A hiatal hernia occurs when part of your stomach pushes up into your esophagus through the opening that separates your chest from your stomach (esophageal hiatus in the diaphragm). This prevents the esophageal sphincter from closing completely, which can cause food and stomach acid to back up into your esophagus, called acid reflux.
Hiatal hernias may be caused by increased pressure in your abdomen when you lift something heavy, push during a bowel movement, cough, or vomit. You can also get a hiatal hernia during pregnancy or from a buildup of fluid in your abdomen.
Risk Factors
Hiatal hernias affect men and women of all ages, but it mainly occurs in people 50 and older. People who are overweight or smokers have a greater risk of developing a hiatal hernia.
Symptoms
Hiatal hernias often don't cause symptoms. When there are symptoms, they can mimic some that happen with gastroesophageal reflux disease (GERD), including:
- Bloating and burping
- Chest pain
- Heartburn
- Pain in your throat or stomach
- Regurgitation of undigested food or liquid
- Sour or bitter taste in the back of your throat
At the University of Miami Health System, we offer a full range of the latest treatments for hiatal hernias. You get personal attention and a treatment plan that gives you the best results. You can be confident you’re working with a knowledgeable, experienced team
Tests
Barium Swallow
Your doctor will have you swallow a liquid dye (barium). They will use an X-ray to watch you swallow the liquid and evaluate the function of your esophagus.
Endoscopy
This imaging test uses a flexible, narrow tube and viewing device (endoscope) guided into your esophagus. This lets your doctor take a closer look at the inside of your esophagus.
Manometry
Manometry is a type of endoscopy that uses pressure sensors to measure your muscle contractions when you swallow.
Bravo™ Esophageal Test
This test measures the amount of acid that comes into your esophagus from your stomach. Your doctor uses an endoscope to put a small capsule in the wall of your esophagus. The capsule measures the amount of acid and sends the information to a receiver you wear on your wrist or around your waist for two days. They will give you instructions about what to do at home during the test. The capsule will pass through your system in a bowel movement after the test.
24-Hour pH Impedance Study
This test measures the amount of reflux that enters your esophagus over 24 hours to see if acid reflux is causing your symptoms. Your doctor guides a flexible tube through your nose and gives you water to swallow, which moves the tube down your throat. They take the other end of the tube, wrap it around your ear, and attach it to a device you wear around your waist. You'll be able to breathe, swallow, and talk comfortably during the test. You'll return the next day to have the tube removed.
Endoscopic Functional Luminal Imaging Probe (EndoFLIP®)
This procedure uses a flexible tube with a balloon at the end, which is fitted with sensors. The test measures the distance across your esophagus and the pressure within it. This information tells your doctor about the stiffness of your esophageal muscles.
Treatments
Lifestyle Modifications
Your doctor may recommend lifestyle changes to reduce symptoms. They may tell you to avoid acidic or fatty foods that cause heartburn, eat at least a few hours before bedtime, avoid lying down after eating, and eat several smaller meals instead of three large meals each day. If you're overweight or a smoker, losing weight and quitting smoking can also help improve your symptoms.
Medication
Your doctor may recommend over-the-counter antacids or prescribe medicines that slow your body's production of stomach acid.
Surgery
If lifestyle changes and medicine don’t relieve symptoms, your doctor may suggest surgery. The procedure will depend on the repairs needed to restore normal function of your esophagus. Our surgeons use minimally invasive approaches that use small incisions, which can help you recover more quickly.
Why Choose UHealth?
Fast, accurate diagnosis. We have the only motility lab in South Florida, which allows our GI specialists to provide accurate results faster. That means they can begin treatment right away, and you can feel better sooner.
Expert care for digestive conditions. Our digestive health experts care for a full range of conditions – from an upset stomach to colorectal cancer. As an academic medical center, we offer the latest, proven approaches backed by the leading-edge research of the University of Miami Miller School of Medicine.
A comprehensive team. Digestive health specialists work as a team with dietitians, surgeons, and other specialists to ensure you get complete care. You work with a team that gives you individual attention and treatment that offers you the best possible results.
Leaders in robotic surgery treatment. We have some of the world’s most experienced robotic surgeons for minimally invasive procedures. We were the first academic medical center in the world to get the da Vinci Xi robotic surgery system. Our surgeons have completed more than 5,000 robotic surgeries — procedures that offer less pain and scarring and a faster recovery.
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