Sliding hiatus hernia is common and often symptomless, but can cause heartburn and GERD. Surgery may be necessary for severe symptoms, with risks and healing times to consider. Paraesophageal hiatus hernia is rarer and requires surgery to avoid tissue death.
A sliding hiatus hernia is a type of hernia in which part of the stomach, along with the gastroesopahgeal junction, protrudes through the hiatus, the hole in the diaphragm that allows the esophagus to connect with the stomach. Normally, the diaphragm separates the contents of the chest from the contents of the abdomen, but in a hiatal hernia, the stomach intrudes into the chest cavity. This condition is actually extremely common and many people have it and have no symptoms. For people experiencing symptoms, there are a few treatment options available.
Most commonly, people with a sliding hiatus hernia experience heartburn and may also have gastroesophageal reflux disease (GERD). In some patients, the stomach is permanently herniated into the chest, while in others, the stomach is pulled up through the hiatus when the patient swallows and the muscles contract. The condition is known as a “sliding” hiatus hernia because the stomach literally slides through the hiatus in a sliding hiatus hernia.
Often, this condition goes unidentified because the patient has no symptoms or the symptoms are so mild that the patient does not complain. In other cases, a medical imaging study reveals the problem. Surgery may be recommended to address the problem if the patient experiences severe or debilitating symptoms, with the goal of the surgery to anchor the stomach in the abdomen and keep it there.
Patients who are considering surgery for this type of hiatus hernia may want to ask about the risks and potential complications of the surgery. It’s also a good idea to inquire about expected healing times, including the amount of time a hospital stay might be needed. Patients with sliding hiatus hernias may also find it helpful to know what can happen if they don’t receive surgery. The surgeon should also be able to provide information on his success rate with patients presenting with a sliding hiatus hernia.
In another type of hiatus hernia, a paraesophageal hiatus hernia, the gastroesophageal junction stays in place and part of the stomach slides through the hiatus so that it is next to the esophagus. This rarer form of hiatal hernia is a serious problem, because the herniated area of the stomach can be cut off from its blood supply, resulting in tissue death. In this case, surgery is needed to correct the problem before complications emerge.
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