Heartburn after every meal? A burning sensation in your chest that worsens when you lie down? It might not always be acidity — it could be a hiatal hernia.
“Hiatal hernia is one of the most under-diagnosed digestive conditions — often mistaken for acidity or reflux,” says Dr. Rajeev Kapoor, senior gastrointestinal and laparoscopic surgeon in Chandigarh. “But with timely detection, it can be managed or corrected effectively.”
1️⃣ What Is a Hiatal Hernia?
A hiatal hernia occurs when the upper part of the stomach pushes up through the diaphragm — the muscle separating the chest from the abdomen — into the chest cavity.
There are two main types:
- Sliding Hiatal Hernia: The stomach and lower esophagus slide up into the chest (most common).
- Paraesophageal Hernia: Part of the stomach pushes beside the esophagus — rarer, but potentially more serious.
2️⃣ What Causes a Hiatal Hernia?
Hiatal hernias usually develop when the diaphragm weakens or when abdominal pressure increases.
Common causes include:
- Chronic acid reflux (GERD)
- Obesity or sudden weight gain
- Pregnancy (temporary increase in abdominal pressure)
- Frequent coughing or straining (constipation, lifting heavy weights)
- Aging, which naturally weakens muscle tissue
“It’s not just lifestyle — sometimes it’s structural. But correcting lifestyle factors makes treatment far easier,” Dr. Kapoor notes.
3️⃣ Common Symptoms You Shouldn’t Ignore
Hiatal hernias can mimic acidity or gastritis. Typical symptoms include:
- Heartburn or burning in the chest after meals
- Regurgitation of food or sour liquid
- Difficulty swallowing (dysphagia)
- Chest discomfort after bending or lying down
- Chronic cough or throat irritation
- In severe cases: vomiting blood or black stools (from ulceration)
If you experience reflux that persists despite medication, it’s worth consulting a specialist.
4️⃣ Diagnosis of Hiatal Hernia
A few simple, non-invasive tests confirm the diagnosis:
- Upper GI Endoscopy: Direct visualization of the hernia and any reflux damage
- Barium Swallow X-Ray: Shows stomach’s position in the chest
- Esophageal Manometry: Measures muscle strength and coordination during swallowing
“Endoscopy remains the gold standard — it helps us assess both the hernia and the degree of reflux,” says Dr. Kapoor.
5️⃣ Treatment Options
a. Lifestyle & Medical Management (for small hernias)
- Eat smaller, more frequent meals
- Avoid lying down for 2–3 hours after eating
- Elevate head while sleeping
- Avoid spicy foods, caffeine, and alcohol
- Maintain healthy body weight
- Proton Pump Inhibitors (PPIs) or antacids may reduce acid production
b. Surgical Management (for large or symptomatic hernias)
When symptoms persist or complications arise, laparoscopic hiatal hernia repair is recommended.
This involves:
- Gently repositioning the stomach into the abdomen
- Tightening the diaphragm opening
- Reinforcing the area with surgical mesh if needed
- Often combined with fundoplication (wrapping the stomach around the esophagus) to prevent acid reflux
“Laparoscopic repair offers a near-permanent cure — most patients resume normal life within a few days,” explains Dr. Kapoor.
6️⃣ Recovery and Outlook
- Hospital stay: 1–2 days
- Diet: Liquids for 2–3 days, then soft foods
- Return to work: 5–7 days
- Long-term results: Over 90–95 % success rate with minimal recurrence
7️⃣ When to See a Doctor Immediately
Seek urgent help if you experience:
- Sudden, severe chest or abdominal pain
- Persistent vomiting
- Difficulty breathing or swallowing
- Black, tarry stools (sign of internal bleeding)
Conclusion
Hiatal hernia is common but highly manageable when diagnosed early. Modern laparoscopic techniques now offer quick recovery, minimal discomfort, and lasting relief from chronic reflux.
For expert evaluation and advanced hiatal hernia treatment, consult Dr. Rajeev Kapoor, one of Chandigarh’s most trusted names in gastrointestinal and minimally invasive surgery.
