Hiatal Hernia

A hiatal hernia occurs when the opening between the abdomen and chest (the diaphragm) is too large, allowing part of the stomach to slip into the chest cavity. This condition can cause heartburn, acid reflux, and other digestive issues. While small hiatal hernias may not need treatment, larger ones can require lifestyle changes, medication, or surgery.

At Hernia Innovations, we specialize in diagnosing and treating hiatal hernias with both non-surgical and surgical options.

What Is a Hiatal Hernia?

Your diaphragm is a dome-shaped muscle that separates the chest from the abdomen and helps with breathing. A hiatal hernia occurs when the upper part of the stomach pushes through the opening (hiatus) where the esophagus passes into the stomach.

There are two main types of hiatal hernias:

• Sliding hiatal hernia: The stomach and lower esophagus slide up into the chest. This is the most common type.
• Paraesophageal hiatal hernia: A portion of the stomach pushes up next to the esophagus. This type is less common but can be more serious.

Common Causes of Hiatal Hernia

Hiatal hernias develop when there is increased pressure in the abdominal cavity or when the diaphragm weakens. Factors include:

• Chronic coughing or repeated vomiting
• Heavy lifting or straining
• Obesity, which increases abdominal pressure
• Pregnancy, due to stretching of abdominal tissues
• Age-related weakening of the diaphragm
• Smoking, which affects muscle and tissue health

Hiatal Hernia Symptoms

Small hiatal hernias may not cause any noticeable symptoms. Larger hernias, however, often lead to:

• Heartburn or acid reflux
• Regurgitation of food or sour liquid
• Bloating and belching
• Trouble swallowing
• Chest pain or discomfort
• Shortness of breath when the hernia is large

Learn more about acid reflux and GERD symptoms

When Should You See a Doctor?

Seek medical care right away if you experience:

• Severe or persistent chest or abdominal pain
• Ongoing nausea or vomiting
• Difficulty with bowel movements or passing gas
• Black, tarry stools or vomiting blood

These may be signs of a strangulated hiatal hernia, which is a medical emergency.

How Hiatal Hernias Are Diagnosed

Your doctor may detect a hiatal hernia during an evaluation for reflux or abdominal pain. Common tests include:

• X-ray with barium swallow – highlights the esophagus and stomach
• Upper endoscopy – uses a flexible camera to view the digestive tract
• Esophageal manometry – measures pressure and muscle movement in the esophagus

Hiatal Hernia Treatment Options

Non-Surgical Treatments

For many patients, small hiatal hernias can be managed without surgery. Options include:

• Lifestyle changes: Eat smaller meals, avoid spicy/fatty foods, and quit smoking
• Weight management: Reduces abdominal pressure and reflux symptoms
• Medications:
  • Antacids to neutralize stomach acid
  • H2 blockers to reduce acid production
  • Proton pump inhibitors (PPIs) to block acid and heal the esophagus

Surgical Treatments

Surgery may be necessary if:

• The hernia is large (paraesophageal)
• Symptoms are severe or persistent
• GERD does not improve with medication

Common procedures include:

• Nissen fundoplication: Tightens the valve between the stomach and esophagus to prevent reflux
• Open repair surgery: Traditional approach with a longer recovery time
• Endoluminal fundoplication: A newer, incision-free technique that tightens the junction via endoscope

Explore Robotic Hernia Surgery options

Recovery and Outlook

Recovery from hiatal hernia surgery varies depending on the procedure. Many patients go home within 24 hours and return to normal activity in a few weeks.

Key recovery tips include:

• Keep incisions clean and dry
• Follow a soft-food diet at first
• Avoid heavy lifting until cleared by your surgeon
• Attend all follow-up appointments

With proper treatment, most patients experience lasting relief from reflux and improved quality of life.

Expert Hiatal Hernia Care at Hernia Innovations

Our experienced hernia specialists provide personalized treatment for hiatal hernias — from accurate diagnosis to advanced surgical repair. With offices in Walnut Creek, Concord, Antioch, and Brentwood, we make it easy to access expert care close to home.

Call us today at (925) 940-1025 or request an appointment online.