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Medications That Can Irritate Hiatal Hernias

The abdominal and chest cavities are separated by a muscular membrane. A hiatal hernia develops when part of the stomach bulges up into the chest cavity through a small hole in the membrane. Because a hiatal hernia itself does not produce symptoms, medications can not irritate a hiatal hernia directly. Some drugs can worsen conditions that may arise as a result of the anatomical defect, however.

  1. Acid Reflux

    • A hiatal hernia can cause acid reflux, a condition in which stomach acid is forced back up into the esophagus. The presence of acid in the esophagus causes heartburn, a bitter or sour taste in the mouth, belching, bloating, stomach discomfort and chest pain.

    Types of Medications

    • Medications associated with worsening the symptoms of acid reflux caused by conditions such as a hiatal hernia fall into three categories: those that weaken the valve between the esophagus and the stomach, those that cause esophageal inflammation directly and those that slow digestion.

    Valve Weakening Medications

    • Medications implicated in weakening the valve (sphincter) between the esophagus and the stomach, thereby allowing the backflow of stomach acid into the esophagus, include tricyclic anti-depressants, asthma medications, tranquilizers and sedatives, estrogen replacements and anticholinergic drugs, such as those used to treat nausea.

    Inflammatory Medications

    • Inflammatory medications intensify the symptoms of acid reflux by causing additional irritation to an already inflamed esophagus. Osteoporosis drugs, iron and potassium supplements, certain antibiotics and the heart medication quinidine contribute to esophageal inflammation.

    Digestion Slowing Medications

    • Medications that slow digestion worsen acid reflux symptoms because they increase acid production and allow it to accumulate in the stomach. Narcotics, such as morphine and oxycontin, and blood pressure medications, such as calcium channel blockers and beta blockers, are associated with slowing the digestion process.

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