Acid reflux results when stomach acid backs up into the esophagus, causing a burning feeling in the chest and throat. The acid reflux action causes the sensation of heartburn. Frequent heartburn may indicate gastroesophageal reflux disease, also called GERD. People with a hiatal hernia often experience acid reflux symptoms and heartburn because the condition weakens muscle tissues in the stomach.
Function
A valve-like muscle in the esophagus, called the lower esophageal sphincter, usually opens when food enters the stomach and closes to prevent contents from backing up. When the sphincter is weakened, it does not close properly and allows stomach acids to flow back up into the esophagus and throat, causing acid reflux. Some people have heartburn occasionally because the sphincter does not work once in a while. However, people with GERD have a permanently damaged lower esophageal sphincter that causes frequent acid reflux.
Further Problems
A large hiatal hernia can cause acid reflux and chest pain, the Mayo Clinic explains. Weakened stomach muscles result in a hiatal hernia that pushes the top part of the stomach upward though the diaphragm into the chest cavity. The diaphragm lies between the stomach and the esophagus and has an opening, called a hiatus, to allow food to pass into the stomach. The weakened muscle tissues in the area increase the risk of acid reflux.
Symptoms
Symptoms of acid reflux and hiatal hernia include chest pain, heartburn that worsens when bending over or lying down and difficulty swallowing. A hiatal hernia itself does not usually cause the symptoms, notes MedlinePlus. The discomfort comes from acid reflux or bile. Acid reflux occurs because of certain foods or medications, but people with hiatal hernia experience acid reflux more easily.
Causes
Possible causes of hiatal hernia include heredity, being born with a large hiatus, injury in the area or persistent pressure from coughing, vomiting, straining or lifting heavy objects. Aging, obesity and smoking also contribute to the risks of hiatal hernia. Obesity, smoking and overeating are among the causes of acid reflux.
Treatment
Treatment for acid reflux and hiatal hernia includes avoiding heavy meals, reducing weight, not lying down or bending over after a meal and not smoking. Medications to reduce stomach acid buildup include antacids to neutralize stomach acid, H2 blockers to decrease acid production and proton pump inhibitors to prevent acid production and heal damaged esophageal tissue. Surgery may be a last resort if medication and lifestyle changes do not work. Surgical methods involve repairing muscle tissue to pull the stomach down into the abdomen or strengthening the lower esophageal sphincter.
