Everyone experiences occasional acid reflux and heartburn, and about 20% of American adults suffer from these symptoms multiple times a week due to gastroesophageal reflux disease (GERD). If you’re one of them, you may also belch a lot, have trouble swallowing, and experience chest pain.
Untreated GERD can cause bleeding ulcers and tissue damage, leading to Barrett’s esophagus, which alters the cells in your esophageal lining and puts you at risk for cancer. If those reasons don’t compel you to seek medical attention, this one should — you may have GERD and a hiatal hernia.
Both conditions require expert care from an experienced, board-certified expert like Dr. Ayub Hussain at Northside Gastroenterology Associates in Houston and Cypress, Texas. He diagnoses and treats many issues involving your digestive tract and can determine whether you’re dealing with GERD, a hiatal hernia, or both.
Here, he explains the common causes of and treatments for hiatal hernias.
Here’s a quick anatomy refresher course to help you understand hiatal hernias.
Your esophagus is the long tube that delivers food and liquid from your throat to your stomach. At the bottom, a sphincter closes tightly and prevents harsh stomach acids from backing up into your esophagus. Underneath your esophagus, a thin muscle called the diaphragm separates your abdomen from your chest cavity. The point where the esophagus passes through the diaphragm is called the hiatus.
If the top part of your stomach pushes through your diaphragm at the hiatus, you have a hiatal hernia.
Genetics may be to blame for your hiatal hernia. Some people are born with an unusually large hiatus, making the stomach’s migration upward almost inevitable.
Acute injury or trauma can also give you a hernia. For example, if you’re in a car accident, the violent forward motion of your abdomen against your stationary seatbelt can exert enough pressure to force your stomach tissue past your hiatus.
Obesity is a common cause of hiatal hernias. Living with the constant pressure of excess abdominal fat weakens the hiatus and allows your stomach to press through.
Stress and strain can also cause hiatal hernias. Lifting heavy objects, straining during bowel movements, chronic coughing, and repetitive vomiting are common hernia inducers.
Hernias fall into two main categories: sliding and fixed.
Most hiatal hernias are the sliding type, meaning they move up and down, in and out of your chest cavity. Sliding hiatal hernias are usually small, present no symptoms, and require no treatment.
As its name suggests, a fixed hiatal hernia pushes through your diaphragm and stays put. It’s not a serious medical concern unless it blocks blood flow to your stomach.
Most hernias don’t cause direct symptoms and are often discovered in patients complaining of GERD symptoms. GERD and hiatal hernias tend to go hand in hand, although neither causes the other.
The only way to know whether you have a hiatal hernia, GERD, or both is to undergo diagnostic tests. If Dr. Hussain suspects a hiatal hernia, he performs an esophagogastroduodenoscopy (EGD), also known as an upper endoscopy. He inserts a long narrow instrument with a tiny camera on the tip through your mouth, down your esophagus, and into your hiatus.
The scope gives Dr. Hussain a clear view of your lower esophageal sphincter, your diaphragm, and a hernia if it’s present.
In many cases, Dr. Hussain treats the symptoms of GERD to reduce your heartburn symptoms. Modifying your diet and approach to meals, changing your sleeping position, losing weight, and using antacids may be part of your treatment.
If these measures don’t improve your symptoms, you may require surgical intervention to repair the hiatal hernia through tiny incisions.
Call us today to schedule an appointment with Dr. Hussain or book online if you suspect GERD or a hiatal hernia. We can diagnose your condition and relieve your symptoms.