Q: My 27 years old wife was suffering from acidity and was asked to undergo endoscopy by the doctor. The findings of the test were: hiatus hernia in the esophagus; mild antral gastritis in the stomach. What does this mean? What is the treatment for these problems?

A:Hiatus hernia is a condition when a part of the stomach which is normally below the diaphragm gets above the diaphragm, which is the partition between the abdomen and thorax. This can rarely be congenital when the babies can be born with the condition. Mostly it is noticed in the adults and the size can vary from small to large. The condition is mostly in the adults, commonest cause being raised intra-abdominal pressure, and frequently associated with over weight and obesity. The larger hernias commonly present with chest symptoms like tightness, and this can diagnose in the chest xray. Frequently there are no symptoms, and diagnosis made as a surprise one on a chest xray. Smaller ones may not cause symptoms. Acidity or heartburn occurs when the acid from the stomach flows the wrong way into the gullet and is entirely dependent upon the pressure at the junction of the gullet and the stomach. In other words, if the pressure is normal a hiatus hernia will not cause heartburn. In your wifes condition the pressure is low enough to allow the acid to flow into the gullet as well as the hiatus hernia. The treatment is to suppress the acid by a group of drugs called PPI, and consult your doctor for this. Antral gastritis is the inflammation of the end part of the stomach and in normally associated with a bacterial infection by an organism called H. pylori, and I assume your endoscopist has tested for this. If not, a blood test can be done to diagnose this. Ask your doctor. It is curable with proton pump inhibitor (PPI) and a course of antibiotics for a week