Hiatal hernia

A hiatal hernia is a problem with the muscles at the top of your stomach that keep it working properly. It can cause some of the same symptoms as heartburn and methods to treat hiatal hernia may be similar. Your Aurora Health Care specialist will diagnose your condition and help you manage any symptoms.

Other names for hiatal hernia include:

• Paraesophageal hernia
• Diaphragmatic hernia
• Hiatus hernia
• Hiatus disease

Symptoms of a hiatal hernia

With most instances of hiatal hernia, symptoms are unnoticeable and don’t need treatment. More serious symptoms of hiatal hernia potentially getting worse may include trouble swallowing, heartburn, belching, tiredness and chest pain.

When you have hiatal hernia symptoms over a long time, stomach acids may back up (reflux) and cause gastroesophageal reflux disease (GERD) or damage the lining of the esophagus. If this continues, it may increase your risk of developing a kind of cancer of the esophagus.

Schedule an appointment with your doctor if you have these possible hiatal hernia symptoms and they are causing you concern. If you're feeling chest pain, seek emergency care or call your doctor immediately, as this may be a sign of a more serious condition.

Hiatal hernia causes

We don’t know any specific hiatal hernia causes. Some things that may contribute to developing a hiatal hernia include:

• Injury
• Age-related changes to the diaphragm
• Being born with a larger hiatal opening than usual

Conditions that increase pressure in the abdomen may also contribute, whether they are from lifting heavy objects, pregnancy, obesity or chronic straining on the toilet.

Women and people older than 50 are more likely to develop a hiatal hernia. For both men and women, hiatal hernia pain is located in the chest or abdomen. You might feel a hiatal hernia if it is compressed while in certain positions or during certain activities.

Hiatal hernia diagnosis

To diagnose a hiatal hernia, your doctor will perform a physical exam. They'll talk to you about your medical history and possible symptoms of hiatal hernia.

Consultation with a pulmonologist may be needed to help rule out other chest and lung conditions. Tests may be performed, including:

• Upper GI endoscopy: A flexible tube equipped with a light and tiny camera (endoscope) is inserted down your throat to see inside the esophagus and stomach. If needed, a tissue sample (biopsy) can be done during an endoscopy. These samples are examined in a lab to check for problems.
• pH monitoring: This test checks for stomach acid in your esophagus.
• Motility testing (esophageal manometry): This test measures if the esophagus is working properly. A thin, flexible tube (catheter) is inserted into your nose, down the esophagus and into the stomach.
• Barium swallow: You’ll drink a liquid that contains barium (a silver-white metallic compound). The barium coats your esophagus and stomach and will show up on fluoroscopic X-rays taken at rest and while you swallow. This test is also known as an esophagogram or an upper GI series.

Self-care for hiatal hernia

Hiatal hernias don't go away by themselves. The only way to move the top of your stomach back beneath your diaphragm is by having surgery. However, you can minimize symptoms by implementing hiatal hernia self-care and making these dietary and lifestyle changes:

• Eat smaller more frequent meals
• Avoid fatty foods, alcohol, chocolate, caffeine and peppermint
• Don't smoke
• Maintain healthy weight
• Don’t lie down right after eating
• Don’t eat for three to four hours before bedtime
• Elevate the head of your bed by six inches

Some people find relief from symptoms with some yoga poses or other exercises that strengthen the diaphragm. Consult with your doctor about what would be best for you.

When you follow these suggestions and adopt a diet for hiatal hernia relief, you may find your symptoms get better or go away. If you’ve been diagnosed with a hiatal hernia, you and your doctor will need to consider it any time you need treatment in that area of your body.

Hiatal hernia services & treatment

Some prescriptions and over-the-counter medicines can be recommended as hiatal hernia medications. Your doctor may suggest them to treat your hiatal hernia symptoms. These may include:

• Antacids: Address symptoms of hiatal hernia but won't fix any damage stomach acid has caused in your esophagus.
• H-2 receptor blockers: Heartburn medications that reduce the amount of acid your body makes. They can help relieve hiatal hernia symptoms for longer periods of time.
• Proton pump inhibitors: Block the acid your body makes, which allows your esophagus to heal.

Hiatal hernia surgery

Sometimes your doctor's suggestion to treat hiatal hernia may include surgery. Hiatal hernia surgery involves moving the top of the stomach and the lower part of your esophagus back below the diaphragm and tightening the opening in the diaphragm to help keep the stomach in the right place. Our thoracic surgery experts use a variety of techniques depending on your condition.