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HIATAL HERNIA

– is also called diaghragmatic hernia.
– protrusion of the stomach through the esophageal hiatus of the diaphragm

  • THERE ARE TWO TYPES:
  1. SLIDING HERNIA- ALMOST LIKE GERD (MAJOR CONCERN- REFLUX AND IT’S COMPLICATIONS)
  2. ROLLING HERNIA- THE FUNDUS ROLLS THROUGH THE ESOPHAGIAL HIATUS AND INTO THE THORAX.

Assessment:
Barium swallow study w/ fluoroscopy

– There is a herniation in the portion of the stomach, protruding towards the thoracic cavity.
Assessment/ Symptoms:
Symptoms are very similar to GERD:

  • DYSPHAGIA (DIFFICULTY SWALLOWING)
  • ODYNOPHAGIA (PAINFUL SWALLOWING)
  • REGURGITATION OF FOODS
  • HEARTBURN (DYSPEPSIA)

There are two types:

  • SLIDING OR ROLLING HERNIA
  • PARAESOPHAGEAL HERNIA

Diagnosis:

  • BARIUM SWALLOW X- RAY.
  • DIRECT VISUALIZATION BY ENDOSCOPY.

Management/ Treatments:

  • MANAGEMENT AND TREATMENTS ARE THE SAME AS GERD.

Treatment:
Elevate the head of bed
Give antacids
Administer H2 Blockers
Administe Proton Pump Inhibitor
Encourage  smaller frequent meals.

Common Drugs to help control symptoms of Hiatal Hernia:

Rantidine (Zantac)  – Histamine Blocker –  decreases gastric acid secretions.

Magnesium Hydroxide (Maalox) – Antacid – decreases the heartburn.

Lansoprazole (Prevacid) – Protein Pump Inhibitor – decreases gastric acid secretions.

 

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