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Esophagitis and Hiatal Hernia
Reflux esophagitis and hiatal hernia are two COMMON gastrointestinal disorders. Esophagitis refers to inflammation and irritation that occurs in the lower esophagus. The esophagus is the long tube that connects the back of the throat to the stomach. Esophagitis occurs most commonly from the back-wash of stomach acid into the lower esophagus. This is the most common cause of "heartburn." Esophagitis is commonly associated with a nonserious condition known as hiatal hernia. This is a relatively common, yet reversible, condition where the stomach displaces (herniates) into the chest through a defect in the diaphragm. This condition often occurs after a large meal. Obesity is also considered a contributing factor in the development of hiatal hernia. Many patients with hiatal hernia will also have associated esophagitis secondary to the reflux of acid into the esophagus. Use of alcohol, aspirin, or caffeine can exacerbate the symptoms of esophagitis. Associated problems such as gastritis and peptic ulcer disease can make this problem worse.
NOTE
Fungal esophagitis has become a more commonly recognized cause for esophageal inflammation due to the prevalence of AIDS. These fungal infections are seen almost exclusively in the immunocompromised patient (e.g. AIDS, cancer etc.). Common symptoms of reflux esophagitis include: difficulty swallowing, heartburn, upper abdominal pain, lower chest pain, belching, and indigestion. Hiatal hernia will often cause lower chest, or upper abdominal pain that can be mistaken by physicians as a symptom related to cardiac problems. Increased belching and indigestion are common. It commonly occurs after a large meal, or in the patient who lies down shortly after a meal. Lying flat often makes the symptoms worse. Evaluation will include history and physical examination to rule out any evidence of gastrointestinal bleeding or peptic ulcer disease. If one of these problems is suspected, an UGI series or UGI endoscopy can be performed. Occasionally, a chest x-ray will show a hiatal hernia. It is the upper GI series that will most often reveal this condition. Treatment involves removal of all irritating factors such as alcohol, caffeine,spirin, and/or nicotine from your lifestyle. Use of antacids can acutely diminish the symptoms. Regular antacid use (after each meal and at bedtime) can lead to healing of the stomach and esophagus. Avoidance of overeating and lying flat immediately following a meal will help impede hiatal hernia. Weight reduction for some patients can reduce these unpleasant symptoms. Your doctor may place you on a medication to reduce acid production in the stomach (e.g. Pepcid, Zantac, Prilosec). The regular use of antacids 30 minutes after meals can also reduce the symptoms associated with this condition.
REMEMBER
Watch closely for chest pain unrelieved by antacids, vomiting dark blood, or black tarry stools. All these problems indicate a more SERIOUS problem requiring EMERGENCY care.
Hope this article will provide you information about esophagitis and hiatal hernia.
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