Hiatus Hernia: Causes, Types, Diagnosis, Treatment, Management

Definition | Causes | Types of Hiatus Hernia | Clinical Feature | Diagnosis | Complication | Nursing Management | Management|

Hiatus Hernia: Symptoms and causes, Treatment

Definition:-

A type of hernia in which part of the stomach protrudes up through the esophageal opening of the Diaphragm. Hiatus hernia is an anatomical abnormality in which the part of the stomach protrudes up through the diaphragm into the chest.

Causes:-

   The exact cause is unknown. It may be due to,

  • Increased pressure within the abdominal cavity. It may be due to – Heavy lifting, Pregnancy, Ascites, Frequent or hard coughing, Boilent vomiting, Starving.
  • Weak LES.
  • Obesity.
  • Aging.

Types:-

  1. type 1st:- Sliding Hiatus Hernia:-

  • Herniation of both the stomach and gastroesophageal junction in the thorax.
  • The most common type of hiatus hernia (90%).

      2.Type 2nd :- Paraesophageal Hiatus Hernia:-

  • It is also known as rolling hiatus hernia.
  • Herniation of all or part of stomach through the esophagus into the thorax,with an undisplaced G.E.junction.
  • It is less common (10%).

Clinical Features:-

  1. In most of the cases, hiatus hernia remains asymptomatic,the disease discovers accidentally.
  2. the clinical feature are :-
  • Heartburn.
  • Dull chest pain.
  • Shortness of breath.
  • Regurgitation.
  • Dysphagia.
  • Palpitaion.
  • Reteosternal chest pain.

Diagnosis:-

  • Endoscopy.
  • Barium swallow X-ray.
  • Chest X-ray.
  • C.T. scan.

Complications:-

  • GERD (most common).
  • Esophagitis.
  • Esophageal ulcer.
  • Aspiration pneumonia.
  • Perforation (cutting of mucus membrane).

Management:-

General Management:-

General Management includes:-

  • Weight Loss.
  • Stop smoking.
  • Maintaining an upright position after taking food.
  • Elevate the head of the bed (20 to 35 cm.).
  • Small and frequent meals.
  • Not lying down or bending over after taking a meal.
  • Avoid tea, coffee, alcohol.

Pharmacological Management:-

  • Antacid.
  • H2- blocker drug.
  • Proton pump inhibitors.

Surgical Management:-

surgical management includes Nissen fundoplication surgery.

Nursing Management:-

  • Prepare the patient for diagnostic tests as needed.
  • Administration Prescribed antacids and other medications.
  • To reduce intra-abdominal pressure and prevent aspiration have the patient sleep in a reverse Trendelenburg position with the head of the bed elevated.
  • Assess the patient’s response to treatment.
  • Observe for complications especially significant bleeding, pulmonary aspiration.
  • Often endoscopy watches for signs of perforation such as falling blood pressure rapid pulse, shock, and sudden pain caused by the endoscope.
  • review prescribed medications, explaining their desired actions and possible adverse effect.
  • Teach the client dietary changes to reduce reflex.
  • Encourage the client to delay lying down for 2 hours after eating.

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