What’s the Difference Between Hiatal Hernia and Acid Reflux?

Hiatal hernia is a condition that can result in heartburn and acid reflux but can be remedied naturally.

What is Hiatal Hernia?

Hiatal hernia is a condition in which the upper part of the stomach pushes through the diaphragm. The diaphragm muscle has a small opening called the hiatus through which the esophagus passes before connecting the stomach. With hiatal hernia, the stomach bulges through that opening into the chest wall.

There are also two types of hiatal hernias called sliding and fixed. A sliding hiatal hernia is usually small and occurs when the stomach and esophagus slide in and out of the chest through the hiatus. It rarely causes symptoms and doesn’t require treatment. A fixed hiatal hernia, also known as paraesophageal hernia, happens when the stomach pushes through the diaphragm and stays there. Most cases are not serious, though there is a risk with a blood flow blockage to the stomach which is considered a medical emergency.

If you’ve been diagnosed with hiatal hernia, you may have been surprised with the news. This condition is actually a common problem. With small hiatal hernias, there may be no symptoms but acid reflux can be one of the first signs. Though not the same, both hiatal hernia and acid reflux go hand in hand. More than 90 percent of people with hiatal hernia have acid reflux.

What are the Symptoms of Hiatal Hernia?

Small hiatal hernias usually have no signs or symptoms. However, larger hiatal hernias can cause a variety of symptoms – some of which are serious. Following are some symptoms of this condition.

  • Heartburn
  • Chest discomfort
  • Upper abdominal pain
  • Constant burping
  • Acid taste in mouth
  • Food/liquid regurgitation
  • Gastrointestinal bleeding (bloody vomit or stools)
  • Swallowing difficulties
  • Nighttime choking, coughing, or wheezing
  • Shortness of breath

How Can I Find Out if I Have Hiatal Hernia?

Your health practitioner can determine if you have hiatal hernia through a physical exam or tests. However, an evaluation is only necessary if you have symptoms that are bothersome. Following are some tests that your doctor may recommend.

  • Upper gastrointestinal (GI) barium x-Ray – detects hiatal hernia and its severity
  • Endoscopy – determines esophageal irritation
  • Esophageal manometry – measures the pressure of the lower esophageal sphincter (LES)
  • 24-hour acid (pH) monitoring test – measures reflux coming into the esophagus

What Causes Hiatal Hernia?

There are several causes of hiatal hernia, but most are not determined unless symptoms arise quickly after its initiation. For the most part, injury or damage weakens the muscle tissue which makes the hiatal hernia possible. Following are some reasons for the condition.

  • Coughing
  • Vomiting
  • Bowel straining
  • Lifting heavy objects
  • Age-related changes in the diaphragm
  • Congenital (i.e., born with an unusually large hiatus)
  • Injury to the area (i.e., trauma or surgery)
  • Obesity
  • Smoking

How do I Reduce Hiatal Hernia Symptoms?

As mentioned earlier, most hiatal hernias are not serious. Conventional medicine will recommend over-the-counter medications to neutralize stomach acid and lower or prevent acid production. This may include antacids, H2 receptor blockers, and proton pump inhibitors. If these medications do not work, surgery may even be recommended to rebuild weak esophageal muscles and putting the stomach back in place while making the hiatus smaller. Even with surgery, hiatal hernia can unfortunately return.

However, alternative medicine has a different approach and believes that an overproduction of stomach acid is not the problem. Because acid reflux is a symptom of hiatal hernia, and not a disease, it is usually low stomach acid that that contributes to the problem. Following are a few natural ways to fix hiatal hernia.

Physical Manipulation Technique

For most, physically manipulating hiatal hernia can provide relief. One technique includes putting about five pounds of pressure on the hernia and pushing the stomach back into place. You can do this yourself or have someone help you. The second technique is probably an easier technique, but it’s not as reliable as the first. It includes drinking a glass of water, raising the arms parallel to the floor, and hopping. Please see the videos below to learn how to do both techniques.

Low Acidic Diet

A whole foods, natural diet low in acidic foods will help hiatal hernia and acid reflux symptoms. A ketogenic diet, as well as a carnivore diet. Opt for certified organic, grass-fed/finished, pasture raised, and wild cuts of meat and eggs. You may also want to try low-acid vegetables and fruits like broccoli, cabbage, green beans, apples, strawberries, and avocados. Feta and goat cheese are low-acidic dairy options. For a full list of low-acidic foods, you may google.

Digestive Supplements

Though acid reflux seems to trigger a lot of acid in the esophagus and the mouth, the problem is actually not due to “too much” acid in the stomach. Acid reflux is not a disease of producing too much acid. As mentioned earlier, it is a condition related and brought on by hiatal hernia. Acid reflux is usually caused by a reduction of hydrochloric acid produced by the stomach. Therefore, certain dietary supplements may help build up the right amount acid to reduce acid reflux and protect the immune system. Following are a few.

Pure Encapsulations® Digestive Enzymes Ultra with Betaine HCl

Pure Encapsulations® Heartburn Essentials

Also, bitter vegetables and herbs are helpful, including a high quality apple cider vinegar. Read How to Make an Apple Cider Vinegar Drink to Boost Gut Bacteria.

Omega Nutrition Certified Organic Apple Cider Vinegar


If you have symptoms of hiatal hernia, you can most likely reduce them with physical manipulation techniques, diet, and digestive supplements. Acid reflux is the most common symptom. This isn’t a disease that produces too much stomach acid. In fact, stomach acid is very important for digestion as well as keeping the immune system healthy. Because acid reflux is a symptom of hiatal hernia, it is a result of not having enough stomach acid.


Dr. Abby Campbell
EditorDr. Abby Campbell
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