Hiatal Hernia
When the stomach slips up. A hiatal hernia occurs when part of the stomach pushes through the diaphragm into the chest cavity. This compromises the lower esophageal sphincter, causing acid reflux. It can also compress the vagus nerve, affecting heart rate, digestion, and breathing. Common and often undiagnosed.
Types of Hiatal Hernia
Sliding (Type I)
Most common (95%). Stomach and junction slide up. Comes and goes with position.
Paraesophageal (Type II)
Stomach herniates beside esophagus. Junction stays in place. More serious.
Mixed (Type III)
Combination of both types. Junction and stomach body both displaced.
Giant (Type IV)
Large hernia. Other organs may herniate too. Colon, spleen possible.
Symptoms
Heartburn
Acid reflux hallmark. Worse after meals, lying down. Burning in chest.
Regurgitation
Food comes back up. Especially when bending over. Sour taste.
Chest Pain
Can mimic heart attack. Pressure behind sternum. Scary but not cardiac.
Breathing Issues
Stomach presses on diaphragm. Shortness of breath. Worse after eating.
Heart Palpitations
Vagus nerve compression. Irregular heartbeat. Often after meals.
Dysphagia
Difficulty swallowing. Food gets stuck. Esophageal compression.
Treatment Approaches
Manual Reduction
Chiropractor or self-technique. Push stomach back down. Temporary relief.
Diet Changes
Smaller meals. Don't eat before bed. Avoid trigger foods. Reduce pressure.
Weight Loss
Reduces abdominal pressure. Major risk factor. Often curative if significant.
Elevate Head
Sleep on incline. Gravity helps keep stomach down. 6-8 inch elevation.
Core Strengthening
Diaphragm exercises. Deep breathing. May help prevent recurrence.
Surgery
Nissen fundoplication. For severe cases. Wraps stomach around esophagus.