Sliding hiatus hernia is one of the sub types of hiatus hernia. The other type is rolling hiatus hernia. Sliding hiatus hernia is more common than the rolling variety. It accounts for 95% of hiatus hernia; the remaining 5% is of rolling type. Esophagus is the food pipe through which the food passes from the mouth to the stomach. Esophagus passes through a hole in the diaphragm. This space is called hiatus.
Diaphragm is a muscular sheath which separates the chest from the contents of abdomen. Normally the stomach remains below the diaphragm.However, in sliding hiatus hernia the upper top part of stomach as well as the lower part of esophagus slides into the chest. In rolling hiatus hernia only the top portion of stomach slips through the hiatus while the gastroesophageal junction remains below the diaphragm.
Sliding hiatus hernia may cause pain and discomfort in chest and upper part of abdomen. It is more obvious when the patient sleeps. Growing age, weak diaphragm, excessive coughing, and heavy physical exercise are few leading causes of sliding hiatus hernia. Most of the time the symptoms of sliding hiatus hernia subside with conventional treatment and home remedies.In severe cases it may require surgical intervention.
Causes Of Sliding Hiatal Hernia
The exact cause for development of sliding hiatus hernia is not clear. However, certain factors are believed to contribute its development.
- It may be an inborn error. This means the person may be born with a larger hiatus (hole).
- It is more common in older age than young people. People above the age of 50 years are more vulnerable. There is muscular degeneration with increasing age.
- Increased intra-abdominal pressure as in large cyst of ovary, pregnancy, wearing tight corset, obesity.
- Women are afflicted more than men.
- Increase of fatty tissue in the hiatus region with decrease in elasticity of diaphragmatic muscles.
- Once the sliding hernia is established, the spasm of lower esophagus muscles and fibrosis of lower end will pull more and more stomach part into the chest.
- Chronic cough, smoking, emotional stress, sedentary lifestyle etc are also responsible for its development.
Sliding Hiatal Hernia Symptoms
Most of the clinical features of sliding hernia are similar to acid reflux disease. Sometimes it may also mimic symptoms related to heart disease. Below are given some of the important symptoms of sliding hiatus hernia:
- Discomfort and pain in chest.
- Burning in middle of chest which we commonly refer it as heartburn.
- The symptoms are more obvious after a heavy meal and after sleeping.
- Shortness of breath
- Feeling of food stuck in the chest.
- Pharyngitis and laryngitis as a result of regurgitation of stomach acid in the esophagus. This means patient may complain of pain in the throat and hoarseness of voice.
- Remaining in certain position, the symptoms become worse, like leaning forward and lifting heavy objects.
Natural Remedies For Sliding Hiatal Hernia
In most cases the symptoms of sliding hernia remain subtle. The person having it may not realize it. In moderate cases, burning in chest, belching etc can be obvious and they may hamper day to day life of the patient. Below are given home remedies which can easily tackle such symptoms effectively.
- If you are obese, focus on reducing your weight.
- Stop consuming excess of tea and coffee, stop smoking and drinking alcohol.
- Eat your dinner 2 hour before you sleep.
- Spread your meals into 6 smaller meals throughout the day, instead of 3 large meals.
- Prop up pillows and sleep in semi recumbent position with lower end of the bed slightly raised.
- Avoid heavy lifting, heavy work, and excessive bending.
- Do light exercise such as walking, jogging etc.
- Drink a glass of aloe vera juice before meals as it eases the symptoms seen after meals.
- Evening prime rose is found effective as it reduces inflammation present in the lower part of esophagus and upper part of stomach.
Surgery for sliding hernia may be indicated if the symptoms are not controlled with home remedies and medicines. If it leads to complications such as stenosis, hemorrhage or if it is associated with stomach ulcer, then patient may require a surgical repair.