A sliding hiatal hernia occurs when a portion of the stomach slides upward into the chest cavity through an opening or hiatus in the diaphragm, which sits between the chest and the abdomen. It happens when supporting tissues become weakened. Risk factors include aging, obesity and smoking. In rare cases, the stomach squeezes through the hiatus and lodges next to the esophagus, threatening to strangle the stomach and cutting off blood supply.
Medication
Sometimes no symptoms occur and regular physical examinations help detect the condition. Symptoms often include heartburn and a gastroesophageal reflux disease, known as GERD, which causes frequent acid reflux and heartburn. A burning or painful sensation in the upper chest and throat occurs and may cause a bitter or sour taste in the back of the mouth and throat. Taking antacids provides instant relief from heartburn. Over-the-counter H2 blockers bring relief from symptoms for several hours by blocking stomach acid production. Doctors can prescribe stronger medication if necessary. Over-the-counter and prescription proton pump inhibitors block acid production and help heal damage to the esophageal tissue, MayoClinic.com notes.
Foods
Avoiding large or heavy meals prevents acid reflux from a hiatal hernia, according to MedlinePlus, a publication of the National Institutes of Health. Heavy meals may also lead to indigestion that results in acid reflux. Focusing on smaller meals promotes weight loss. Excess weight can cause acid reflux because of pressure on the abdomen. Waiting three to four hours before lying down after eating avoids acid reflux by giving food time to digest. Avoiding foods that trigger heartburn reduces symptoms. Some products include fatty or fried foods, tomato-based products and citrus fruits or juices. Caffeine, carbonated drinks and alcoholic beverages also trigger heartburn.
Surgery
Doctors may recommend surgery for people who cannot find relief through dietary changes or medication and suffer from severe acid reflux symptoms. Pain from eating, nausea or vomiting and bowel movement difficulties may indicate a strangulated hernia or obstruction, according to the Cleveland Clinic. Surgery may involve pulling the stomach back down into the abdomen and making a smaller opening at the diaphragm. In some cases, surgeons may repair a weakened esophageal sphincter in combination surgery. The weakened muscle in the esophagus promotes frequent acid reflux. Advances in surgical techniques for a hiatal hernia include less-invasive laparoscopic methods. Doctors use a flexible tube inserted into a small incision. A tiny inserted camera allows surgeons to view images inside the body as they perform the operation and repair the weakened tissue. Patients can reduce recurrence of a hiatal hernia by avoiding pressure on the abdomen and keeping a healthy weight.
