What Is a Hiatal Hernia and What Is Its Role in GERD?

What Is a Hiatal Hernia

To answer the question what is a hiatal hernia condition, one must first understand what any type of hernia is in the first place. When most people think of a hernia, they think of a back injury or a hip injury from lifting or pulling something heavy. While these physical acts can certainly cause hernias, they are not the only type. What might be even more confusing is that there are different types of hiatal hernias as well, making it even perhaps a bit more difficult to fully understand. A hernia occurs anytime a part of the body moves or is pushed into an area that is does not belong. So what is a hiatal hernia? It is this same condition, only involving the stomach. When a hiatal hernia is present, it means that a bulge or piece of the stomach has been pushed through the opening in the diaphragm known as the hiatus. Most of the time, it is not a serious condition. However, some complications can exist, and one type of hiatal hernia is more problematic than the other.

There are two main hiatal hernia types (although, there are actually considered to be four stages of the condition). A sliding hiatal hernia occurs when the part of the stomach that meets the esophagus is bulged out of the hiatus opening. Most of the time this looks like a bulge in a balloon. This is the most common of the hiatal hernia types. But, this type alone does not in itself accurately answer the question of what is a hiatal hernia, because in rare cases, a more dangerous type may occur. This is referred to as a paraesophageal hernia, and it occurs when the stomach does not bulge together with the connection to the esophagus, rather ends up alongside it.

Identifying symptoms can make defining just what is a hiatal hernia even a bit more challenging. People with a small, sliding hiatal hernia may experience no symptoms at all as the actual physical condition in itself does not actually cause symptoms. Others may experience common symptoms of hiatal hernia that are almost always attributed to GERD and acid reflux. These symptoms can include burning sensations in the chest, discomfort and pain in the upper central part of the abdomen, coughing, hiccupping and belching.

Because the most common symptoms of the condition relate to stomach acid, it may come as no surprise that most of the time, treatment for hiatal hernia symptoms involves the use of medications that are designed to reduce the amount of acid produced by the stomach, most commonly proton pump inhibitors and H2 receptor blockers. This can seem a bit confusing because understanding what is a hiatal hernia is to understand that it in itself actually produces no symptoms unless complications are present or the hernia is large, paraesophageal or at risk of becoming strangulated. So, why do some people without a hiatal hernia experience GERD but many people with a hiatal hernia also experience the symptoms? The answer has to do with physiology and ultimately, just what is a hiatal hernia.

There are protective mechanisms in the body that allow for proper digestive processes to take place and are in place in order to prevent acid from backing up into the esophagus, which is what causes symptoms in a majority of people. When a hiatal hernia is present, the tissue composed sphincter that is found where the stomach and esophagus meet can become no longer positioned correctly, and therefore it may be less capable of doing its job, which is allowing food to come in, but nothing to come out. This is what is responsible for GERD symptoms in persons with a hiatal hernia quite simply, but there may be other contributing factors as well. It has been speculated that slow digestion can also lead to excess stomach acid making backups more likely and, that sudden pressure changes can provide a boost for tissue irritating acid to travel to places that it does not belong. All of these factors easily explain how a hiatal hernia and GERD really are connected.

Once a hiatal hernia is suspected, it is best to see a health care provider for some tests and an evaluation. Although symptoms may be present, a hiatal hernia diagnosis is still important because it provides an opportunity to ensure that the hernia is not dangerous or overly large. If the condition is present, a hiatal hernia treatment course will be laid out and will likely include medications. However, knowing just what is a hiatal hernia means knowing enough to know that medications enough might not be enough to bring about relief from hiatal hernia symptoms, and some lifestyle changes might be in order. The most common of these is a diet for hiatal hernia symptom relief. Perhaps unsurprisingly, these types of diets eliminate high acid foods like citrus as well as spicy, fatty, greasy and sugary edibles and replaces them with lower acid produce options, lean meats and fat free dairy, instead. These diets have proven to be incredibly successful in many people, and although dietary intake is not considered relevant amongst hiatal hernia causes, it can certainly be responsible for triggering symptoms.

It is incredibly important to remember, however, that medications and diets as well as other alternative types of treatment are only practical in the case of small and sliding hernias. Those that are large, at risk of strangulation or further complicated are often not treatable in these easier methods. Typically, surgery for hiatal hernia repair is required in these cases. The reason is that the blood supply to the stomach can be cut off entirely, which is a medical emergency.

So, what is a hiatal hernia? It is a common condition that is estimated to affect up to one in five people. It occurs when part of the stomach becomes displaced through an opening in the diaphragm, and most of the time does not produce any symptoms. When it does, it is likely because of the orientation of the tissue that keeps acid from backing up into the esophagus. This does not happen for everyone, but when it does, it is often easily treated with acid reducing medications, thoughtful dietary changes, adding in more physical activity, and reducing stress.