Hiatal hernias result when a part of the stomach pushes through the diaphragm and up into the chest. Large hiatal hernias can produce acid reflux and other digestive problems. In some cases, surgery is required but self-care and medication can address symptoms.
Causes
Some people have a larger-than-normal esophagus hiatus--the opening in the diaphragm where the esophagus moves from the chest to the abdomen--reports Dr. Jay Marks of MedicineNet.com. This larger space allows the stomach to move through it. Other possible causes include a shortened esophagus, a loose attachment between the esophagus and diaphragm, injury to the area, and weakness or strain in nearby muscles.
Symptoms
Large hiatal hernias cause acid reflux, burping, chest pain and nausea, says the Mayo Clinic, as the hernia prevents the normal process that keeps stomach acid from flowing back up the esophagus.
Medication
Medications to reduce or block acid production, including over-the-counter antacids, proton pump inhibitors and H-2 receptor blockers, can relieve symptoms.
Self-Care
Avoiding fatty and spicy foods, eliminating caffeine, alcohol and tobacco, and eating smaller meals can ease symptoms. Avoid lying down for at least three hours after eating and elevate the head of your bed if your reflux is worse upon waking.
Surgery
Large hiatal hernias unmitigated by conservative treatments require surgery, which usually reduces the size of the esophagus hiatus and puts the displaced portion of the abdomen back in place.
