Hiatal Hernia is an anatomical weakening or enlargement of the opening in the diaphragm where the esophagus meets the stomach. The defect can allow a section of stomach to slide or roll into the chest cavity. This causes the reflux of stomach content back to the esophagus. Esophageal Reflux may also be occur without the presences of a Hiatal hernia. It is reported that approximately 60% of people over 50 have a Hiatal hernia with about 9% being symptomatic.
However, over the years we have also noticed a significant increase in reflux disease in patients who have had adjustable gastric band placed. Quite frequently the reflux symptoms after the band is ” blamed” on the patient’s eating habit. Most of the time all studies are reported as “normal” and the complaints are discounted. Other symptoms of Hiatal hernia may or may not include shortness of breath, heart palpitations, or a feeling of food being stuck.
It is important to confirm the presence or absence of a hiatal hernia when considering revision from an adjustable gastric band procedure. Any hiatal hernia identified either before surgery or at the time of the operation will need to be repaired surgically.
With a hiatal hernia repair, the opening is made smaller, and the esophagus, stomach and the junction between them is returned to the proper location to minimize-eliminate reflux.