Digestive System Surgery:Esophageal Hiatus Hernia

• A disease which a part of stomach break into thoracic.
• By looseness of esophageal hiatal and pressure from abdominal.
• Symptom is heart burn by backflow of stomach acid.
• Grouped into Sliding type, paraesophageal type and combined type.
• Surgical operation when oral medicine treatment does not work.
• Daily habit to prevent backflow of stomach acid.

A disease which a part of stomach break into thoracic.

There is a muscle named as diaphragm between thoracic and abdominal. Organs continuing from thoracic to abdominal, such as Esophagus, main artery and inferior main artery, are coming through the diaphragm. The hole where thoracic is coming through diaphragm is called as esophageal hiatus.

The status where part of stomach in the abdominal breaks into thoracic through the esophageal hiatus, is called as esophageal hiatal hernia.

By looseness of esophageal hiatal and pressure from abdominal.

Esophageal hiatus become loose by advancing age or congenital reason, and by applying pressure from abdominal, esophageal hiatal hernia is developed. Report says that this disease is common among middle to high aged women.

The reason of abdominal pressure, chronic cough caused by obesity or bronchial asthma can be considered.

Symptom is heart burn by backflow of stomach acid.

Even though there is esophageal hiatal hernia, in case if there are no symptoms, it does not become problem. But by having esophageal hiatal hernia if stomach acid backflows to esophagus, symptoms like heart burn or abnormal feeling at thoracic area may appear. These status is called as reflux esophagitis.

Grouped into Sliding type, paraesophageal type and combined type.

Diagnosed by upper alimentary canal contrast study or upper alimentary canal endoscopic exam. Depend on the shape of hernia, it is categorized into ;

• Sliding type

• Paraesophageal type

• Combination type

Among above category, sliding type is common.

Surgical operation when oral medicine treatment does not work.

Oral medicine treatment is performed to prevent backflow of stomach acid as main symptom improvement. But when oral medicine treatment does not improve symptom, then surgical operation is performed.

Bring a broken stomach part back to abdominal, and make loosed and enlarged esophageal hiatus to small to prevent breakage. And, surgery, which binds stomach around esophagus to prevent backflow of stomach acid, is added. (Nissen method). Recently, laparoscopic surgery, which apply less burden to patient, is conducting.

Daily habit to prevent backflow of stomach acid.

Refraining from alcohol, caffeine or oily food may prevent backflow of stomach acid. Besides, backflow of stomach acid becomes easy to occur if lay down immediately after the meal.