Hernia Types: Hiatal Hernias

2023-08-07

Hernia Info Authors

About Hiatal Hernias¹

Do you have a consistent bulge in the upper part of your stomach? Or maybe you have frequent heartburn or other symptoms of gastroesophageal reflux disease (GERD)? While they may not be painful or noticeable, hiatal hernias can certainly cause discomfort and other problems.

A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm).² Although most common in people 50 years of age and older, hiatal hernias are frequent across all ages and genders. Oftentimes people can go without treatment for non-symptomatic hiatal hernias. However, it is encouraged to seek medical advice for your specific situation, especially if you are experiencing GERD-like symptoms.

Symptoms of Hiatal Hernias

While many people affected by hiatal hernias never experience symptoms, some may feel gastro-reflux-like symptoms such as heartburn, acid reflux, bloating, and discomfort in the stomach.¹ Smaller hiatal hernias are often associated with little-to-no symptoms, whereas larger hiatal hernias have more frequent GERD-like symptoms, like heartburn, when food is digested.² If you have a hiatal hernia, you may experience:

Chest or abdominal pain
Shortness of breath
A feeling of being full shortly after eating
Gastroesophageal Reflux Disease (GERD)-like symptoms:
- Heartburn
- Regurgitation of food or liquids into the mouth
- Bitter or sour taste in the back of the throat
- Bloating or belching

Contact your healthcare provider immediately if you experience any adverse symptoms or complications, including:

Fever or chills
Nausea or vomiting
Difficulty urinating or passing a bowel movement
Increased pain, swelling, redness, tenderness
If your hernia looks bigger or can’t be pushed back inside

Some Potential Causes of Hiatal Hernias³

Although the exact cause of hiatal hernias is unknown, people who smoke and/or are overweight tend to be affected more often. Pregnancy can also lead to a hiatal hernia as there is extra fluid buildup and pressure in the abdomen. Hiatal hernias may occur for a number of reasons—the most common being an increase in pressure in the abdominal cavity. Additional potential causes include:

Age
Being born with an unusually large hiatus (large opening) in the diaphragm
Injury/trauma to the area
Obesity
Chronic coughing
Lifting heavy objects/physical strain
Straining during bowel movement
Repetitive vomiting

Ways to Diagnose Hiatal Hernias¹

To identify whether or not you have a hiatal hernia, your healthcare provider will likely begin with a physical examination and may use multiple diagnostic techniques, including a(n):

Barium swallow
Endoscopy
Esophageal manometry
pH test
Gastric emptying studies

Prevention, Medication, and Lifestyle Changes¹

Although there is no way to prevent a hiatal hernia, here are some things that may lower the chances of getting one:

Maintaining a healthy weight
Avoiding acid foods (citrus, juice, tomatoes, etc.)
Limiting fatty, fried, and caffeinated items (carbonated drinks, alcohol, condiments, etc.)
Creating a better bedtime routine
Eliminate snacks at least three hours before bedtime
Elevate your head 6 inches higher than your body when lying down
Quitting smoking
Reducing the amount of pressure you put on the abdomen by not:
Lifting heavy objects
Wearing restrictive clothing that is too tight in the abdomen

Typical Treatment for Hiatal Hernias¹

Specific treatment for a hiatal hernia will be determined by your doctor and depends on many factors, including the severity of your symptoms, general health, and location of the hernia. Surgery may be required for people with a hiatal hernia who have severe, long-lasting esophageal reflux and whose symptoms are not relieved by medical treatments or lifestyle changes.

Surgical Treatment

There are two primary surgical options for hiatal hernia repair: open and minimally-invasive laparoscopic surgery. The appropriate type of surgery for you may depend on the size, severity, and location of your hernia. Ask your doctor about which option is right for you.

Open Surgery: As the traditional surgical method, an open surgical procedure involves making a large incision over the area of the hernia. The hernia bulge is returned to its correct position and a mesh is often placed to help strengthen and support the weakened area before closing up the incision.
Laparoscopic Surgery: A surgeon will use several small, ‘key-hole’ sized incisions during laparoscopic surgery. Instruments, such as a camera, are then inserted through the incisions to perform the operation.

Emergency surgery may be needed if the hernia is causing blood supply to be cut off or if you have severe GERD-like symptoms that do not respond to medical treatments. Learn more about surgical techniques here.

What Are the Next Steps to Treating a Hiatal Hernia?

Be sure to talk to your doctor and ask questions about hernia diagnosis and treatment options if you are experiencing hiatal hernia symptoms.

The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.

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References

This site is not intended as a substitute for professional medical care. Only your physician can diagnose and appropriately treat your symptoms. BD does not recommend the use of any particular physician or team of physicians. Please consult your healthcare provider for advice regarding who should be part of your hernia repair team.