Hiatus is any opening in the ‘diaphragm’ which separates the chest cavity from the stomach. Normally the different organs in the body have their own area or place. Sometime the stomach may protrude out into the hiatus. It is usually a small part of the stomach which enters into the hiatus and bulges up to the chest.

This condition is known as Hiatus Hernia.

In Hiatus Hernia, a small part of the stomach enters into the diaphragm right up to the chest causing pain. There are 2 types of Hernia namely Sliding Hernia and Para-oesophageal (food pipe) Hernia. The Sliding Hernia is the most common type where the part of stomach bulges into the hiatus. The uncommon type is oesophageal Hernia where the stomach squeezes the food pipe and narrows it in size and which is a cause for concern.

The symptoms of Hernia may include:

• A visible swelling beneath the skin of the stomach
• A feeling of heaviness in the abdomen
• Constipation and pain in upper abdomen
• Heartburn and discomfort and acid reflux [GERD]

• Most of the times the cause of Hiatus Hernia is a bodily defect, which may be an unusually large opening of the diaphragm, into which a part of the stomach slides
• Sometimes the Hernia may develop over a period of time which may be due to inflammation of the food pipe because of diet and hyperacidity
• Any injury in or near the abdomen

Usually in case of Hernia there are no symptoms for a long time and if there is pain in the upper abdomen, then an X -Ray or endoscopy may reveal Hernia. The image will clearly show a ‘sac ‘protruding into the space between what is the food pipe and the stomach.
As Hernia causes GERD or acid reflux which means the acids come back again to the food pipe from the stomach, then Hiatus Hernia may be the resultant condition.

Complications in Hernia are rare but can be serious. Complications may include:

• Oesophageal ulcers [of the food pipe]
• Oesophageal stricture [narrowing of food pipe]
• Changes in cell lining in lower oesophagus [food pipe]
• Strangulation of oesophagus [food pipe] in Oesophageal Hernia which may require immediate surgery

As Hiatus Hernia is a physical abnormality, the Gastroenterologist may suggest surgery to correct the deformity in both the types of Hernia.

Acid reflux is the main symptom of Hernia which can also be treated by adopting certain lifestyle changes.

A fine example of recovery is of ‘The Rock’ or Actor Dwayne Johnson.

Rock hurt himself in a Wrestle mania fight with John Cena and had to undergo an emergency surgery for Hernia tears. He is doing fine after the surgery.

To manage the severity of symptom like GERD or Acid reflux caused by Hiatus Hernia, the following lifestyle changes are recommended:

• Having of 5- 6 small meals in a day rather than 3 large meals
• Avoiding of lying down immediately after eating or drinking
• Avoiding foods which cause severity of symptoms
• No bending or stooping over after eating
• Using a raised bed from the header side to avoid acid reflux
• Mild Exercising and no smoking