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After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.


Anatomy - Hiatal Hernia

A hiatal hernia happens when the upper part of the stomach pouches through a hole in the diaphragm into the chest cavity. The diaphragm is a large muscle separating the abdomen from the chest cavity. There is a natural opening (hiatus) in the diaphragm where the stomach is connected to the esophagus.

The diaphragm helps prevent stomach acid from pushing into the esophagus. A small hiatal hernia often causes no symptoms. Large hiatal hernias often allow food and stomach acid to back up into the esophagus that leads to heartburn.


Abdominal Cavity Anatomy

The abdominal cavity holds several organs, including:

  • Stomach and lower esophagus
  • Liver
  • Pancreas
  • Gallbladder
  • Spleen
  • Kidneys
  • Bladder

Causes of Hiatal Hernias

Increased pressure in the abdominal cavity is the most common cause of hiatal hernias. Some of the things that can cause the pressure to increase include:

  • Vomiting
  • Frequent or hard coughing
  • Straining during defecation
  • Physical strain
  • Heavy lifting
  • Obesity
  • Pregnancy

Hiatus Hernia: Signs, Symptoms and Treatment

Hiatal Hernia Symptoms

Small hiatal hernias cause no signs or symptoms. Larger hiatal hernias may cause a variety of symptoms, that include:

  • Heartburn
  • Acid reflux (backflow of stomach acid into the esophagus)
  • Regurgitation of liquids or food into the mouth
  • Feeling full soon after you eat
  • Difficulty swallowing
  • Shortness of breath
  • Dry cough
  • Bad breath
  • Nausea and vomiting
  • Chest or abdominal pain

The symptoms may be the same as those for gastroesophageal reflux disease (GERD), which occurs when digestive juices move from the stomach into the esophagus. A large hiatal hernia can cause blood or black stools due to gastrointestinal bleeding.

Hiatal Hernia Diagnosis

There are several tests to reach this diagnosis, and they include:

Barium swallow - drink a special liquid, then x-rays are done that will show the size of a hiatal hernia and any problem with the esophagus

Endoscopy - a long, think flexible instrument is used to view the upper digestive system

Esophageal manometry - measures the strength and muscle coordination of the esophagus when swallowing

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A pH test - the acid levels in the esophagus are measured, which helps to determine which symptoms are related to the acid in the esophagus

Gastric emptying studies - the rate the food levels the stomach is examined, which is very important in patients with nausea and vomiting

Hiatal Hernia Treatment

If the hiatal hernia is not causing problems, then it does not need treatment. If the patient has the symptoms of GERD, then some treatment is necessary. People over the age of fifty are more likely to have a hiatal hernia.

There are some changes in lifestyle that may help, including:

  • Losing weight for obese patient
  • Eat smaller meals
  • Avoid acidic foot, such as tomato sauce and citrus fruits
  • Limit fried and fatty foods, caffeine, chocolate, peppermint, alcohol, carbonated beverages, mustard, ketchup and vinegar
  • Eat your last meal of the day 3-4 hours before bed
  • Keep your head elevated at least 6” higher than the rest of your body
  • Quit smoking
  • Wear comfortable loose clothing as a tight belt puts pressure on your abdomen
  • Take medications after eating to reduce stomach acid

Over-the-counter (OTC) medications come in two types: histamine antagonists (H2 antagonists and H2 blockers), and proton pump inhibitors (PPIs). Both reduce the production of stomach acid. Some of these include:

  • Cimetidine (Tagamet HB)
  • Famotidine (Pepcid AC)
  • Nizatidine
  • Esomeprazone (Nexium 24 HR)
  • Lansoprazole (Prevacid 24 HR)
  • Omeprazole (Prilosec OTC)

Zantac is a H2 blocker that was removed from the market in 2020, as it was found to have a cancer-causing agent.

If these do not work, there are prescription strength medications, including:

  • Pantoprazole (Protonix®)
  • Rabeprazole (Aciphex®)
  • Esomeprazole (Nexium®)
  • Omeprazole (Prilosec®)
  • Lansoprazole (Prevacid®)


Severe and chronic hiatal hernias may require surgery. There are two types of common surgeries for this hernia repair.

The hiatal hernia is pulled back into the stomach and the valve at the bottom of the esophagus is repaired by closing the hole in the diaphragm. A permanent, tight sphincter is the result. In very severe cases there is a larger incision to allow for better visibility during the surgery. A longer recovery time is required with the larger incision.

Laparoscopic surgery repair is called the Nissen fundoplication. Several small incisions are made instead of one larger one. This repair is also a permanent repair and there is less infection risk with a shorter recovery time as well.

Hiatal Hernia: Quick Fix Treatment by Dr.Berg

Final Thoughts

Hiatal hernias are common, particularly in people over the age of fifty and with obesity. There are lifestyle changes listed above that may help. There are several types of medication and surgery is available when all else fails.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Pamela Oglesby


Pamela Oglesby (author) from Sunny Florida on May 24, 2021:

Hi Rachel,

Unless the hernia is very large it should not affect his breathing. Very large hiatal hernia can put pressure on your lungs. This is really an important question to ask his doctor if he is having trouble breathing. I hope he will be okay.

Rachel L Alba from Every Day Cooking and Baking on May 23, 2021:

Hi Pamela. My husband has a hiatal hernia. we were wondering if it could affect his breathing.

Pamela Oglesby (author) from Sunny Florida on May 19, 2021:

Hi Flourish,

I'm sorry to hear you have so many Gerd-related issues. My nephew is the same way and having surgery next month to hopefully fix this problem. I hope you can stay somewhat healthy. I appreciate your comments.

FlourishAnyway from USA on May 18, 2021:

My problems with GERD didn't surface until pregnancy when I threw up constantly for six months. I often say that my daughter "broke" whatever keeps my food down. Now I have all kinds of GERD-related issues, including Barrett's esophagus, NET, and a large hiatial hernia. It's an uncomfortable feeling.

Pamela Oglesby (author) from Sunny Florida on May 18, 2021:

Hi Linda,

As a retired RN I still love medical problems, with treatments, of course. I am glad you find my articles useful.

I appreciate your comments, as always.

Linda Crampton from British Columbia, Canada on May 16, 2021:

Thank you for sharing your knowledge, Pamela. Your articles about health problems are very useful.

Pamela Oglesby (author) from Sunny Florida on May 16, 2021:

Hi Peace,

Thank you is much for reading and commenting.

Pamela Oglesby (author) from Sunny Florida on May 16, 2021:

Hi MG,

I am glad you have increased your knowledge about some of these fairly common health problems. I appreciate your thoughtful comments.

Peace Tobe Dike from Delta State, Nigeria. on May 16, 2021:

Insightful..thank you for sharing.

MG Singh emge from Singapore on May 15, 2021:

Hi Pamela, a great addition to my knowledge. You are doing a great service by bringing all these facts to the knowledge of persons like me.

Rosina S Khan on May 15, 2021:

Thank you, Pamela, for praying for me. Blessings and love to you too, my friend.

Pamela Oglesby (author) from Sunny Florida on May 15, 2021:

Hi Rosina,

I am so glad to see you are well enough to be back on Hubpages. I prayed you would be well.

Of course, no one wants this condition. I am glad you found this article informative .

I am so glad to see you, and I appreciate your comments my friend. Blessings and love to you.

Rosina S Khan on May 15, 2021:

It was good to know about Hiatal Hernia facts. It was knowledgeable and thought-provoking to me. Like others, I wouldn't want this condition. Thank you, Pamela, for a great, insightful article.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Bill,

Constant may have been a symptom to this disease for your father-in-law. I'm glad you found this article useful. Coughing could have been a result of some lung disease also.

I appreciate your comments, as always. I hope you have a great weekend as well.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Sp,

That is my goal that anyone who reads this recognizes the symptoms.I don't wish this on anyone, but it is not horribly painful likes me diseases. As you said there are forms of relief.

I appreciate your comments. I hope you have a good weekend.

Bill De Giulio from Massachusetts on May 14, 2021:

Great information, Pam. Definitely not something I want to experience. I believe my father in-law had a Hiatal Hernia, which was caused by his constant coughing. Thank you for sharing this important medical info. Have a great weekend.

Sp Greaney from Ireland on May 14, 2021:

This article explains this condition really well. I think anyone who reads this article will be able to tell whether they have this condition or not.

At least there is some form of relief for it, but still I wouldn't wish it on anyone.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Eric,

I missed you, Eric, so, I am glad you are back. No one wants this problem.

I appreciate your comments. Have a great weekend with that adorable son of yours.

Eric Dierker from Spring Valley, CA. U.S.A. on May 14, 2021:

Glad to be back learning from you. I sure do not want this issue at all.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Miebakagh,

Sometimes the doctor will tell you to use the OTC medications if your case is mild, but getting the doctor's opinion is important.

Thank you for your comments. I appreciate them always.

BRENDA ARLEDGE from Washington Court House on May 14, 2021:


Enjoy your weekend too!

It seems the weather here will finally be nice. 70's.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on May 14, 2021:

The problem is serious. But the read is informing and educating. I think also self treatment via, OTC is not good.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Fran,

I wouldn't think you would be reading medical journals for relaxation or whatever. Haha

Thank you for reading and commenting. I always appreciate your comments. Have a good weekend!

fran rooks from Toledo, Ohio on May 14, 2021:

Pamela, another informative and well-presented article. I won't have to read medical journals with your superb articles. Thanks for sharing.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Brenda,

Acid reflux is a symptoms, but I know a lot of people just think they ate something too spicy or something like that. No one needs this problem! You certainly do not need a problem at all.

I appreciate your comments. Have a great weekend!

BRENDA ARLEDGE from Washington Court House on May 14, 2021:

I never really understood this although I've heard about people having these.

They usually think they have acid reflux.

Great article but one thing I don't need to have.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Linda,

At least you understand what your father-in-law was dealing with now.

I appreciate your thoughtful comments. I hope you have a good weekend.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Peggy,

That is exactly what I try to do. I want to make medical issues understandable.

I appreciate your nice comments. Have a good weekend.

Linda Lum from Washington State, USA on May 14, 2021:

My father-in-law had this problem and often complained of feeling that something he ate was "caught" in the back of his throat. The coughing and retching were dreadful. I didn't really understand what he was dealing with. Your article makes it very clear.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Lorna,

I agree that lifestyle changes can certainly make a huge difference in anyone's health.

I appreciate your very thoughtful comments.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Chitrangada,

I agreee that we all tend to take our bodies for granted. I always hope my articles help someone.

Thank you so much for your very kind words. I appreciate them very much. Blessings

Lorna Lamon on May 14, 2021:

It's certainly worth making those lifestyle changes as part of a self-help routine. This is an excellent article Pamela which fully explains this condition.

Chitrangada Sharan from New Delhi, India on May 14, 2021:

A very well explained article about Hiatal Hernia. You have mentioned the symptoms and the treatment, in an easy to understand way. I am sure this will be very helpful to those, who have such symptoms, to get proper medical guidance in this regard.

You are doing a wonderful job, by spreading medical awareness. We all have a tendency to take our bodies for granted. But, one should be careful, even if there are mild symptoms. This will help to have an early diagnosis and better treatments.

Thank you for sharing this excellent information.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Bill,

No, this is not fun. Glad you are healthy except for a bit of painful arthritis. I appreciate your thoughtful comments,

Have a wonderful weekend!

Bill Holland from Olympia, WA on May 14, 2021:

That doesn't sound like fun at all. Remind me never to have this! :) As always, thank you for the medical facts, written in a way which makes them easy to understand. You are quite good at doing that.

Happy Weekend, my friend!

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Misbah,

I'm glad this article was informative to you. Hiatal hernias are fairly common, so it is good information to know.

Thank you so much for your comments.

Blessings and love to you Misbah.

Misbah Sheikh on May 14, 2021:

Pamela, this is a very well researched and helpful article. Thanks for sharing this informative article. I learned a lot from your article today.

Blessings and love

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Umesh,

I am glad you liked the article. I always appreciate your comments.

Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on May 14, 2021:

Well explained. Thanks.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Liz,

I am sorry to hear about your father. I am glad this article was helpful for you.

I appreciate your comments, and I hope you stay healthy.

Liz Westwood from UK on May 14, 2021:

I have read your article with great interest, as there is a tendency in my family towards hiatal hernias. My father once thought he was having a heart attack, but the symptoms were put down to his hiatal hernia. Complications from it contributed greatly to his death and it featured on his death certificate as a cause of death. I especially appreciate your clear explanation and use of diagrams in this article.

Pamela Oglesby (author) from Sunny Florida on May 14, 2021:

Hi Constant Juma,

Thank you very much for your comments.


Useful and informative.

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