent belching, nausea and digestive difficulties are also not uncommon. Obviously all these symptoms tend to get worse – as well as all the ailments related to the malfunction of the digestive system – in the supine position and even more when you move your head down (when, for example, you lower yourself to pick up something from the ground ).

Some advices

As it is easy to imagine, in less severe cases the symptoms of hiatal hernia are alleviated with simple precautions, improving one’s lifestyle and diet according to one’s physiological well -being . It is good, for example, to avoid heavy, high-calorie meals, eat smaller portions, and break hunger with snacks and small fillers. A proper diet would be free of alcohol, coffee, acidic foods, chocolate and spicy foods, and in general anything that causes indigestion or that can irritate the stomach and esophagus walls. After meals, the supine position should always be avoided: a little digestive walk is better. It is also important to stop smoking and to start practicing physical activity, even if it is mild. 

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