What Causes a Hiatal Hernia?

Hernia Overview
A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity.

Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal wall hernias).

There are two types of hiatus hernia:
·    Sliding hiatus hernia – the most common type.  These are small hernias that slide up and down and in and out of the lower chest.
·    Rolling hiatus hernia – this is less common. Part of the stomach pushes up through the hole in the diaphragm next to the oesophagus.

How Do People Get Hernias?
It might take a long time for a hernia to develop or it might develop suddenly. Hernias are caused by a combination of muscle weakness and strain, although the cause of the weakness and the type of strain may vary. Hernias are actually more common in babies and toddlers. And most teens who are diagnosed with a hernia actually have had a weakness of the muscles or other abdominal tissues
from birth (called a congenital defect).

What Causes a Hiatal Hernia?
Most of the time, the cause is not known. Some people develop a hiatal hernia after sustaining an injury to that area of the body; others are born with a weakness or an especially large hiatus. Some experts suspect that increased pressure in the abdomen from coughing, straining during bowel movements, pregnancy and delivery, or substantial weight gain may contribute to the development of a hiatal hernia.

Signs and symptoms
Small hernias
Most small hiatal hernias cause no problems.
Large hernias 
·    Heartburn
·    Belching
·    Chest pain
·    Nausea

In rare cases
·     Severe chest pain
·    Difficulty swallowing (dysphagia)
·    Obstruction of your esophagus

Inguinal
The most common type of hernia is found in the groin and is called an inguinal hernia. This type of hernia is caused by a loop of bowel pushing through a weakness in the inguinal canal. The inguinal canal is a triangle-shaped opening between layers of abdominalmuscle near the groin.
They are most common in men and male babies, and occur when a loop of bowel slides down the narrow canal down towards the scrotum.
98 out of 100 people who develop a hernia in their groin are male.

Diagnosis
Doctors make the diagnosis by examination. Lumps in the groin that resemble hernias may be swollen lymph nodes or undescended testicles. A swelling in the scrotum may be a varicocele (a condition in which the blood supply of the testis develops varicose veins) or a spermatocele (a collection of sperm in a sac that develops next to the epididymis). Sometimes the doctor performs an
ultrasound to help make the diagnosis.

How can a hernia be repaired?
Hernias usually need to be surgically repaired to prevent intestinal damage and further complications. The surgery takes about an hour and is usually performed on an outpatient basis  (which means the patient can go home the same day of the procedure). This surgery may be performed by an open repair (small incision over the herniated area) or by laparoscopic surgery (minimally
invasive). Your surgeon will determine the best method of repair for your individual situation.