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A hernia is caused when the muscle that holds an internal organ in place relaxes, allowing for movement of that organ, which can cause a multitude of problems, and in some cases, and inordinate amount of pain. The hiatal hernia, simply put, occurs when the stomach slides from the abdominal cavity partially into the chest cavity.
We know by now that what causes acid reflux is the failure of the valve, or the lower esophageal sphincter (LES) to close properly after food has been ingested, thereby allowing for the fluid to rise from the stomach into the esophagus. A hiatal hernia will weaken the LES, thereby making it more difficult for it to close properly, and thus allow for fluid to reflux out of the stomach.
Although it is clear that there is a direct correlation between acid reflux and hiatal hernias (most people discover that they have a hiatal hernia when they get examined by their doctor for acid reflux), they are not necessarily always seen in tandem with each other. You may have GERD without having a hiatal hernia and vice versa.
Common causes of a hiatal hernia are; pregnancy, obesity, tight clothing around the abdomen, constipation, chronic coughing, strenuous weightlifting, or abdominal injury. Many people who have a hiatal hernia do not know because unlike other forms of hernia, the hiatal hernia does not show itself physically, i.e. there are no bumps or protrusions recognizable on the outside of the body. Generally, hiatal hernias are more common amongst people over fifty; it is very rare for a young adult or child to have this condition.
In order to alleviate, or to reduce the intensity of these symptoms, you should do the following;
- Eat smaller meals more frequently
- Avoid acidic or spicy food
- Do not eat before going to bed
- Avoid heavy lifting
- Avoid bending after heavy meals (which you won't be having anyways, because you'll be grazing instead!)
- Lose weight
- Quit smoking.
There are a variety of medications that you can take as well including antacids, proton pump inhibitors, and but the easiest, most effective way to decrease your symptoms is to alter your diet to include foods that are easily digestible and avoid those that stimulate flare ups.
Surgery in the vast majority of cases is extremely rare as most people with hiatal hernias continue to live a normal life without discomfort or additional problems. With that said, however, you never want to ignore an issue that is going on in your body and will probably want to address it. If you are having trouble swallowing, a sore throat, wheezing or coughing, or difficulty breathing, then you most certainly will want to consult your doctor.
While most specialists recommend that you make the lifestyle changes noted above rather than resorting to pharmaceuticals as the first line of defense, you definitely should make an appointment to see your doctor if you have any persistent symptoms.