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Hiatal Hernia Symptoms & Remedies

A hiatal hernia occurs when a portion of the upper stomach protrudes through the opening in the diaphragm called the hiatus. Most hiatal hernias are perfectly harmless and asymptomatic, and require no treatment. Some, however, cause heartburn and acid reflux which can be treated with simple remedies. Severe hiatal hernias, while rare, can be life-threatening and usually require surgery.

  1. Types

    • There are two main types of hiatal hernia. Sliding hernias cause the gastro-esophageal junction and a portion of the upper stomach to slide up into the chest cavity through the hiatus. This usually happens only when swallowing. This is the most common type of hiatal hernia. The other type, a paraesophageal hernia, occurs when the upper stomach protrudes through the hiatus permanently and sits next to the esophagus.

    Common Symptoms

    • The two most common symptoms of a hiatal hernia are heartburn and GERD (gastro-esophageal reflux disease). These cause a burning sensation in the chest and regurgitation of stomach acid, also called acid reflux.

    Severe Symptoms

    • Very occasionally, a hiatal hernia may become severe. This may lead to a strangulated hernia, where the part of the stomach that protrudes through the diaphragm loses its blood supply and begins to die. The symptoms of a strangulated hernia include severe pain in the chest or abdomen, nausea, vomiting, constipation and the inability to pass gas. A strangulated hernia is considered a medical emergency and needs immediate attention.

    Non-surgical Treatment

    • The heartburn and reflux caused by a hiatal hernia are usually easily treated with non-surgical methods. Heartburn medications, whether over-the-counter or prescription, generally help. Patients may also find it helpful to avoid lying down immediately after a meal, and to elevate their head while lying down. Weight loss or stress reduction are also sometimes indicated.

    Surgery

    • Particularly bad hiatal hernias sometimes require surgery. This surgery is called a Nissen fundoplication. It involves wrapping the upper part of the stomach around the lowest part of the esophagus to prevent it from moving.

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