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Digestive Disorders

Hiatal hernia

02/27/2008

Question:

Is hiatal hernia hereditary? My grandmother had surgery for it in her 50s, now I am in my 50s and have the same thing. If it is not hereditary what causes it? Can it be caused by wearing a belt that is too tight or anything like that? Does it cause GERD, or is it the other way around, GERD causes hiatal hernia, or what is the relationship between them? Is there any other treatment besides surgery? Thanks!

Answer:

Sir/Madam,

There maybe some familial correlation with any form of hernia. Some families may have a higher preponderance of abnormal protein in their connective tissue that can predispose them to hernias, including hiatal hernias. However, factors like being overweight or obese, smoking or smoke exposure or heavy physical labor is a far more common cause of hiatal Hernias. I doubt if wearing a belt can cause this condition. hiatal Hernias are almost invariably associated with GERD, with the hernia arising first and interfering in the function of the reflux valve at the Gastro-Esophageal junction (where your esophagus and stomach meet). This causes reflux.

Non-surgical treatment of GERD is prevalent and safe (medications like nexium or prevacid, also diet modification and weight loss). However there is no non surgical treatment for hiatal Hernias. These gradually get worse and not better. The most important thing that you need to remember is that yearly follow up is ABSOLUTELY vital in case you chose not to have an operation, as persistent reflux can cause precancerous changes in the esophagus. hiatal Hernias can be safely repaired using Minimally Invasive Techniques (Laparoscopically), which would entail an overnight stay and 5 tiny incisions.

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Response by:

Prakash  Gatta, MD Prakash Gatta, MD
Formerly, Assistant Professor of Surgery
College of Medicine
University of Cincinnati