Chest Pain Connected with Hiatal Hernia: Remedies and When to Request Assistance
A hiatal hernia is a condition where the upper part of the stomach or another internal organ bulges through the opening in the diaphragm called the hiatus. This can lead to chest pain and is associated with gastroesophageal reflux disease (GERD) and heartburn.
Causes:
A hiatal hernia occurs when part of the stomach pushes upward through the diaphragm muscle via the hiatus, the opening normally allowing the esophagus to pass through. This can happen due to weakening or enlargement of the hiatus. Factors that contribute include aging, obesity, smoking, and increased pressure on the abdomen from heavy lifting, coughing, or straining.
Symptoms:
Many people with hiatal hernias have no symptoms. When symptoms occur, chest pain is a common complaint and may be due to acid reflux or irritation. Other symptoms include heartburn, acid reflux, difficulty swallowing, bloating, burping, abdominal pain, sore throat or hoarseness, nausea or vomiting, shortness of breath, and trouble breathing.
Chest pain related to hiatal hernia usually arises from GERD, which the hernia can cause by impairing the function of the esophageal sphincter, allowing acid to irritate the esophagus. In some cases, a hiatal hernia can affect the respiratory system, causing trouble breathing, an intense tightness in the chest, shortness of breath, and compression of the heart.
Treatment Options:
Treatment options for hiatal hernia may vary, with lifestyle changes, medications, and, in some cases, surgery being possible solutions.
- Lifestyle and Dietary Changes: Stopping smoking, eating small meals, avoiding oily or fried foods, caffeine, alcohol, and maintaining a moderate weight can help manage the symptoms of a hiatal hernia. Being upright while eating and eating at least before going to bed can also help.
- Medications: Proton pump inhibitors are medications used to treat heartburn, acid reflux, GERD, and stomach ulcers. Over-the-counter antacids can also help manage the symptoms.
- Surgery: If medications and lifestyle changes fail or complications develop, surgery may be recommended. Surgical options include repairing the hernia by repositioning the stomach and shrinking the hiatus opening, fundoplication, which strengthens the esophageal sphincter by wrapping the stomach’s upper part around it to prevent acid reflux, and other procedures like endoluminal fundoplication and transoral incisionless fundoplication.
Emergency medical care is required if symptoms like severe chest pain, vomiting, fever, inability to pass stool or gas, or blood in stool appear, as these may indicate a strangulated hernia, a medical emergency.
Only 9% of individuals over 50 years old with a hiatal hernia experience symptoms. If people suspect their hiatal hernia is worsening, they should contact a doctor.
It is important to note that chest pain can indicate a serious medical condition, such as a heart attack, and individuals should contact a doctor immediately if they experience chest pain. Chest pain related to GERD can feel similar to the pain associated with a heart attack. Individuals should contact a doctor if their symptoms persist for longer than 3 weeks, do not resolve from using OTC antacids, or worsen.
References: [1] Mayo Clinic. (2021). Hiatal hernia. https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20354796 [2] National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Gastroesophageal Reflux Disease (GERD). https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-gerd [3] American College of Gastroenterology. (2020). ACG Clinical Guideline: Diagnosis and Treatment of Gastroesophageal Reflux Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145124/ [4] British Society of Gastroenterology. (2017). British Society of Gastroenterology Guideline: Management of Gastro-oesophageal Reflux Disease. https://www.bsg.org.uk/media/1251/bsg-gord-guidelines-2017.pdf [5] National Health Service. (2021). Hiatus hernia. https://www.nhs.uk/conditions/hiatus-hernia/
- The diaphragm muscle's weakening or enlargement can lead to a hiatal hernia, where the upper part of the stomach or another internal organ bulges through the hiatus.
- Aging, obesity, smoking, and increased pressure on the abdomen from heavy lifting, coughing, or straining are factors that can contribute to the occurrence of a hiatal hernia.
- Symptoms of a hiatal hernia can range from no symptoms at all to chest pain, heartburn, acid reflux, difficulty swallowing, bloating, burping, abdominal pain, sore throat or hoarseness, nausea or vomiting, shortness of breath, and trouble breathing.
- Chest pain related to a hiatal hernia usually arises from GERD, which the hernia can cause by impairing the function of the esophageal sphincter.
- Lifestyle changes, such as stopping smoking, eating small meals, avoiding oily or fried foods, caffeine, alcohol, and maintaining a moderate weight, can help manage the symptoms of a hiatal hernia.
- Medications like proton pump inhibitors and over-the-counter antacids can also help manage the symptoms of a hiatal hernia.
- In some cases, surgery may be recommended for a hiatal hernia if medications and lifestyle changes fail or complications develop.
- GERD, a chronic disease, can have serious complications if left untreated, such as an increased risk of chronic respiratory conditions and esophageal cancer.
- It is essential to recognize that chest pain can indicate a serious medical condition, such as a heart attack, and immediate medical attention should be sought if chest pain is experienced.
- Routine medical examinations, like those offered by Medicare, can help detect potential health issues like a hiatal hernia, heart disease, and neurological disorders.
- In addition to heart health, maintaining overall health and wellness also involves managing mental health, skin conditions, hearing, eye health, nutrition, cardiovascular health, and fitness and exercise, among other aspects.
