Hiatal Hernia

Gastroesophageal Reflux 

Definition:  A condition in which a portion of the stomach protrudes upward into the chest through an opening in the diaphragm (the sheet of muscle used in breathing that separates the chest from the abdomen). Stomach content is coming out of the stomach into the esophagus for an extended period of time.

Causes, incidence, and risk factors:  The cause is unknown but may be the result of a weakening of the supporting tissue. Obesity and smoking may be risk factors in adults. Children often have this condition present at birth (congenital). Hiatal hernia is usually associated with gastroesophageal reflux in infants.  Regurgitation of gastric acid from the stomach into the esophagus can result from this condition. 

Symptoms:  Frequently there are no symptoms, but the following may occur:

  • swallowing difficulty 
  • aspiration pneumonia
  • apnea
  • asthma
  • hoarseness
  • gastric or esophageal dysmotility may also contribute to symptoms
  • chest pain 
  • belching

Signs and tests: Barium swallow X-ray, EGD (esophagogastroduodenoscopy), External esophageal ph monitoring, gastric emptying scan.

Treatment: The goals of treatment are to relieve symptoms and prevent complications.  Medical therapy is aimed at reducing regurgitation of stomach contents into the esophagus (gastroesophageal reflux). Medications that neutralize stomach acidity, or that strengthen the lower esophageal sphincter, may be prescribed.

Medications that improve esophagus and gastric motility may be used. Failure to control the symptoms by general or medical measures, or the onset of complications, may require surgical repair of the hernia. 

Expectations (prognosis): Most symptoms are alleviated with treatment. 

Complications: Slow bleeding and iron deficiency anemia (esophagitis), pulmonary (lung) aspiration, stricture of the esophagus.

As with any procedure we perform, your child's safety and well-being our #1 priority.  As always, feel free to contact us with any question that you have.  We would be happy to answer it for you.