The exact cause of hernia is unknown most of the times. But the more possible causes of hiatal hernia are as under;

• Congenital- The individual might have been borne with large hiatal opening.
• Increased and intense pressure on the abdomen and adjacent muscles while coughing,straining while bowels, pregnancy, obesity, or while lifting heavy objects.
• Injury to the area

The following are the option to treat hiatal hernia;

Drug therapy:

It is taken mostly to relieve the associated heartburn and acid reflux. The commonly prescribed medicines are;

• To reduce the acid production: H-2-receptor blockers, including cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75).
• To neutralize acid: Gelusil, Maalox, Mylanta, Rolaids and Tums for quick relief.
• To stop acid production and healing of oesophagus: Proton pump inhibitors including lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC).

Surgical interventions:

In most of the cases, surgery is not required but it is done in emergency situation like paraesophageal hernias. In the surgical procedure the surgeon either pulls your stomach down to the original place that makes the hiatus smaller, reconstruct the weak sphincter of oesophagus or remove the hernia sac completely.

This can be done using one of the following procedure;

• Thoracotomy: In this surgery is done through a single incision on your chest wall.
• Laprotomy: surgery is done through an incision in the abdomen.
• Laparoscopic: Surgery is performed using the small camera and surgical tools which are inserted in the abdomen through multiple small incisions. This is the minimally invasive technique.

If you are diagnosed with hiatal hernia with severe chest and abdomen pain, have difficulty in bowels and unable to pass gas, or if you have a strangled hernia which has led to obstruction in blood flow then you are an ideal candidate for the surgery.

Hiatal hernia surgery is often performed laparoscopically which is minimally invasive technique.

The surgery is done under general anaesthesia in which several incisions of around 5-10 mm are made on the abdomen. Then the small camera/laparoscope is inserted in the abdomen through these incisions which makes the surgeon to see inside the abdomen. Surgical tools are also inserted through these holes. With the guided images of the hernia on the monitor the surgeon then perform the surgery. As the incisions are small there is an added advantage of the less pain, lesser risk of infection and less scarring with rapid recovery. The surgeon may then pull your stomach down to its right place and will make the opening of the diaphragm smaller to prevent further episode, or reconstruct a weak oesophageal sphincter or may remove the hernia sac. The option depends upon your medical condition.

You results are permanent and would be relieved of your symptoms after the surgery.

Most patients are able to walk around the day after hernia surgery. You can resume your day to day activities after a week but complete recovery takes around 2-3 weeks whereas more strenuous activities like lifting heavy weights should be avoided for 3 months after the surgery. You would stay at the hospital for 1-2 days and another week before you can go back. You thus need a total of 8-9 days to get hiatus hernia surgery done in India.