What’s making you burp?

If you have been experiencing acid reflux, heartburn and belching, even nausea or chest pain, you could have a hiatal hernia. The condition is extremely common, often going undiagnosed and untreated for years.  Being largely asymptomatic, you may never know you have one unless your doctor finds it while checking for another condition.

However, if you are experiencing symptoms which are not relieved by over-the-counter medication, it may be time to check with a physician to see if you have a hiatal hernia.

A hiatal hernia occurs when a portion of the stomach is pushed up through the hiatus, a small hole in the diaphragm which the esophagus passes through on the way to the stomach. When the stomach pushes through, a small pocket or hernia is formed. This allows food and acid to back up, or reflux, into your esophagus. By allowing reflux to occur over time, there is an increased chance that esophageal cancer will develop.  Therefore it is important to seek treatment.

More than 60 percent of people over the age of 50 have a hiatal hernia. Out of that number, however, only about 9 percent will develop symptoms. In most cases, it will not even affect your lifestyle. But if the hernia becomes large or symptoms increase, a hiatal hernia can require medication or surgery.

Heredity is often a factor in the cause of hiatal hernia. The diaphragm may be weak or the hiatus may be larger than normal. Injury to the area or pressure within the abdomen caused by heavy lifting, hard coughing or sneezing, pregnancy, vomiting, constipation or obesity can cause a hernia. Smoking has also been determined to be a risk factor.

If diagnosed, there are minor lifestyle changes you can make to minimize the hiatal hernia’s effect on your daily life, including:

  • Eat several smaller meals throughout the day rather than a few large meals.
  • Avoid foods that trigger heartburn, such as chocolate, onions, spicy foods, citrus fruits or tomato-based foods.
  • Avoid alcohol.
  • Stop smoking.
  • Limit foods high in fat.
  • Sit up after you eat, rather than taking a nap or lying down.
  • Eat at least three hours before bedtime.
  • Lose weight if you’re overweight or obese.
  • Elevate the head of your bed 6 inches.
  • Reduce your daily stress.

In very rare cases, if you have been diagnosed with a hiatal hernia and your symptoms are not reduced through medication and lifestyle changes, a gastroenterologist may suggest surgery to return the stomach to its correct position or to make the hiatus smaller. The minimally invasive procedure may be performed through a small incision in the abdomen or chest cavity or laparoscopically with a camera inserted through several incisions on your abdomen.

Hiatal hernias affect millions of people each year and severe cases are very rare. With knowledge and a few lifestyle changes, people with the condition can normally reduce or even eliminate symptoms.