Sliding hiatal hernia is the most common type of hiatal hernia, wherein the junction of the esophagus and stomach, known as the gastro-esophageal junction, and a part of the stomach protrude into the chest due to a tear or weakness in the diaphragm. The junction may stay permanently in the chest, but sometimes it just moves up the chest only during swallowing. This happens because with each swallow, the muscle of the esophagus contracts causing the esophagus to shorten and to pull up the stomach. After swallowing, the herniated part of the stomach falls back into the abdomen.
Usually, the mild sliding type of hernia has no symptoms. The larger and the more severe the hernia is, the more are the symptoms experienced by the patient. In addition, the symptoms are almost always the same with that of gastroesophageal reflux disease or GERD. These symptoms include dull chest pain, belching, nausea, and heartburn which is caused by the reflux of acid contents into the esophagus. The patient also experiences shortness of breath caused by the hernia’s effect on the diaphragm, and heart palpitations due to irritation of the vagus nerve.
The possible causes of hiatal hernia includes any injury to the area; an inherited weakness in the surrounding muscles; being born with an unusually large hiatus; and persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement or while lifting heavy objects. Hiatal hernia is most common in people who are obese, smokers, and those who are 50 years old or more.
Most people don’t experience signs and symptoms, so they won’t be needing any treatment. Some would just need medications for heartburn such as antacids, h2-receptor antagonists, or proton pump inhibitors.
Lifestyle modifications may help control the signs and symptoms of acid reflux caused by a hiatal hernia. Consider eating several smaller meals throughout the day rather than a few large meals. Also try to avoid foods that trigger heartburn, such as chocolate, onions, spicy foods, citrus fruits and tomato-based foods. Avoid alcohol, stop smoking, lose weight, and avoid intake of fatty foods. Sit upright immediately after you eat, rather than lying down. Eat at least three hours before bedtime. Lastly, follow a regular exercise regimen to improve circulation all throughout your body.