My case study is on a patient who has a hiatal hernia. There is a small opening in the diaphragm, called the hiatus. A hiatal hernia is what occurs when a portion of the stomach pushes up through this opening. It is most common in people over the age of 50, and is so common it affects about half of the population (Kowalczyk & Mace, 2009). According to Eisenberg and Johnson, this condition is “the most common abnormality detected on upper GI examinations” (2012). In most cases, a small hernia will not cause the patient any issues. However, if they have a large one, which can occur just from having a large hiatus, they may feel food and acid refluxing into the esophagus which can cause heartburn. Sometimes over the counter antacids will be enough
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To start, the doctor may ask for a blood test. This will check for anemia from blood loss. An esophagram, which is what my patient had done, would be performed under fluoroscopy to see what happens to the esophagus and stomach during swallowing. A patient may undergo endoscopy, which is when a long, flexible tube with a light and a camera are passed down the throat to look for tears or inflammation. Lastly, there test called manometry in which a tube is inserted through the nose down into the esophagus. The tube is pressure sensitive and measures pressure and movement inside the esophagus (Mayo Clinic Editors, 2015).
There is a wide range of treatment options for a hiatal hernia. Most people can manage their symptoms with over the counter antacids to neutralize the acid. H-2 receptor blockers reduce the production of acid. Lastly, proton pump inhibitors block acid production, to allow the esophagus time to heal. If none of these things alleviate the symptoms and discomfort, surgery may be required. According to the Mayo Clinic, “An operation for a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller” …show more content…
For the esophagram, the patient would be instructed to take some crystals which will produce air in the stomach. They would then be told to drink a thick barium mixture, while standing on the foot board of the x-ray table which would be in a vertical position. They will have to change positions as instructed by the radiologist or technologist in order for different views and angles to be obtained. Then the table will be lowered to be fully horizontal, and the patient will be instructed to roll in a complete circle. This is to coat the stomach with the barium so all aspects of it may be seen. The doctor will have the patient drink the barium continuously through a straw so it may be captured as they are swallowing. Lastly, the radiologist may request a normal x-ray in the RAO position while the patient is drinking.
As part of my research on this topic, I polled some friends who have this condition. Neither one of them had any actual symptoms. Both of their hernias were discovered during testing for other things. Neither of them had an esophagram done; one had an endoscopy for another issue. The other was a result of scarring from an old incision from a previous procedure. That one will be having surgery to correct it. Both stated that it does not affect their day to day lives; they are not even taking medication for
To start, the doctor may ask for a blood test. This will check for anemia from blood loss. An esophagram, which is what my patient had done, would be performed under fluoroscopy to see what happens to the esophagus and stomach during swallowing. A patient may undergo endoscopy, which is when a long, flexible tube with a light and a camera are passed down the throat to look for tears or inflammation. Lastly, there test called manometry in which a tube is inserted through the nose down into the esophagus. The tube is pressure sensitive and measures pressure and movement inside the esophagus (Mayo Clinic Editors, 2015).
There is a wide range of treatment options for a hiatal hernia. Most people can manage their symptoms with over the counter antacids to neutralize the acid. H-2 receptor blockers reduce the production of acid. Lastly, proton pump inhibitors block acid production, to allow the esophagus time to heal. If none of these things alleviate the symptoms and discomfort, surgery may be required. According to the Mayo Clinic, “An operation for a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller” …show more content…
For the esophagram, the patient would be instructed to take some crystals which will produce air in the stomach. They would then be told to drink a thick barium mixture, while standing on the foot board of the x-ray table which would be in a vertical position. They will have to change positions as instructed by the radiologist or technologist in order for different views and angles to be obtained. Then the table will be lowered to be fully horizontal, and the patient will be instructed to roll in a complete circle. This is to coat the stomach with the barium so all aspects of it may be seen. The doctor will have the patient drink the barium continuously through a straw so it may be captured as they are swallowing. Lastly, the radiologist may request a normal x-ray in the RAO position while the patient is drinking.
As part of my research on this topic, I polled some friends who have this condition. Neither one of them had any actual symptoms. Both of their hernias were discovered during testing for other things. Neither of them had an esophagram done; one had an endoscopy for another issue. The other was a result of scarring from an old incision from a previous procedure. That one will be having surgery to correct it. Both stated that it does not affect their day to day lives; they are not even taking medication for