All Hernias are not alike.

By Steven Baldridge

A hernia is a hernia, right? Well, yes and no. Hernia is a general term for an organ or tissue pushing through an opening in the supporting tissue around it. But which organ and which area of the body? Hiatal hernias are the upper portion of the stomach pushing up through the diaphragm. This is one cause of gastric reflux. On the other hand, when the organ is the intestine and the area is somewhere in the abdomen or groin, this is a different hernia altogether. Stick with me while we talk about both kinds.

We’ll start with Hiatal Hernias, and more broadly, reflux. We all have a ring shaped muscle (sphincter) at the bottom of the esophagus, where it connects to the stomach. This muscle relaxes when you swallow to let food into your stomach. Then it tightens immediately to keep food, and stomach acid, in the stomach. When this muscle fails to do its job, stomach acid backs up into your esophagus. Your stomach is designed to handle that much acid but your esophagus is not. This can cause not only occasional heartburn, but may cause more serious damage.

If reflux is not treated, it can lead to other health problems. Esophagitis happens when the acid actually damages the tissue of the esophagus causing it to be inflamed. Left untreated, this can lead to scarring or even cancer. Breathing problems can happen when stomach acid gets all the way up to your windpipe (traches).

What can cause this muscle to fail to do its job? Some medicines can cause the irritation of the lining of the esophagus. Of course, alcohol use and smoking can also cause or worsen these conditions, but you assumed that, didn’t you? Quite often there is simply too much pressure pushing stomach contents upward. Now you will wisely ask “What causes this increased abdominal pressure?” Your reflux and the resulting heartburn may be simply because you ate a week’s worth of food in an afternoon. Hello Thanksgiving dinner and the grazing that followed. Hello all-day pizza and nachos and wings during the football marathon. Also quite possibly there is just too much you. Obesity greatly increases your likelihood of gastric reflux and related complications. This is also why pregnant women tend to have trouble with reflux – increased physical pressure in the abdomen.

But back to hernias. Reflux could be the hiatal hernia we spoke about earlier. A hiatal hernia happens when the top portion of the stomach is pushed up through the normal hole in you diaphragm where the esophagus comes down. This makes a tight band around a portion of the stomach instead of lining up with that band of muscle as it should. Acid can pool in this pouch, causing irritation. So reflux is that irritation caused by stomach acid slipping up the esophagus. Is yours caused by a hiatal hernia? I don’t know. That’s why you will join us January 16 so you can speak one-to-one with Dr. Megan Sippey for a FREE screening.

Dr. Vineeta Gahlawat will also be present to tell us about the type of hernias that happen when the muscles of your abdomen pull apart enough for a small bit of your intestines to poke through, causing a bulge under the skin. If this happens near your belly button (umbilicus) you have an umbilical hernia. If it is in your groin (inguinal area) you have an inguinal hernia. If it is in your abdominal wall in general, it is an abdominal hernia. And of course, if the weak spot is the result of an incision from a previous surgery, it would be an incisional hernia. See how medical terminology works?

Often these hernias are no more than a painless swelling that presents no problems and needs no immediate medical attention. For others, a hernia may cause discomfort and pain, with the pain getting worse when standing, straining, or lifting heavy items. In some cases, a hernia needs immediate surgery because the gut becomes trapped by the surrounding muscle.

Both of these common hernias will be discussed by UH Samaritan surgeons Dr. Megan Sippey (Hiatal Hernias and Reflux), and Dr. Vineeta Gahlawat (Abdominal, Umbilical, and Inguinal Hernias).

Join us Thursday, January 16, 2020, beginning at 5:30 pm.
UH Administrative Services Building, 663 East Main Street, Ashland OH.

Following the presentation, you will have the opportunity to be screened by either of these fine surgeons. Please register for this FREE screening by calling 419-207-2563.

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