The diaphragm is a muscle that separates the chest cavity from the abdominal cavity. A small opening, the hiatus, in the diaphragm allows the esophagus enter through the chest cavity into the abdominal cavity. The junction of the esophagus and the stomach is called the gastroesophageal junction. Due to increased abdominal pressure, etc. the gastroesphageal junction may extend into the chest cavity. This is a Hiatal Hernia.  Many patients have no symptoms primarily because of the use of over the counter antacids. Others may have heartburn related to gastroesophageal reflux disease (GERD). Hiatal hernia, GERD, and reflux disease need to be evaluated by a surgeon for possible surgical repair. The conventional treatment with over the counter or prescription medication that suppresses acid production and release is not advisable for long term. There is a large body of scientific evidence, which has demonstrated medical and metabolic conditions that have risen from chronic use of antacids. It is to be noted that FDA never approved these medications for long-term use.

Hiatal Hernia Causes:

• heavy lifting
• coughing
• obesity
• injury
• persistent vomiting
• age related

Hiatal Hernia Post Sleeve Gastrectomy

Symptoms:

• sour taste
• reflux
• heartburn
• belching
• chest or abdominal pain
• difficulty swallowing
• vomiting
• no symptoms

Surgical Treatment:

Laparoscopic Surgery is done to tighten the junction between the stomach and esophagus. The most common surgery is done by pulling the stomach back below the diaphragm and wrapping the top of the stomach around the junction between the stomach and esophagus. The stomach is then sewn in place. Surgery is the only way to treat a hiatal hernia that is causing severe symptoms. There is also a technique that can be utilized for hiatal hernia repair post Sleeve Gastrectomy. 

Further information regarding Hiatal Hernia here.

Dr. Ara Keshishian has more than 18 years of advanced surgical skill and expertise in both open and minimally invasive surgical hernia repairs.