Hiatal Hernia and GERD Comparison: Similarities and Differences!

Hiatal Hernia and GERD

A hiatal hernia and GERD related symptoms are very intimately linked, however there are actually similarities and differences between the two very common conditions. The differences are not related to symptoms, rather, the mechanism of action that causes the symptoms. This subtle difference however can make for differences regarding management and treatment of the condition.

The hiatal hernia acid reflux relationship refers to the pain and discomfort that both conditions lead to. The pain and discomfort is a result of acid reflux, a condition in which stomach acid backs up into the esophagus where it does not belong. While the stomach is well lined to protect itself from these volatile liquids, the esophagus is not. When stomach acid enters the esophagus, it quickly causes irritation and inflammation which can lead to persistent symptoms. The symptoms associated with a hiatal hernia and GERD are chest pain, trouble swallowing, burning sensations in the chest, coughing, hiccupping and belching as well as regurgitation and vomiting in some cases, too.

What causes these identical symptoms between conditions is a very subtle difference in the functioning of the lower esophageal sphincter (LES). This sphincter is in charge of keeping stomach acid from coming up into the esophagus. When it is not functioning correctly or not positioned properly, it is more difficult for it to do its job. Both hiatal hernia and GERD related symptoms likely result from the malfunction of this sphincter, but what causes it to not work properly in the first place is where the difference may lie.

In the case of a hiatal hernia, a condition in which part of the stomach is pushed or moves through the opening in the diaphragm known as the hiatus, the LES can be moved as well and therefore not in the right position to adequately prevent the backup of stomach acid. Conversely, in GERD that is not a result of a hiatal hernia, the causes can vary. For instance, smoking cigarettes can relax the LES and make it less likely to perform properly. Additionally, both pregnancy and obesity may contribute to the poor functioning of the LES.

Aside from these causal differences, much of the remaining relationship between a hiatal hernia and GERD related symptoms is relatively similar. For instance, a diet for hiatal hernia symptom relief is identical to one that is used in persons with GERD that do not have a hiatal hernia. These types of diets are twofold and involve removing certain foods as well as adding more of others. For many people, dietary changes alone including considerations for hiatal hernia foods to avoid are often enough to help keep symptoms at bay, as eliminating trigger foods that cause an uptick in stomach acid reduces the likelihood of an esophageal backup.

Trigger food avoidance is one of the most essential parts of any treatment plan for persons suffering from both a hiatal hernia and GERD. There are some common sense problem edibles like hot sauce and spicy fare that people with both conditions tend to abstain from. However, there are other acid reflux foods to avoid that persons with either condition should also consider taking off the menu. For instance, onions and garlic, tea and coffee, anything carbonated, foods that are fatty, greasy or fried as well as whole fat dairy can all contribute to symptom formation. When these foods are eliminated or their intake greatly reduced, in many cases both GERD and hiatal hernia relief from symptoms might be possible.

The similarities between the two do not stop at symptoms and dietary changes alone, however. In fact, when it comes to hiatal hernia remedies, they are almost identical to those used in persons with GERD alone that do not have a hiatal hernia. Most of the time, these include hiatal hernia medication, although that term is really a bit misleading. There is no medication that actually treats either the physical problem of the hernia or the root causes of GERD. These medications (proton pump inhibitors and H2 receptor blockers) are used merely to treat the symptoms of a hiatal hernia and GERD, which relate to acid reflux. Medications reduce the amount of acid that is in the stomach and therefore help to prevent it from backing up.

Ultimately, there is very little difference between a hiatal hernia and GERD. Many people who have a hiatal hernia have GERD (although some are asymptomatic altogether) but, not everyone who has GERD has a hiatal hernia, even though it is considered a potential underlying cause. The reason why the two conditions are so intimately related is because they very often exist side by side. Their treatment plan is often very similar and their symptom triggers are identical. The differences lie in mere physiology in some but not all cases, and what specifically is responsible for allowing symptoms to develop in the first place. In most cases, they are not thought of as separate conditions, merely coexisting symptom producers or causative forces.

References:
https://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1
https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940