A hiatal hernia is a common condition, and many people who have one never know it. It happens when part of the stomach pushes up through the diaphragm into the chest. Small ones often cause no trouble at all. Larger ones can lead to acid reflux and discomfort. Here is what a hiatal hernia is, how it connects to heartburn, and when it needs treatment.
What a Hiatal Hernia Is
The diaphragm is the muscle that separates your chest from your abdomen. It has a small opening called the hiatus where the esophagus passes through to reach the stomach. In a hiatal hernia, the upper part of the stomach slides up through that opening. This can weaken the barrier that normally keeps stomach acid down, which is why reflux is common with larger hernias.
Symptoms
Many hiatal hernias cause no symptoms. When they do, the symptoms usually come from acid reflux and can include:
- Heartburn, especially after meals or when lying down
- Regurgitation of food or a sour taste
- Chest or upper belly discomfort
- Trouble swallowing
- Feeling full quickly or burping often
Severe chest pain or trouble breathing is not typical and should be checked right away to rule out heart problems. See our guide on heartburn versus heart attack.
What Causes It
Hiatal hernias become more common with age as the tissue around the hiatus weakens. Anything that raises pressure in the abdomen can contribute, including obesity, pregnancy, heavy lifting, frequent coughing, and straining. Some people are simply born with a larger hiatus.
How It Is Diagnosed
A hiatal hernia is often found during tests done for reflux or other symptoms. An upper endoscopy can show the hernia and check the esophagus for irritation. A barium swallow x-ray is another way to see it. Because reflux and hiatal hernia often go together, we look at the whole picture rather than the hernia alone.
Treatment
Treatment depends on your symptoms. A small hernia with no symptoms usually needs nothing more than routine care. When reflux is the problem, we treat that:
- Lifestyle and diet: smaller meals, not eating close to bedtime, raising the head of the bed, losing extra weight, and following reflux-friendly eating.
- Medication: acid-reducing medicines such as proton pump inhibitors to control symptoms and protect the esophagus.
- Surgery: reserved for large hernias or severe reflux that does not respond to other treatment. It repairs the opening and restores the barrier.
When to See a Doctor
See a gastroenterologist if you have frequent heartburn, trouble swallowing, or reflux that does not settle with over-the-counter treatment. Long-standing reflux can irritate the esophagus over time, and we can check for that and keep it under control.
Talk to a Gastroenterologist in Mountainside, NJ
If your symptoms keep coming back or you are not sure what is causing them, Dr. Amber Khan can help. We see patients from across Union County and New Jersey.