A hiatus hernia is a condition that occurs when a portion of the stomach slips through the opening in the diaphragm into the chest cavity. The diaphragm is a muscular structure that separates the chest and abdominal cavities, and the esophagus connects to the stomach through the opening in this structure. In a hiatus hernia, the upper part of the stomach, which is normally located in the abdominal cavity, moves upwards through this opening into the chest cavity. This can cause stomach acid to leak into the esophagus, causing reflux. Depending on the extent of the hernia, symptoms can be mild or severe.

A hiatus hernia can present itself with symptoms that vary from person to person. One of the most common symptoms is a burning sensation in the chest caused by stomach acid leaking into the esophagus. This burning sensation can become more pronounced, especially after meals or while lying down. It is also common for stomach acid to come into the mouth as a bitter or sour liquid as a result of reflux. Some patients who have difficulty swallowing may feel a feeling of food getting stuck in the throat or difficulty eating. Chest pain may accompany a hiatus hernia in some cases and can sometimes be confused with heart pain. In addition, stomach problems such as frequent belching, bloating and indigestion may also occur.

The diagnosis of a hiatal hernia is made based on the patient's complaints and some tests that the doctor will perform. The following methods are usually used:

Endoscopy:

This method is used to examine the inside of the esophagus, stomach and intestines. A thin tube containing a camera (endoscope) is advanced through the mouth to the stomach so that the doctor can directly observe the hiatal hernia and possible damage.

Barium swallow test:

The patient is given a contrast material called barium and then an x-ray is taken. The barium coats the esophagus and stomach, allowing these structures to be seen more clearly on the x-ray image. This allows it to be determined whether the stomach has slipped up through the diaphragm.

pH test:

This test measures the amount of acid in the esophagus. It is used to determine whether stomach acid is leaking into the esophagus and to confirm reflux. A sensor is placed in the lower part of the esophagus and acid levels are measured over a period of time.

Manometry:

This test, which measures the pressure and movement of the muscles between the esophagus and stomach, is used to examine the effects of a hiatal hernia on the muscle structure. It evaluates whether the esophagus' contraction movements are normal.

These tests are widely used to diagnose hiatal hernia, and doctors decide which method to use based on the patient's symptoms.

Reflux, medically known as gastroesophageal reflux disease (GERD), is a digestive system disorder that occurs when stomach acid or stomach contents leak back into the esophagus. Normally, the muscular ring between the stomach and esophagus, called the lower esophageal sphincter (LES), prevents stomach contents from returning back into the esophagus. However, if this muscle weakens or does not close completely, stomach acid leaks upwards, causing reflux symptoms.

The most common symptom of reflux is a feeling of heartburn. This burning usually increases after meals or when lying down. In addition, stomach contents reaching the mouth, leaving a sour or bitter taste, and acidic liquid coming into the mouth are also common complaints. If reflux continues for a long time, it can cause irritation, inflammation (esophagitis) in the esophagus and more serious health problems.

Reflux can be caused by lifestyle factors (overeating, weight, smoking, alcohol consumption), anatomical problems (such as a hiatal hernia) or conditions such as pregnancy. Treatment is usually done with lifestyle changes and acid-suppressing medications, but more severe cases may require surgery.

Reflux usually manifests itself with symptoms caused by stomach acid leaking into the esophagus. These symptoms can sometimes be mild, but long-term reflux can cause more serious symptoms. The most common symptoms of reflux are:

• Burning in the chest (heartburn): A burning sensation in the chest area occurs as a result of stomach acid leaking into the esophagus. This is especially worse after meals or when lying down.
• Stomach acid leaking into the mouth: Stomach contents may leak into the throat or mouth as a sour or bitter taste. This can cause an unpleasant taste and irritation in the throat.
• Difficulty swallowing: Due to irritation or damage in the esophagus, it may be difficult to swallow.
• Chronic cough: Coughing, which increases especially at night, can be caused by stomach acid leaking into the throat.
• Throat tickling or hoarseness: As a result of stomach acid irritating the throat, the voice can become hoarse or a constant tickling sensation can occur in the throat.
• Stomach bloating and gas: Reflux can cause bloating and gas problems by increasing stomach pressure.
• Mouth odor: Stomach acid and undigested food can cause bad breath when they flow back into the esophagus.

Reflux symptoms can get worse, especially after heavy meals, when leaning forward or lying down. Long-term reflux can cause inflammation of the esophagus and more serious health problems, so it's important to get it treated.