You Ask , They Answer
Q
: What ’ s hiatal hernia and its telltale signs ?
A
: A hiatal hernia is a medical problem that occurs when the protection valve between the stomach and oesophagus experiences a structural defect , allowing some of the acidic stomach content to go up to the oesophagus and even part of the stomach itself , also known as reflux . This often causes symptoms like a burning sensation because the oesophagus doesn ’ t have defensive mechanisms against acids , unlike the stomach . Other typical symptoms are bloating , stomach discomfort , nausea , vomiting , and sourness in the throat , especially early in the morning . Some people may also have atypical symptoms like headaches , shortness of breath , and even teeth or gum problems .
Q
: What are the common causes of hiatal hernia ?
A
: It can be congenital , meaning you are born with it , or you can acquire it along the years . You usually see hiatal hernia in obese people because anything that increases pressure in the abdomen , like extra weight , can cause it . For the same reason , weightlifters and people who cough or sneeze a lot or have difficulty with bowel movements are at a greater risk of developing hernia . Hormonal changes can also lead to hernia .
Q
: What are the treatment options ?
A
: We divide them into two — medical and surgical . More than 70 percent of people will get better with medical treatments that reduce acidity along with food education and lifestyle modifications . Most people can just take some tablets for a short period of time and have a good response .
However , people who have a large hiatus hernia and severe reflux disease and don ’ t respond to medical treatment for about six months will have to go for surgery . This is often a minimally invasive procedure that requires one day of hospitalisation , or it can even be done as a day care surgery . It will help solve the problem in more than 90 percent of cases when performed by an experienced surgeon .
Q
: What are the risks of untreated hiatal hernia / reflux disease ?
A
: If people neglect symptoms and don ’ t seek treatment , the disease may progress and the patient may experience some alarming symptoms like difficulty in swallowing , coughing blood , weight loss , and weakness . This is what we call gastroesophageal reflux disease ( GERD ), a condition that affects daily life as people cannot eat certain foods or have to take medical leave often .
The ultimate complication may be cancer or problems requiring major surgeries . That ’ s why it ’ s better to treat hernia and reflux disease before complications arise .
Q
: Can people prevent hiatal hernia ?
A
: People who sneeze or cough a lot can have their medical problems treated to reduce the risk of developing hernia .
Obesity is also preventable with a good diet . People are recommended to eat foods that don ’ t stay in the stomach for too long . Hence , they should avoid fried foods or those that are too oily and spicy . Overeating can increase the risk of hernia , so eating in moderation contributes to its prevention .
A good practice is also to avoid drinking and eating at the same time because fluids can increase pressure on the stomach . It ’ s advised to eat first and then drink only about 30 minutes after .
People should also go to bed three to four hours after having dinner as lying down may increases the risk of reflux .
Dr Mustafa Mohamed Taher Al-Khafaji
Dr Mustafa Mohamed Taher Al-Khafaji is a surgeon specialised in general , upper gastrointestinal , and bariatric surgery at the Cengild G . I . Medical Centre in Kuala Lumpur .
C
M
Y
CM
MY
CY
CMY
K
12 ISSUE 5 | 2023 GlobalHealthAsiaPacific . com