Managing Hiatal Hernia Discomfort | What is a Hiatal Hernia?

If you frequently experience heartburn and acid reflux even when avoiding trigger foods, you may be dealing with an underlying hiatal hernia. This common condition occurs when part of the stomach pushes up through the diaphragm, disrupting the lower esophageal sphincter (LES). 

Over 60 million Americans have a hiatal hernia, and many don’t even realize it. Learning about this condition and how to manage it naturally is key to finding lasting relief from discomfort.

What is a Hiatal Hernia?

A hiatal hernia develops when the upper part of the stomach protrudes through an opening in the diaphragm called the hiatus. Normally, the esophagus passes through this opening and the stomach sits below the diaphragm. But with this condition, a portion of the stomach squeezes through and rests in the chest cavity. This interferes with the functioning of the LES.

The LES is a ring of muscle at the bottom of the esophagus that normally stays tightly closed to prevent food and stomach acid from flowing back up. But a hiatal hernia impairs the LES, allowing acid reflux to occur more easily. A hiatal hernia can range in size from 1 cm to over 5 cm. The most common type is a sliding hiatal hernia, where the stomach slides up through the hiatus into the chest.

What Causes a Hiatal Hernia?

Various factors can prompt development of this condition, including:

• Obesity or chronic excess weight, which increases pressure on the stomach and diaphragm
• Pregnancy, where hormonal changes and increased abdominal pressure affect the LES
• Older age, as tissues weaken over time
• Intense vomiting, which strains the LES
• Congenital abnormality where the hiatus opening is overly large
• Connective tissue disorders like Marfan syndrome
• Previous trauma or surgery involving the abdomen

Hiatal Hernia Symptoms

Common symptoms associated with a hiatal hernia include:

• Heartburn
• Acid reflux
• Difficulty swallowing
• Shortness of breath
• Chest pain
• Belching
• Bloating
• Nausea

These occur from the weakened LES allowing gastric acid to reflux back up through the esophagus. Symptoms may worsen when lying down, bending over, or eating large meals. Let your doctor know if you have frequent heartburn and suspect an underlying hiatal hernia.

Diagnosing this Condition

A hiatal hernia often goes undiagnosed, as symptoms can mimic other conditions like gastric reflux disease (GERD). But your doctor can use various methods to check for a hiatal hernia:

• Barium swallow x-ray – You swallow a chalky liquid that coats the esophagus, showing its structure and any hernias.
• Endoscopy – A lighted scope examines the esophagus, stomach, and LES to visualize a hernia.
• Manometry – Measures LES and esophageal muscle function and coordination.
• pH monitoring – Checks for abnormal acid levels in the esophagus indicating reflux.

Getting a clear hiatal hernia diagnosis is important before pursuing treatment options.

Hiatal Hernia Treatment Options

Several options exist for managing a hiatal hernia, and we’ve detailed a few below:

Lifestyle and Diet Modifications

Making healthy lifestyle adjustments is the first line of treatment:

• Losing excess weight to reduce pressure on the LES and stomach. Even modest weight loss can help.
• Eating smaller meals more frequently instead of large portions.
• Remaining upright for 2-3 hours after eating to allow gravity to keep acid down.
• Avoiding trigger foods like alcohol, citrus fruits, tomatoes, chocolate, caffeine, and others.
• Quitting smoking, as it damages the LES.
• Wearing loose clothing to prevent added abdominal pressure.
• Managing stress through relaxation techniques. Stress worsens GERD.

Medications

If lifestyle changes are insufficient, medications can further control acid production and reflux:

• Antacids neutralize stomach acid after it occurs but don’t prevent reflux.
• H2 blockers lessen acid secretion more long-term.
• Proton pump inhibitors or PPIs reduce acid production and promote healing.
• Prokinetics tighten the LES while improving stomach emptying.

Natural Supplements

Some herbal supplements may also be beneficial for your digestive health:

• Milk thistle strengthens stomach lining integrity to prevent acid erosion.
• Red raspberry leaf tones and tightens stomach and esophageal tissues.
• Manganese aids connective tissue repair and overall digestive health.
• Raw spleen concentrate supports immune function in the digestive tract.
• Quercetin is a potent anti-inflammatory flavonoid that helps heal damaged tissues.
• Black currant oil provides antioxidants for tissue protection.
• Vitamin C promotes collagen production to maintain the esophageal lining.

Surgery

Those with ongoing severe symptoms may benefit from surgery to reinforce the LES. This may involve tightening the opening in the diaphragm or outright repositioning the stomach to below the diaphragm where it belongs. Surgery aims to restore normal LES function and prevent reflux.

While small hiatal hernias often cause no problems, larger ones can provoke nagging GERD symptoms. But through healthy lifestyle choices and natural remedies, relief is possible. With the right comprehensive plan, most people achieve substantial control over their hiatal hernia discomfort. Supporting overall digestive health is key, not just neutralizing acid after it occurs. Give your body what it needs to prevent issues, and you can feel your very best.