What is a hiatal hernia?
Your chest and abdomen are separated by your diaphragm – a large dome-shaped muscle that is responsible for a major part of breathing. A hiatal hernia occurs when the top portion of the stomach extends through the diaphragm into the chest.
What are the symptoms of a hiatal hernia?
Most hiatal hernias do not cause symptoms. More than half of all people over the age of 50 have one. A hiatal hernia may make it easier for food and stomach acid to back up into your esophagus. This can cause heartburn, chest pain, belching and nausea.
How is a hiatal hernia diagnosed?
Your doctor may find a hiatal hernia during an endoscopy (EGD) or barium swallow x-ray while trying to determine the cause of heartburn, chest pain or upper abdominal pain.
How is a hiatal hernia treated?
Hiatal hernias that do not cause symptoms probably will not require treatment. However, if you experience frequent gastroesophageal reflux (GERD) your doctor may recommend the following treatments:
- Weight loss: Losing weight alone may relieve your symptoms.
- Medications: Over-the-counter antacids (Maalox, Mylanta, Tums); Acid reducing medications called H-2 blockers (Pepcid, Tagamet, Zantac); Acid blocking medications called proton pump inhibitors (Prevacid, Prilosec, Dexilant, Nexium, Protonix, Zegerid, Aciphex).
- Diet Modification: Avoid fatty, spicy foods, caffeine, chocolate, onions and citrus. Eat smaller meals. Avoid eating 3 hours before bed.
- Surgery: Few people require surgery to repair a hiatal hernia. This option is usually considered only when medications and lifestyle changes fail to reduce reflux symptoms.
When to seek medical advice
If your symptoms are severe, occur often or are accompanied by coughing, wheezing, asthma, a sore throat, difficulty swallowing or chest pain, contact your health care provider.