Doctors usually diagnose a hiatal hernia in people trying to determine the cause of their heartburn.

A hiatal, or hiatus, hernia occurs when the upper part of the stomach pushes through an opening in a large muscle called the diaphragm, which separates your abdomen from your chest. This condition causes part of your stomach to push up into your chest region.

Doctors don’t know the exact cause, but hiatal hernias are more common in people ages 50 and older, people who are overweight, or who are pregnant.

You may not know you have a hiatal hernia, as it often does not cause symptoms. A hiatal hernia can cause acid reflux, heartburn, and other symptoms that can make you feel sick.

Let’s go over how a hiatal hernia can cause heartburn, other symptoms of a hiatal hernia, how to treat heartburn caused by this condition, and when to see a doctor.

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A hiatal hernia is sometimes associated with gastrointestinal conditions like gastroesophageal reflux disease (GERD) and typically manifests with symptoms of heartburn and regurgitation.

GERD is a condition that occurs when stomach content — including stomach acid — persistently flows back into the long muscular tube called the esophagus, which connects the mouth and the stomach. The backflow of the acid content of the stomach into the esophagus is called acid reflux.

In a 2021 study that evaluated 728 people with GERD, 95.4% had hiatal hernias, showing that these two conditions are closely linked.

People with a hiatal hernia are at a higher risk of developing GERD because the upper part of their stomach bulges into the chest cavity, making it harder for food to push down properly. A hiatal hernia also makes it hard for the diaphragm to properly place pressure on the esophagus to prevent acid reflux.

Heartburn is one of the most common symptoms of GERD, as the refluxed acid in the esophagus causes a burning sensation in the chest. Heartburn is also the most common complaint among people with hiatal hernias. In people with a hiatal hernia who experience acid reflux, heartburn typically occurs after eating or when lying in a reclined position.

But many people with hernias, especially those with small hiatus hernias, may not show these symptoms.

Older research from a 2014 study involved 75 people with hiatal hernias using a self-assessed questionnaire. Results indicated that those with a large hiatus hernia were more prone to heartburn and acid regurgitation compared with those with small hernias.

Other symptoms of a hiatal hernia include:

Heartburn can be inconvenient and painful. Below are some home remedies that may help.

Licorice supplement

A 2017 observational study suggests that taking supplements or herbal formulas containing licorice root may relieve heartburn. But it’s best not to take too much to avoid health issues like high blood pressure and low potassium levels.

Chew gum

Interestingly, chewing gum may provide some relief from heartburn. This is because chewing gum stimulates the production of saliva, which may help dilute and clear out the stomach acid in the esophagus.

Baking soda

Sodium bicarbonate, commonly known as baking soda, is an alkaline substance. Some people use it as an antacid for treating stomach acidity symptoms like heartburn. But it’s best to speak with a doctor about this before using this treatment method to prevent excess reduction of stomach acid or destabilizing your electrolyte level.

Avoid trigger substances

Some foods or substances you ingest can trigger acid reflux and heartburn, including:

  • alcohol
  • coffee or caffeinated beverages
  • tomatoes
  • cigarette
  • spicy and fatty foods

These foods may increase stomach acid production or reduce the pressure on a valve called the lower esophageal sphincter (LES), which lies between the end of the stomach and the stomach. It functions to prevent stomach content from flowing back into the esophagus.

If you’ve received a diagnosis of hiatal hernia, you may experience symptoms like heartburn, bloating, and trouble swallowing. Speak with your doctor if your symptoms persist or worsen. Also, let them know if you’re experiencing unintended weight loss or nausea and vomiting.

Your doctor may suggest any of the following treatments if you’re experiencing heartburn due to a hiatal hernia.

Medications to neutralize or reduce acid production

These may include medications like over-the-counter (OTC) antacids for treating occasional acid reflux. Medication options may also include H2 receptor blockers to help reduce stomach acid production. These include famotidine (Pepcid AC) and cimetidine (Tagamet HB).

Medications that block stomach acid production

Medications like proton pump inhibitors (PPIs) block stomach acid production and may enable the esophagus to heal from wounds caused by constant acid reflux. Your doctor may recommend an OTC PPI or prescribe a stronger one.

Surgery

A doctor may recommend surgery to repair a hiatal hernia if it’s causing you severe heartburn or other complications. The surgery may involve:

  • reconstructing your esophageal sphincter
  • making the opening in your diaphragm smaller
  • pulling your stomach down from the chest region into your abdominal region, where it’s supposed to be

Most people with a hiatal hernia may not need treatment because they don’t always cause problems, especially when the hiatal openings are small.

But if you’re experiencing persistent symptoms like heartburn, pain when swallowing, sickness, or a bloated feeling, it’s recommended that you speak with a doctor about an ideal treatment option.