What's the Difference Between True Hiatal Hernia and Hiatal Hernia Syndrome?

A true hiatal hernia has the physical protrusion of part of the stomach, whereas hiatal hernia syndrome does not. Although they share the same symptoms and treatment, it is still best to consult an expert physician for correct manipulation of hiatal hernia.

GASTROINTESTINAL

Sheryl Aguelo

7/27/20262 min read

True hiatal hernia is a condition when part of the stomach protrudes, or herniates through the opening of the diaphragm and into the chest cavity. Almost 50% of all Americans have true hiatal hernia and asymptomatic. True hiatal hernia is not considered dangerous unless they produce persistent symptoms. The esophagus has a muscular sphincter that prevents backing up out of the stomach and refluxing into the esophageal tube. When part of the stomach slides out of place (herniates), the ability of the muscular rings to keep food and acid in the stomach may be inhibited. Hiatal hernia syndrome has no protrusion into the chest but the proximal stomach causes upward pressure against the diaphragmatic hiatus.

True hiatal hernia and hiatal hernia syndrome have the same signs and symptoms. These include fatigue, mental dullness, easy satiety, shallow chest breathing, fast respiratory rates, feeling of tightness in the throat, difficulty swallowing, reflux, chest pains, flatulence, non-productive cough, and presence of bulge below the inferior margin of the ribs. The causes of true hiatal hernia include poor diet, overeating, trauma to the stomach, food allergies, stress. These cause weakness of stomach muscles.

Hiatal hernia syndrome may be genetic. There is a wide diaphragmatic hiatus. It may also be caused from trauma or increased intra-abdominal pressure. The examples of trauma include abdominal surgery, horseback riding, falling from the height, and excessive abdominal exercise.

In order to assess for detection of hiatal hernia syndrome, Dr. Failor used tender points:

- left of xyphoid
- 4th ICS mid clavicular
- 4th ICS mid axillary
- T 10-11 left paravertebral area

The treatment of hiatal hernia syndrome is performing the actual sliding the hiatal hernia. This technique is called Visceral Manipulation. Post manipulation exercises include heel drops, leg raise, and knee raise. The diet is about reducing the pressure in stomach and diaphragm. Avoid overeating and large meals, chew your food properly, and avoid stressful discussions while eating.

True hiatal hernia and hiatal hernia syndrome are not considered dangerous. Overeating is the major cause. It adds more pressure to the muscles of the stomach. Consistent eating large meals weaken the muscle causing hernia. Therefore, eating adequate amount is necessary to prevent hiatal hernia. However, if there are persistent symptoms, consulting an expert physician to manipulate hiatal hernia is recommended to prevent complications.

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