Hiatal hernias are very common and it is estimated that by age 60, up to 60 percent of people have one to some degree. Hiatal hernias can occur at any age, although they are more common after the age of 50. For some people there are no symptoms associated with it, and it may be discovered during a routine endoscopic exam. For others, they may have a miserable experience on a regular basis with heartburn, acid reflux and other digestive symptoms such as gas, bloating, belching, abdominal pain/pressure or feeling like you have a sock stuck in your throat. Sometimes this can present with chest pain and difficulty taking in a deep breath, making one believe they are having a heart attack. If you experience these symptoms, you definitely want to seek immediate medical attention to correctly diagnose what is causing your symptoms and ensure you are not in a life-threatening emergency situation.
What Is A Hiatal Hernia?
Your esophagus is the pipe that carries food from your mouth to your stomach. As it passes from your thoracic cavity to your abdominal cavity, the esophagus passes through a hole in the diaphragm called the hiatus. Below the diaphragm, the esophagus joins up to the stomach. A hiatal hernia occurs when part of the stomach pushes up through the hiatus and is above the diaphragm. There are two basic types of hiatal hernia—sliding and fixed. Sliding hiatal hernias do just as the name implies, the stomach can slide above the diaphragm into the chest cavity whereas fixed (or paraesophageal) has a part of the stomach pushing through the hiatus and staying lodged there. The fixed type is less common but can cause more serious problems requiring surgery.
What Causes A Hiatal Hernia?
There are a number of different theories of causes or contributing factors that can create a hiatal hernia, although most of the time the cause is not known. Some of the more common proposed causes include:
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Congenital Defect—some people may be born with a larger hiatus creating weakness or instability for holding the stomach below the diaphragm.
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Increased Abdominal Pressure-repeated or long term pressure from such conditions such as pregnancy, constipation, vomiting or coughing.
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Direct Trauma—a direct blow to the chest or abdomen can loosen the hiatus allowing the stomach to move up.
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Overweight/obesity—higher rates of hiatal hernias are found in people that are overweight or obese.
Natural Strategies To Treat A Hiatal Hernia
There are a number of various approaches to dealing with a symptomatic hiatal hernia. There are no medications that will correct a hiatal hernia, although medications are typically prescribed to reduce associated symptoms including acid blocking medications to alleviate the irritation to the esophagus due to acid reflux. Long term use of these medications can create additional digestive issues as well as promote loss of nutrient assimilation leading to diseases such as osteoporosis.
In more severe cases, surgery may be recommended. This should be a last resort option due to the many possible side effects including severe discomfort when eating and inability to vomit or belch normally.
Many people have excellent outcomes with certain lifestyle changes and natural treatments. Here are some strategies you can start doing immediately:
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Meal Planning and Timing—You want to avoid eating 3-4 hours before laying down to go to sleep. Also, smaller meals/portions are better tolerated, even if it means eating more often than the traditional breakfast, lunch and dinner.
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Weight Loss—If you are overweight, this can increase abdominal pressure during daily activities, in turn pushing your stomach up.
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Avoiding Foods That Aggravate Your Esophagus—Most people know what foods are their specific triggers. The more common foods to watch out for include foods that are spicy, greasy, tomato sauces, citrus and onions. Also be aware that caffeine and alcohol relax or weaken the sphincter between your esophagus and stomach.
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Modifying Your Sleep Position—A slight elevation (6 inches) of your head above your feet can help food from going back up your esophagus.
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Avoid sit-ups—Consider other options for core strengthening exercises such as plank exercises that do not increase abdominal pressure as much.
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Acupuncture—Many people find improvement with overall digestive function using acupuncture.
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Chiropractic Assisted Maneuver—For many decades, chiropractors have used a manual abdominal adjustment which tractions the stomach back down towards its normal position. Many patients experience immediate relief of their symptoms with this procedure and find this as a successful correction of the underlying problem.
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