Acid Reflux and Hiatal Hernia

A hiatal hernia is the stomach moving through an opening in the diaphragm into the chest cavity. This opening is called the esophageal hiatus or diaphragmatic hiatus. Some of the stomach sits in the abdomen, whereas the rest of it is in the chest.

These hernias falls under two categories:

• Sliding Hernia - The gastroesophageal junction (the place where the esophagus meets the stomach) and part of the stomach slides into the chest. This junction stays permanently in the chest, or will slide into the chest while swallowing. The esophagus contracts while swallowing, causing the esophagus to shorten and pull on the stomach. At the end of each swallow, the junction falls back into the abdomen. This type of hernia is the most common among Americans.

• Para-Esophageal Hernia - Part of the stomach is squeezed into the chest next to the esophagus. This type of hernia remains in the chest and cause serious problems, like incarceration (the hernia is stuck and being squeezed) and strangulation (when there's a lack of blood supply, which kills the tissues involved, after incarceration persists too long). This type of hernia is the least common among Americans, but should it occur, the problem must be corrected through surgery.

How Are These Hernias Associated With Acid Reflux?

When a hernia develops, it weakens the LES (lower esophageal sphincter) and as a result, it looses the ability to prevent reflux from the stomach into the esophagus. Pressure in the abdomen from coughing, straining during bowel movements, pregnancy and delivery, or weight gain may contribute to this development. These causes are also very similar to the cause of acid reflux

Most people do not experience any symptoms, but if you are experiencing symptoms then they will be very similar to acid reflux:

• Difficulty swallowing

• Heartburn

• Regurgitation

• Frequent hiccups

• Sensation of pressure in the chest

• Frequent belching

• A sour or bitter taste in the mouth

• Discomfort or pain in the esophagus

• Discomfort or pain in the stomach

How Is Hiatal Hernia Diagnosed?

This ailment is diagnosed with a specialized X-ray that allows the doctor to look into the esophagus.

When Should I Call the Doctor?

If you have severe pain in the chest or abdomen, become nauseated, vomiting, or are unable to have a bowel movement, you may have a strangulated hernia. This is considered a medical emergency. Please call your doctor IMMEDIATELY!

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