Hiatal Hernia and Reflux Disease
Gastroesophageal reflux disease (GERD) is defined as the abnormal reflux (pathological) of the gastric or duodenal content towards the esophagus which produces a short, medium or long term injury (inflammation, stenosis and premalignant or malignant injuries). At present, it constitutes one of the most frequent digestive tract diseases in the western civilization.
The hiatal hernia is one of the main causes for gastroesophageal reflux disease and it is defined as the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm.
- Common symptoms
- Reflux (Heartburn)
- Dysphagia (difficulty in swallowing)
- Bad breath
- Less frequent symptoms
- Thoracic Pain
- Recurring respiratory diseases: laryngitis, Pharyngitis, sinusitis, pneumonitis, asthma among others
- Chronic cough
- Dental erosion
The following complications can be presented or displayed: Barrett's esophagus, esophageal stenosis, esophageal hemorrhage, ulcers and esophageal cancer.
The diagnosis is confirmed with an endoscopy, in most of the times, it’s accompanied by performing biopsies directed on the zones in which an injury is suspected. In some cases it may be necessary to perform an esophageal manometry and 24-hour pHmetry.
Surgical treatment is directed to reconstruct the anti-reflux barrier that is altered in patients afflicted by this disease. From the point of view of the disease, surgery is more logical than medical treatment, because the anatomical alteration that is caused by this disease is corrected with surgery. In the case of the hiatal hernia, the innards must be returned into their original place in the abdominal cavity and close the orifice by which they penetrated into the thorax using stitches or synthetic meshes.