Stomach Disorders: Hiatal Hernia Flashcards
What is the esophageal hiatus?
• An opening in the diaphragm through which the esophagus and the vagus nerve pass.
What is a hiatal hernia?
• This occurs when a portion of the upper part of the stomach bulges through the diaphragm
What are some causes of hiatal hernia?
- Obesity
- Weakened diaphragm
- Pregnancy
- Ascites
- Tumors
- Heavy lifting
What are the general s/s of hiatal herniation?
• Same as GERD w/ the exception of the rolling hernia which adds fullness and difficulty breathing to the list
What are the two types of hiatal hernia?
- Sliding
- Paraesophageal (rolling)
What is a sliding hiatal hernia?
- Occurs when the stomach and the lower part of your esophagus slide up into your chest through the diaphragm.
- This is the most common type of hiatal hernia
What is a paraesophageal hernia?
- Occurs when the esophagus and stomach stay where they should be, but part of the stomach squeezes through the hiatus to sit next to the esophagus.
- This is more dangerous as:
- The stomach can become squeezed and lose its blood supply
- It can apply direct pressure against the heart
What are the s/s of a sliding hiatal hernia?
- Similar to those w/ acid reflux/GERD
- Worsens after meals or in supine position
What are the s/s of a rolling hernia?
- Feelings of fullness after eating
- Breathlessness or suffocation
- Usually no reflux
What diagnostic tests are used for hiatal hernia?
- Barium swallow
- Upper endoscopy
What is the tx for a sliding hiatal hernia?
- Similar to GERD
- Weight loss
- No bent lifting
What is the tx for a rolling hernia?
- Surgical
- Laparoscopic Nissen Fundoplication (LNF)
How does a Laparoscopic Nissen Fundoplication (LNF) help prevent/resolve paraesophageal hernia?
• The procedure wraps part of the stomach around the cardiac sphincter reinforcing it and making the area larger and more difficult to penetrate through the hiatus.
What are two types of drugs that can help manage s/s of hiatal herniation?
- Antacids
- H2R Blockers (such as Ranitidine (Zantac))
Post LNF nursing management will include:
- Typical surgical post-op care
- NG tube management
- Post-op teaching for self-care and prevention