The All-In-One Guide to Hiatal Hernia


Sometimes, it’s possible for the upper section of your stomach to push its way up through the diaphragm and settle in the chest region. When this happens, you may have a hiatal hernia.

The diaphragm is a muscle whose task is to help you breathe. It’s usually large and it lies between your chest and your abdomen. Under normal circumstances, the diaphragm lies above the stomach. For people with this condition (a hiatal hernia), however, a part of the stomach forces its way through the muscle. The hiatus is the opening through which it moves.

The Esophageal Cancer Awareness Association says that this condition mainly affects people who are aged 50 and above. It also affects 6 out of 10 people by the time they are aged 60.

What Are the Causes of a Hiatal Hernia?

Though the precise condition of this condition remains unknown, it is thought that injuries or some other damages weaken the muscle tissues. This opens up the way for the stomach to move through your diaphragm.

The other cause is repeatedly applying a lot of pressure on the muscles that surround your stomach. This may happen when:

  • Vomiting
  • Coughing
  • Lifting heavy objects
  • Straining during bowel movements
  • It is also possible to be born with a hiatus that is abnormally long, the stomach can thus easily move through.

The risk of occurrence of a hiatal hernia can be increased by several factors including:

  • Aging
  • Smoking
  • Obesity

Hiatal Hernia Types

There generally exist two forms of this condition:

Sliding Hiatal Hernia or a Paraesophageal Hernia. It is more prevalent than a fixed hiatal hernia. It usually occurs when your stomach and esophagus make their way through the hiatus and into your chest. It usually tends to be rather small. Symptoms do not really manifest and treatment may not be necessary.

Fixed Hiatal Hernia. It is also referred to as a paraesophageal hernia. It is not as common as a sliding hiatal hernia.

Hiatal Hernia Symptoms

It is not common for a hiatal hernia to cause any symptoms, even fixed hiatal hernia. If any arise, however, they are usually caused by other factors including bile, stomach acid and air entering the esophagus. Some common symptoms include:

  • Trouble swallowing
  • Epigastric pain/ chest pain
  • Belching
  • Heartburn that worsens when you lie down

Medical Emergencies

A strangulated hernia or even an obstruction may prevent blood from flowing to your stomach. This is a medical emergency. If you feel any of the following, call your doctor immediately:

  • Nausea
  • If you have been vomiting
  • If you can’t empty your bowels or pass gas

It is not safe to assume that your discomfort and chest pains are being caused by a hiatal hernia. It could be that peptic ulcers and heart problems are on the horizon. The cause of these symptoms can only be determined through testing. Therefore, visit your doctor if they arise.

What’s the Connection Between GERD and Hiatal Hernia?

When the acid in your stomach, liquids, and food find their way into your esophagus, gastroesophageal reflux disease (GERD) occurs. Nausea after meals and heartburns are common effects of GERD. Having GERD is common if one already has a hiatal hernia. This, however, doesn’t mean that either condition is the cause of the other. It is possible to have GERD without a hiatal hernia or a hiatal hernia without gastroesophageal reflux disease.

Diagnosis Hiatal Hernia

Several tests can be used to diagnose a hiatal hernia

Barium X-Ray. Your doctor might instruct you to drink a liquid containing barium just before the X-ray is taken. A clear silhouette of the upper digestive system is provided by this x-ray. The image gives your doctor the vast location of your stomach. The doctor will diagnose a hiatal hernia if your stomach is protruding through your diaphragm.

Endoscopy. Your doctor might choose to perform an endoscopy. In this process, your doctor will slide a narrow tube into your throat and push it down your esophagus and further down into your stomach. The innate part of your stomach is easily visible to your doctor. Any distraction and strangulation will be easily visible too.

Treatment Options

As earlier stated, treatment for most cases of a hiatal hernia is not necessary. Treatment is however determined by the occurrence of symptoms. Medications may be used to treat heart burns and acid reflux. Surgery would be the next option if medication fails.


Your doctor may prescribe certain medications including:

  • Over-the-counter anti-acids. These will neutralize stomach acid.
  • Prescription or over-the-counter H2 receptor blockers. They lower the production of acid.
  • Proton-pump inhibitors. They prevent acid production which gives enough time for your esophagus to heal. They may be prescription or over-the-counter drugs


Though it is not commonly recommended, surgery might be the only option if medication fails to get rid of your hiatal hernia.

By performing surgery, a hiatal hernia can be repaired by pulling back the stomach into the abdomen and thereafter reducing the size of the hiatus (a small opening in the diaphragm). This procedure may also entail removing the hernia sacs and surgical reconstruction of the esophageal sphincter.

Having a hiatal hernia does not necessarily mean that you need surgery. This method is normally reserved for patients with more severe cases and whose response to other treatments is too slow and ineffective.

Having some dangerous symptoms due to a hernia may mean that surgery could be the only option you have. These symptoms could include:

  • Ulcers
  • Bleeding
  • Scarring
  • Narrowing of the esophagus

The success rate of this surgery is estimated at 90%. Reflux symptoms will however still return in 30% of the people.

How to Prepare for a Hiatal Hernia Surgery

Your doctor will provide you with all the information that you will need regarding all the preparations for your surgery.

It generally includes:

  • A 2 -3 miles walk daily
  • Avoiding the intake of clopidogrel (plavve) for not less than a week before surgery
  • A week of not smoking before surgery
  • Staying away from Non-Steroidal Anti-inflammatory drugs (NSAIDs) a week before surgery
  • Doing some breathing exercises several times per day
  • Eating or drinking 12 hours before surgery is prohibited. This surgery doesn’t normally require a clear liquid diet

How is the Surgery Performed?

Hiatal hernia surgeries can be performed in various ways such as endoluminal fundoplication, laparoscopic repairs, and open repairs. The surgeries usually take about 2-3 hours and they are all performed under common anesthesia.

Open Repair. This surgery involves more details and invasion than laparoscopic repair. For this particular procedure, your surgeon may make one huge surgical incision in your abdomen. After this, your stomach will be pulled back into place and it will be wrapped around the esophagus-lower-potion in order to create a smaller and tighter sphincter. If your doctor finds the need to hold your stomach in place by inserting a tube, then the tube must be removed in approximately 2-4 weeks.

Laparoscopic Repair. Due to the less invasive nature of this procedure, there is a reduced the risk of infection and recovery is usually quicker. Only 3-5 tiny incisions will be made in the abdomen. The surgical instruments will be inserted into your body through the incisions.

Your surgeon will pull your stomach into your abdomen guided by images that are portrayed on a monitor by the laparoscope. The upper part of your stomach will then be wrapped around your lower esophagus, creating a tighter sphincter and thus preventing reflux from occurring again.

Endoluminal Fundoplication. This is the newest procedure and is also the least invasive among the three. There is no need for incisions in endoluminal fundoplication. In place of incisions, an endoscope with a lighted camera will be inserted into your esophagus through your mouth. Your surgeon will then place a few clips that are small in size at the point of the intersection of your stomach and esophagus. These clips will help prevent food and stomach acid from going back into the esophagus.

How’s the Recovery Process?

During the recovery process, your doctor will prescribe medications that should be taken only with food. Most people will feel a burning pain or a tingling sensation around the incision site. The feeling is, however, temporary.

NSAIDs can be used to treat it. Other medications for the same include over-the-counter ibuprofen (Motrin)

After the surgery, you will need to clean the area around the incision and the incision itself with clean water and soap daily. Stay away from pools, hot tubs, and baths. The shower is the only option here. To prevent the stomach from increasing in size your diet will have to be restricted. Instead of the normal 3 large meals, you are used to, you will need to take 4-6 meals each in small quantities after which you will slowly move onto light foods such as scrambled eggs and mashed potatoes.

Most hiatal hernia symptoms are caused by acid reflux. Symptoms can be reduced by developing another diet. Instead of 3 times with large quantities of food each day, try eating several times each day each with small quantities.

Eating snacks or meals a few hours before bed is also not advisable.

Consider staying away from the following foods because they will increase your risk of heartburn:

  • Alcohol
  • Spicy foods
  • Citrus fruits
  • Chocolate
  • Onions
  • Caffeine
  • Foods containing tomatoes

Other ways of reducing your symptoms include:

  • Avoid lying down or bending over after eating
  • Raising the upper part of your bed by not less than 6 inches
  • Stopping smoking

Lifestyle Changes

It might be possible for the upper part of your stomach to move into your chest cavity by pushing through the diaphragm. This condition is referred to as a hiatal hernia.

Acid reflux is one of the major symptoms that you might experience. Acid reflux might cause a lot of discomfort and pain after taking certain foods or meals.

The symptom can be reduced by eating foods whose acid production is low. Below is some information on the foods that you should eat, the foods that you should consider avoiding and other tips that can help you deal with a hiatal hernia.

Foods and Beverages You Should Avoid

These are some of the foods and beverages that you should skip if you are suffering from gastroesophageal reflux disease (GRED).

The foods include:

  • Mint and peppermint
  • Chocolate and cocoa
  • Onions and garlic
  • Spicy foods
  • Foods rich in sodium,
  • Fried foods
  • Oranges, limes and other citrus foods
  • Spaghetti, salsa, and other tomato-based foods
  • Tomatoes

Beverages that you should avoid include:

  • Whole milk
  • Coffee
  • Wines, spirits, and beer among other alcoholic drinks
  • Soda and other carbonated drinks
  • Caffeine teas

Foods and Beverages to Consume

Foods that will not lead to more acid production in your stomach are still available. Plenty, actually. The unprocessed foods, that is, whole foods are very good options. This is because they contain lots of fiber which can help to reduce acid reflux.

You should try eating

  • Whole grains
  • Pears, melons, berries and apples and other non-citrus fruits
  • Fruits
  • Almond milk. Soy and other plant-based milk types
  • Chia seeds, almonds and other nuts and seeds
  • Vegetables like sweet potatoes, carrots, leafy greens, peas, green beans, squash, and artichokes.
  • Lean proteins
  • Yogurt
  • Certain juices like cabbage juice, aloe vera, and carrot

Cooking and Eating Tips

Simple things like the way you prepare and eat your meals can make a difference. If for instance, you experience heartburn, you might want to prepare your foods in a healthier way than you are accustomed to. For example, heartburns can be triggered by fried foods. Your symptoms may also worsen if you eat too much at a go.

The following are a few tips:

  • Prepare meals with healthy fats like coconut, avocado, and olive oils
  • Whenever possible eat whole foods. The fiber that these foods contain should help to reduce influx. Aim to eat less processed foods
  • Instead of eating 3 huge meals a day, aim to eat small quantities several times daily during the day
  • Incorporate probiotic food into your diet. Cultured vegetables such as pickles are a good option. Other good choices include home-made yogurt and kefir. Probiotic supplements may also come in handy.
  • Drink plenty of plain water. This is the best beverage that you can drink. At least 8 glasses per day should be enough. In order to reduce acid production by adding water to reduce acid production by adding some lemon to the water. Although lemon is an acidic fruit outside the body, it produces alkaline products once it has been metabolized.

Hiatal Hernia Prevention

Though it is not easy to keep a hiatal hernia away, the risk of occurrence can be reduced by not smoking and maintaining healthy body weight

Avoid heavy lifting and other abilities that may lead to abdominal strain in order to prevent a hiatal hernia that is associated with abdominal pressure or associated with abdominal pressure.

Consult your doctor if you constantly strain when moving your bowels. Your doctor may suggest that you change your diet in order to include more fiber-rich foods

What Happens When Hernia is Not Treated?

Sitting in a painful hernia is highly advised against. A hernia is a visible protrusion of either an organ or tissue or even fat through an uncommon open space in your body. A hernia manifests itself as a lump in your groin and abdomen. A hernia is more visible when one is on their feet.

Like other conditions, a hernia will not treat itself. It might need surgery. However, most patients fail to seek surgery because of the common perceptions about surgery. You don’t have to go through surgery. There are other safe and simple and even quick out-patient procedures which often use local anesthesia. They usually take under one hour for completion and once you undertake them, you will be able to resume your daily activities within no time. It could even be the same afternoon. Surgeries often involve repairing a hernia.

A bowel, if it gets stuck within a hernia, can be easily strangulated due to loss of blood supply. This is the main reason why surgical treatment is preferred. It’s important to consult a surgeon about surgical treatment of a hiatal hernia. The surgeon will ask about your medical history in detail. He will also perform a similarly detailed examination. Thereafter, he will come up with the best treatment for the condition.

Hiatal Hernia Can Present with Heartburns in Women

Acid reflux disease and heartburns are some of the common diseases that affect women of all ages. When the acid in the stomach makes its way back into the esophagus, this problem occurs. Our bodies have a muscle that is known as the diaphragm and it separates the abdominal cavity from the chest. When you consume food or drink, they move from the mouth and down into the esophagus. The food then moves through your diaphragm and finally into the stomach. Consuming too much food and at a very high speed causes the esophagus to expand and consequently causes the opening at the diaphragm to stretch. This eventually causes widening of a hiatal hernia, a muscle of the diaphragm. Symptoms of heartburn can arise from this.

Obesity is also a common factor that leads to a hernia because the increased weigh on the abdomen causes the stomach to move upwards thus causing the acid to back up into the esophagus. The major factor for this condition arising in women is pregnancy since it has the same effect as obesity. Another common cause is genetics. Caffeine in sodas and coffee, as well as nicotine in tobacco, are some of the dietary factors that lead to the occurrence of gastroesophageal reflux disease, also referred to as GERD. Hiatal hernia, reflux, heartburn, and GERD are all similar names that are used to refer to the same condition.

The initial treatment is usually taken by mouth. Some of the most common prescription medications include Pepcid, Tagamet, Zantac, Protonix and Prilosec among others. Surgery might be necessary if the medications fail to control the heartburns. A large incision was usually used in surgery two decades ago. The incision was always done on the upper abdomen. The process was very painful and the recovery period often lasted from four to six weeks. Laparoscopic surgery was later introduced in the 1990s and the recovery period after the surgical treatment was shortened dramatically. Around the same time, however, new medications were introduced into the market. these were also able to control heartburn and the associated symptoms as well as GERD and other associated problems.

A medical breakthrough happened at the beginning of 2000 when a biologic surgical mesh was added in order to repair the diaphragmatic muscle tear in patients suffering from GERD. The mesh served to enhance the operation and the long-term results were made better than they previously were. Since the material is recognized as natural tissue by the body, communication between the graft and the body signals to all the surrounding tissue to grow across and cover the scaffold. Nutrients and cells are thus attracted to this area. This fastens the healing process. The scaffold is used by the body to heal the torn tissue in the muscle. As time moves on, the scaffold remodels itself completely into strong and fully functional tissue. Consequently, patients go through an incredibly fast and efficient two to three-week recovery period after which they are able to resume their normal activities.

the main advantage if incorporating the biologic material is that it is readily accepted by the body faster than other treatments. This fastens the healing process. Once the biologic graft is fully remodeled, it becomes similar to the patient’s tissue in terms of strength and functionality. The material is also undetectable once the healing process has been completed. This provides a permanent repair. On the other hand, synthetic surgical meshes are not preferred for this kind of treatment since they become very stiff and tough once they are inside the body. They cannot be used to treat hiatal hernias because of their stiffness. They also tend to tear often and they may also erode into your stomach and esophagus. This may lead to very serious side effects which would call for further treatments including dangerous surgeries. Such issues do not occur with biologic meshes.

The use of biologic meshes has proven to be quite effective in women who have had a hiatal hernia and it has provided exceptional results. However, this procedure might not necessarily work for everyone. In most cases, the symptoms of heartburn can be relieved by diet, medications and weight loss. However, surgery has consistently proven to be the most efficient method of treating a hiatal hernia. Before considering any medication or surgery for a hiatal hernia, it is highly recommended that you seek professional advice from a laparoscopic surgeon or a gastroenterologist who is familiar with heartburn treatment.

Weight Lifting and Hiatal Hernia

Weight lifting can be associated with several causes of a hiatal hernia. Some of the potential causes of a hiatal hernia include straining, sustaining abdominal injuries and lifting of heavyweights. These factors are all consistent with weightlifting – causing strain in the stomach muscles may lead to a weakness in the wall of the diaphragm, thus creating a hole. Other factors that may cause a risk in developing this form of a hernia include putting unnecessary pressure on the abdomen, being overweight, tight belts and clothing and having a persistent and forceful cough.

Prevention. Learning to lift weights the right way may help lifters to prevent a hiatal hernia. Bending from the knees when one is lifting is usually highly recommended by trainers rather than bending from the waist as excessive pressure may be created on the diaphragm and the chest region. Lifters should also consider their strengths before considering lifting weights. Overworking yourself with weights that are above your lifting limits may cause a lot of strain in your muscles which may, in turn, lead to a hiatal hernia. Bridges and crunches, both activities that strengthen your core muscles, will help to keep you healthy and strong. In addition, they will lower the risk of weak muscles that indicate a hiatal hernia.

Crunches are performed by lying flat on your back while clasping your hands behind your head and at the same time bending your knees. Your feet should be kept flat on the floor as you lift your shoulders and head off the floor and tighten your stomach at the same time. On the other hand, a bridge is performed by putting your hand on your sides and lying on your back, with your knees bent. Lift your hips from the floor as you contract the stomach muscles.

Restriction of Activities. If the main symptom of a hiatal hernia does not manifest itself, it is possible to continue lifting weights and be unaware that you have the condition, acid reflux. If your doctor is of the opinion that your weight lifting activities are hazardous to your health, he can restrict your sporting activities. If your hernia has been repaired, you can result to working with lighter weights as well as hand weights. This is because too much pressure on the abdomen may cause worsening of a hiatal hernia.

Considerations. Invasive treatment is not usually required to treat the moderate-sized and other small hiatal hernias. Their treatment is usually based on elimination of the symptoms that they bring along, particularly heartburn symptoms. In order to avoid further complications, strangulate hernias and other types of larger hernias should be attended to. A strangulated hernia occurs when the circulation to a certain area of your stomach is cut off after it makes its way through the diaphragm and twists. Once a hiatal hernia has been surgically repaired, you should discuss your weight lifting activities with your doctor. The site that a hernia occupied might always have a weak tendency and it might open up once again in the future.

How to Lose Weight When You Suffer from Hiatal Hernia

When a small portion of your stomach squeezes its way through your diaphragm and into the chest cavity through a small opening in the diaphragm referred to as the hiatus, a condition known as a hiatal hernia occurs. The hiatus is the connection between the stomach and the esophagus. Most hiatal hernias do not usually cause symptoms, large ones, however, may lead to heartburn, nausea and chest pains. If you are overweight, regular exercises are generally recommended as part of your treatment. Gentle exercises that target the abdomen are also allowed as long as they do not increase pressure around that region.

  • Slant Board Bicycles

Step 1. In order to perform slant board bicycles, select a flat surface, for instance, the floor and place a slant board on it. Follow the recommendations of the National Health Federation. Lie with your back lying on the board and your face up. Your feet should be at a higher position than your head. Now, hold on to the slant board. In particular, the sides.

Step 2. Raise the knees into the air and bend your legs. Your knees should be above your abdomen.

Step 3. Imagine now, that you’re riding an imaginary bicycle and cycle your legs in the air. Make sure that you make 15 full cycle repetitions with each leg. Unless your abs are a bit sore, aim to perform this exercise every day.

  • Abdominal Curls with Raised Knees

Step 1. In this exercise, you will follow the recommendations of lien on your back in order to execute abdominal curls with raised knees. Bend your knees so that your heels will touch the tips of your fingers. Your arms should be at your sides and on the floor. If this position is uncomfortable, extend your knees and slide your feet forward. The angle of bending your knees should be one that is comfortable for you.

Step 2. Now, slowly move your upper body upwards until the weight is lifted off your shoulder blades. Hold this position for three seconds. Repeat the exercise 15 times. Count three sets of 15 reps each.

Step 3. Once you feel that you’re ready to increase the level of the workout, raise your head and shoulder blades 2 inches from the floor. Hold the position momentarily and drop to the floor once again. Count three sets of 15 reps each. Execute this workout, together with the bicycles, every day. if however, you are not yet strong enough to do both of them, it’s okay to alternate.

  • Weight Loss

Step 1. As is recommended by, eat smaller meals, especially at night. Count the calories you consume, or better yet, keep a perfect record of what you eat and how much of it so that you can share the information with your doctor. The trick to losing weight is reducing calorie intake and exercising regularly. Ask your doctor for advice on precisely how many calories you should cut since it is not wise to cut all of them.

Step 2. Make sure to drop all foods that cause heartburn from your diet. They include chocolate, spicy foods, tomato-based foods, onions and citrus fruits. Reduce the number of fatty foods as well from your diet.

Step 3. Do not eat three hours to your bedtime.

Step 4. Execute various workout plans for 30 to 60 minutes for the better part of the week. Aim at performing the exercises at a moderate intensity for the activity that you choose to undertake. Some specific types of exercises are not recommended. As such, choose what the one that you enjoy and that also doesn’t cause pain. It should still be moderate. Activities that may require too much strenuous and vigorous efforts should be avoided totally.

Check out more info on hiatal hernia here:

9 Home Remedies For Acid Reflux
Step by Step Guide On Relieving Gas Pain In Chest
The Best Abs Exercises For All Levels Of Gym-Goer – Infographic
Getting Rid Of GERD: The Complete Guide On How To Reduce Acid

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