Hernia: Symptoms, Diagnosis and Treatment
A hernia is a common abdominal problem that can affect men and women. It is caused by organs that bulge past surrounding tissue or muscle. Whether hernias grow slowly or develop all at once, they can be risky and require surgery to avoid dangerous complications. The board-certified surgeons at Beaufort Memorial have extensive experience in many types of minimally invasive hernia repair, including da Vinci robotic surgery.
Common hernia types include:
- Femoral
- Hiatal
- Incisional
- Inguinal
- Umbilical
- Ventral
Many digestive health problems can be managed by your primary care provider. Find a provider accepting new patients. If necessary, he or she can refer you to one of our board-certified gastroenterologists.
What Are the Symptoms of a Hernia?
Symptoms, which vary by hernia type and location, range from a small, pain-free lump to a noticeable, painful swollen bulge in the affected area. Other symptoms may include:
- A dull aching sensation
- A sense of feeling full or signs of bowel obstruction
- Increase in the bulge size over time
- Increased pain at the site of the bulge
- Pain while lifting
- Swelling or bulge in the groin
How Are Hernias Treated?
Hernias usually require surgery to repair them. Your doctor will recommend the best treatment plan for you and your type of hernia.
What Is a Hiatal Hernia?
Your diaphragm is a thin muscle separating the chest and abdomen that supports the lower esophageal sphincter, which prevents stomach acid from flowing back into the esophagus. When the upper part of the stomach pushes through an opening in the diaphragm, the end result is a hiatal hernia.
There are two types of hiatal hernia. The most common is a sliding hiatal hernia, which is often treated nonsurgically. A paraesophageal hiatal hernia, however, may require surgery once symptoms arise.
What Are the Symptoms of a Hiatal Hernia?
Hiatal hernias do not show up as bulges, as other hernias might, but they can cause a variety of uncomfortable symptoms that are similar to those of gastroesophageal reflux disease (GERD):
- Bad breath
- Chest pain
- Dry cough
- Heartburn
- Indigestion
- Nausea and/or vomiting
- Regurgitation (bringing food back up)
- Trouble breathing or swallowing
- Tooth decay
How is Hiatal Hernia Diagnosised?
Because all GERD-like symptoms are not caused by a hiatal hernia, determining the source of your pain is essential to appropriate treatment. If your physician suspects you have a hiatal hernia, he or she may order one or more of the following tests for a definitive diagnosis.
- Barium esophagram or upper GI X-ray — This simple, noninvasive test takes images of your chest for analysis. During an X-ray for a hiatal hernia, you will swallow a special drink made of barium, a substance that allows physicians to view your esophagus as you swallow. Also called a barium swallow, this drink helps your physician and radiologist pinpoint potential problems.
- Upper endoscopy — A thin, flexible tube is inserted through the mouth and guided to the esophagus. There, a tiny video camera gives physicians a clear view of the upper gastrointestinal tract, which includes your esophagus, stomach and duodenum (the first part of the small intestine), to determine the type and extent of a hiatal hernia.
How is a Hiatal Hernia Treated?
Your treatment depends on the type of hiatal hernia you have and its progression. As long as the hernia remains small and isn’t causing severe symptoms, monitoring is often the only treatment necessary. Other times, over-the-counter or prescription medications, such as proton pump inhibitors, are used to reduce stomach acid as well as GERD symptoms.
In severe cases, the opening in the diaphragm could grow so large that the stomach and other organs could slip through it into the chest. To prevent this, surgeons turn to laparoscopic repair. During repair, the surgeon inserts a thin, flexible tube into your abdomen and guides it to your diaphragm. A tiny video camera on the end serves as the surgeon’s eyes, allowing the surgeon to return the stomach to its rightful place and close the hole created by the hernia.