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Sliding Hiatus Hernia

Separating the lungs from the stomach is a sheet of muscle called the diaphragm. The diaphragm expands and contracts to suck in air into the lungs. A small hole in the diaphragm allows the food passage or esophagus to carry food and liquid into the stomach. This small hole or hiatus usually fits tightly around the esophagus ensuring that food or liquid does not trickle into the air passage. However, due to a number of reasons, the hiatus may weaken or even enlarge allowing the stomach to move up and down through the hiatus.

Hiatal hernia may occur due to hereditary reasons, obesity, strain or damage to the core muscles during physical activity, heavy exercise such as boxing or weight lifting, or even pressure due to abnormal bowel movement.

In sliding hiatus hernia, a portion of the stomach slides back and forth through the hole into the chest region. Most cases of mild sliding hiatal hernia may cause no pain and show very few major symptoms. However, complicated cases or serious hiatus hernia may require surgery to correct the problem.

Sliding Hiatus Hernia Symptoms, Treatment, Diagnosis & Causes


Some sliding hiatus hernia symptoms may go unnoticed due to the small size of the hiatus. Individuals may not encounter any major problems or complications from small sliding hiatus hernia conditions. However, in the case of enlarged hiatus, individuals may suffer from symptoms such as:

  • Heartburn or acid reflux
  • Regurgitation of food or belching
  • Pain or pressure in the chest region caused by the stomach heaving up through the hiatus and constricting the esophagus, and nausea and vomiting.

While most cases of sliding hiatus hernia may not cause many problems, sometimes complications may occur. These may lead to inflammation, chronic bleeding causing anemia, scarring of tissue, narrowing of the esophagus and stomach acids flowing into the lungs causing breathlessness.


In case of sliding hiatal hernia, treatment may be required only in certain rare cases where severe complications arise or there is concern over dislocation. Otherwise, sliding hiatal hernia cure may comprise of medications and a change in diet and lifestyle. In certain cases, sliding hiatal hernia repair may be suggested by your doctor to either lessen the size of enlargement or strengthen the diaphragm. In some individuals, the acid reflux due to a sliding hiatal hernia may cause unbearable pain, inflammation, and even bleeding. Your doctor may suggest surgery for sliding hiatal hernia in such cases. This may involve reconstructing the weakened esophageal hole or hiatus. Other sliding hiatal hernia treatments may include

  • Antibiotic medication to relieve heartburn or acid reflux, antacids or other stomach acid neutralizers. Ensure that you follow any medication for sliding hiatal hernia treatment under the supervision of your doctor. Many of these medications may have severe side effects due to prolonged use or when mixed with other existing medications. Talk to your doctor about your specific condition and enquire about sliding hiatal hernia natural treatment.
  • Acid reflux caused by sliding hiatal hernia may be reduced through few changes in your diet and general lifestyle. Eating smaller, more frequent meals throughout the day may help reduce the strain on your digestive tract. Avoid acid reflux triggers such as caffeine or caffeinated beverages, smoking, alcohol, spicy or oily food, fatty foods, citrus fruits such as oranges and lemons, citrus juices or drinks, tomato based foods, onions and garlic, and so on.
  • Other than dietary changes, your doctor may also prescribe certain cautionary moves to reduce the risk of acid reflux. These include eating your meals at least three hours before bedtime, not lying down immediately after a meal, and positioning your pillow or the head of the bed such that it may be elevated by about six inches. The gravitational pull should avoid symptoms of heartburn or acid reflux. Obesity may worsen the condition in individuals suffering from sliding hiatal hernia.
  • Although individuals with sliding hiatal hernia should avoid heavy physical activity, you may practice moderate intensity exercise to lose weight. Another acid reflux trigger includes stress. Therefore, sliding hiatal hernia natural treatment may include reducing stress by practicing breathing exercises, Yoga or Tai Chi, enabling you to calm your mind and provide stress relief.


Tests to determine a sliding hiatal hernia may include an X-ray or an endoscopy exam. In the case of an X-ray exam, individuals drink a medicated liquid that covers the upper digestive tract, including the throat, esophagus, stomach, and small intestine. This allows your doctor with a clear silhouette of your upper digestive tract. It also enables them to determine if you suffer from an enlarged hiatus or if there has been a shift or movement of the stomach through the hiatus. Endoscopy shows a clear sliding hiatal hernia prognosis and allows your doctor to determine further course of action to treat it.

During an endoscopy exam, a supple elastic tube attached with a video camera may be inserted through the throat into the individual's esophagus and stomach to determine any inflammation, scarring or bleeding. Other tests or procedures used to determine sliding hiatal hernia includes an ultrasound of the abdomen to check for abnormalities, esophageal Ph monitoring to check for abnormal levels of acid in the esophagus over 24 hours, and a cardiac evaluation consisting of electrocardiogram to rule out any heart conditions.


It is difficult to determine the exact cause of sliding hiatal hernia in individuals. However, possible causes may include

  • A history of this condition in the individual's family.  A history of weakened diaphragm muscles, which may cause enlarged hiatus.
  • Strain or injury to the area due to intense physical activity such as weightlifting or accident

Repetitive activities that may cause pressure on the diaphragm such as continuous coughing, wheezing, vomiting, or strain during bowel movement may provide other causes for sliding hiatal hernia. In some cases, a congenital reason, such as being born with an enlarged hiatus or weak diaphragms may also register as sliding hiatal hernia causes.

Submitted on January 16, 2014