Hiatal Hernia
What Is a Hiatal Hernia?
A hiatal hernia occurs when a portion of the stomach pushes upward through the diaphragm into the chest cavity. The diaphragm normally separates the chest from the abdomen and contains a small opening called the hiatus through which the esophagus passes before connecting to the stomach. When this opening becomes enlarged or weakened, part of the stomach may move upward into the chest.
Hiatal hernias are common and may occur gradually over time, especially with aging or increased abdominal pressure. Many patients also experience symptoms related to acid reflux or GERD. At Chicago Metabolic & Digestive Surgery Center, Dr. Jihad Kudsi provides advanced evaluation and minimally invasive surgical treatment for hiatal hernias and related foregut disorders for patients throughout Chicago and surrounding suburban communities.
Types of Hiatal Hernias
There are two primary types of hiatal hernias:
Sliding Hiatal Hernia
This is the most common type and occurs when the stomach and lower esophagus slide upward through the diaphragm.
Paraesophageal Hiatal Hernia
In this less common but potentially more serious form, part of the stomach pushes beside the esophagus and may become trapped. Larger paraesophageal hernias can sometimes lead to complications requiring surgical treatment.
Symptoms of Hiatal Hernia
Some patients may have no symptoms, while others develop symptoms related to reflux or pressure within the chest and upper abdomen.
Common symptoms may include:
- Heartburn
- Acid reflux
- Chest discomfort
- Difficulty swallowing
- Regurgitation of food or acid
- Bloating after meals
- Chronic cough
- Hoarseness
- Feeling full quickly after eating
- Upper abdominal pain
Symptoms often worsen after large meals, lying down, or bending over.
Causes & Risk Factors
Several factors may contribute to the development of a hiatal hernia, including:
- Aging and weakening of tissues
- Obesity
- Chronic coughing
- Heavy lifting or straining
- Pregnancy
- Chronic constipation
- Increased abdominal pressure
Hiatal hernias are more common in adults over the age of 50.
Diagnosis of Hiatal Hernia
Accurate diagnosis is important to determine the size of the hernia, evaluate reflux symptoms, and identify associated digestive conditions.
Diagnostic testing may include:
- Upper endoscopy (EGD)
- Barium swallow study
- Esophageal manometry
- Esophageal pH testing
- CT scan or imaging studies
These tests help evaluate esophageal function, acid reflux, and the anatomy of the hernia.
Treatment Options for Hiatal Hernia
Treatment depends on the size of the hernia, severity of symptoms, and the presence of GERD or other complications.
Lifestyle & Dietary Modifications
Some patients may improve symptoms with conservative measures such as:
- Eating smaller meals
- Avoiding late-night eating
- Weight management
- Avoiding trigger foods
- Elevating the head during sleep
- Smoking cessation
Medical Management
Medications may help reduce acid production and control reflux symptoms. Common medications may include:
- Antacids
- H2 blockers
- Proton pump inhibitors (PPIs)
Minimally Invasive Hiatal Hernia Surgery
For patients with persistent symptoms, severe reflux, or large paraesophageal hernias, surgery may be recommended.
Dr. Jihad Kudsi specializes in advanced minimally invasive and robotic foregut surgery, including hiatal hernia repair and anti-reflux procedures. Surgical treatment typically involves repositioning the stomach into the abdomen, repairing the diaphragmatic opening, and restoring the normal anti-reflux barrier.
Robotic & Laparoscopic Hiatal Hernia Repair
Minimally invasive surgical techniques may offer:
- Smaller incisions
- Less postoperative discomfort
- Faster recovery
- Reduced scarring
- Shorter hospital stay
- Improved visualization and surgical precision
In some patients, fundoplication may also be performed to help reduce acid reflux symptoms after hernia repair.
Complications of Untreated Hiatal Hernia
Without treatment, some hiatal hernias may contribute to:
- Chronic GERD
- Esophagitis
- Difficulty swallowing
- Bleeding or ulcers
- Barrett’s esophagus
- Strangulation of the stomach in rare cases
Early evaluation may help prevent long-term complications and improve quality of life.
Expert Foregut & Digestive Surgical Care
Chicago Metabolic & Digestive Surgery Center is led by Dr. Jihad Kudsi, a nationally recognized surgeon specializing in minimally invasive, robotic, bariatric, and foregut surgery. Dr. Kudsi provides personalized treatment plans using advanced surgical techniques to help patients achieve lasting symptom relief and improved digestive health.
The practice offers comprehensive hiatal hernia and reflux care for patients throughout Chicago, Naperville, Downers Grove, and surrounding communities.
Schedule a Consultation
If you are experiencing chronic reflux, chest discomfort, swallowing difficulty, or symptoms of a hiatal hernia, contact Chicago Metabolic & Digestive Surgery Center to schedule a consultation and learn more about available treatment options.
For in-depth information please visit Dr. Kudsi’s website: Hiatal Hernia
