google_counter
background_img

Treatment of hiatal hernia (gastroesophageal hernia) abroad

Hiatal hernia occurs when the abdominal part of the esophagus and other organs (stomach, small intestine, omentum) protrude into the chest cavity. This pathology is met in 0,5% of population.

 

Gastroesophageal hernia requires surgical treatment. Refusal of the treatment leads to the increased risk of developing esophageal cancer.

 

Hiatal hernia

 

Causes of hiatal hernia (gastroesophageal hernia)

Abdominal and thoracic cavities are separated by a barrier calleddiaphragm. Diaphragm has several gaps including the esophageal hole. Esophagus passes from thoracic cavity into the abdominal cavity through this hole.

 

If the diaphragm stops to hold an esophagus, it moves up because pressure is in the abdominal cavity is higher than in thoracic cavity. That’s how hiatal hernia develops. Hernia is a protrusion of the abdominal part of the esophagus and stomach fragment into the chest thoracic cavity. Less often, small intestine loops and omentum also moves away.

 

Causes of hernia causes:

  • High intra-abdominal pressure
  • Reduction of anatomical structures strength that fixes the stomach and the esophagus into the abdominal cavity
  • Displacement of the esophagus due to its up retractions from the chest cavity

 

Intra-abdominal pressure might go up because of:

  • Obesity
  • Intense physical stress
  • Pregnancy
  • Non-stop vomiting
  • Severe cough
  • Ascites (fluid accumulation in the abdomen)
  • Oncological processes

 

Weakening of the connective tissue structures that fix the esophagus can appear due to:

  • Age involution
  • Congenital abnormalities
  • Abnormal metabolic processes
  • Asthenic (lean) body type

 

Esophagus can not only be pushed up from the abdominal cavity, but it can also sometimes be pulled from the thoracic cavity. It happens due to a number of reasons:

  • Short esophagus
  • Peptic ulcer
  • Chemical or thermal burns
  • Esophagus traumas with scarring

 

Hernia types

 

Hernia types

There are three hiatal hernia types: axial (sliding), paraesophageal, and mixed. In the first case, the abdominal part of the esophagus and an adjacent part of stomach move freely into the chest cavity and come back when body position changes. This is the most common hiatal hernia.

 

While having paraesophageal hernia, a part of stomach goes up and locates directly next to the chest section of esophagus.

 

There are three stages of hiatal hernia severity:

  • Stage 1 is when only abdominal esophagus section enters the thoracic cavity
  • Stage 2 is defined when cardiac orifice enters thoracic cavity and stomach part is located directly next to the esophageal opening
  • Stage 3 occurs when stomach part goes higher than diaphragm level

 

There are fixed and unfixed hiatal hernias. Unfixed hernia appears from time to time depending on the patient’s body position.

 

Hiatal hernia symptoms

 

Hiatal hernia symptoms

Hiatal hernia is asymptomatic in about half of cases. Other half report pain and heartburn as basic symptoms.

 

Pain characteristics for hiatal hernia:

  • It is located in the epigastric region
  • It spreads along the esophagus
  • Its intensity can be low or mild
  • Pain is dull and aching
  • 20% of patients tell about pain irradiation into the heart
  • Pain occurs only after a meal
  • Painful sensations strengthen when a person bends forward and in horizontal position
  • Physical activity strengthens the pain
  • Hiccups or burps weaken pain
  • Pain decreases in vertical position

 

Hiatal hernia leads to the cardiac orificeclosing process (it’s a place where esophagus enters the stomach). As a result, stomach contentgets into the esophagus irritating its walls. Then heartburn, burps, regurgitation of food occurs.

 

Lots of patients complain about burning pain behind the breastbone and it is often confused with heart pain.

 

Hiatal hernia diagnostics

 

Hiatal hernia (gastroesophageal hernia) - Diagnostics

In the majority of cases, hiatal hernia is easily diagnosed with the help of radiography. The picture is done in horizontal position. Method sensitivity is 94%.

 

To increased radiography sensitivity use of following is applied:

  • Contrasting agent injection
  • Use of the poses when intra-abdominal pressure is increased
  • Injection of medicines (atropine, neostigmine) to low the digestive tract organs tone

 

Endoscopic diagnostic methods are more informative. A doctor examines the esophagus and the stomach using a tube with a camera. He can detect not only hernia, but also can evaluate condition of the mucous membrane of the esophagus,  identify possible complications, and take biopsy for histology analysis.

 

Hiatal hernia treatment abroad

 

Treatment of hiatal hernia (gastroesophageal hernia) abroad

Hiatal hernia can be treated conservatively as well as with surgery. Prescription of medicines or some other conservative treatment methods doesn’t cure the illness, but it facilitates its flow and reduces the risk of complications.

 

Drug therapy includes the prescription of medicines that will normalize motility of the gastrointestinal tract and relieve heartburn.

 

Surgery is the basis of the treatment. It helps to remove the hiatal hernia once and forever. Depending on the clinical course, different types of surgeries are done:

  • Hernia repair (hernioplasty) is a herniorrhaphy with esophageal diaphragmatic ligament strengthening
  • Gastropexy is a fixation of a stomach
  • Fundoplicationis a restoration of an acute angle between the abdominal section of esophagus and fundus

 

Untreated hiatal hernia can be accompanied by multiple complications:

  • Reflux esophagitis
  • Peptic ulcer
  • Esophagus obstruction
  • Intussusception of the esophagus into the stomach
  • Acute bleeding
  • Prolapse of the gastric mucosa in the esophagus
  • Perforation (perforation, rupture) of the esophagus
  • Strangulated hernia

 

Complications are treated conservatively and surgically. Some of them require emergency surgical help.

 

Hiatal hernia prognosis

 

Hiatal hernia (gastroesophageal hernia) - Prognosis

Untreated hiatal hernia leads to the reflux esophagitis progression that leads to peptic esophagus ulcer as a result. Peptic ulcer is a precancerous condition. Patients who don’t treat hernia have the risk of cancer increased by 3 times in 6 years and by 5 times in 12 years.

 

Prognosis is favourable after the surgical treatment. Hiatal hernia symptoms, including heartburn, completely disappear. Risk of recurrence is low and post-surgery complications are rarely met.

 


 

Find the best Hiatal hernia (gastroesophageal hernia) hospital

Diagnostic
Price from
1671.00
Nissen fundoplication
Price from
8943.00
General therapeutic rehabilitation
Price from
510.00

Need Help?

Need Help?

Do you want the most effective treatment? We will help you to find a hospital in any country in the world specializing in your disease. Fill out the application and our specialist will contact you!

Thank you!

We received your treatment application in the best Europe clinics. Our manager will contact you within the next 24 hours.