Hiatal Hernia: Is it Related to Back Pain?

Hiatal hernia is a hernia of the stomach. It normally affects people over the age of 50. 90% of people with Hiatal hernia will face mild or no symptoms. It can normally be treated with lifestyle adjustments and also by medication to alleviate the symptoms.

Many people with Hiatal hernias may experience some problematic symptoms. These symptoms can include Hiatal hernia pain radiating to the back, acid reflux, heartburn, etc.

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This can make it difficult to live with a hiatal hernia without any form of intervention. In some cases, surgery may be required to correct the problem.

In this article, we’ll take a look at how Hiatal hernias occur and what you can do to manage them.

How Do We Define Hiatal Hernia?

Hiatal hernia is the hernia of the stomach. It occurs when a part of the stomach protrudes from the abdominal cavity into the thorax.

The stomach is separated from the chest cavity by a sheet of muscle called the diaphragm. The diaphragm has several openings. These are there to allow some important structures through from the upper half of the body to the lower half.

Define Hiatal Hernia

These are the esophagus leading to the stomach, the inferior vena cava reaching the heart, and the descending aorta reaching the lower parts of the body.

A hiatal hernia occurs when the esophageal opening of the diaphragm is weakened and enlarged. This causes a part of the stomach to squeeze through to the chest cavity. This causes problems related to digestion and chest pain.

The exact cause of Hiatal hernia is still not known. Hiatal Hernia in children is not as common. But they are most likely caused by birth defects, congenital anomalies, or hereditary factors.

Most of the time hiatal hernias don’t show any symptoms and are not considered to be life-threatening. Large hernias however may lead to severe complications and can only be treated by surgery.

What Are The Signs of a Hiatal Hernia?

Most of the time hiatal hernia shows no signs or symptoms. They are discovered by accident by some other unrelated investigation or checkup.

The majority of the signs of Hiatal hernia are very similar to GERD or Gastroesophageal Reflux Disease. So there may be a chance of it being misdiagnosed.

The signs of Hiatal hernia are:

  • Burning sensation in the chest or heartburn. It is commonly felt in the front of the chest, just behind the breastbone. It is most prominent right after eating.
  • Regurgitation or having small bits of bitter-tasting digested food or fluid coming back up to the mouth. This phenomenon is called acid reflux.
  • It causes difficulty or pain in swallowing food
  • Hiatal hernias cause burping and belching after taking food
  • It causes persistent bad breath and doesn’t go away
  • It can make you feel bloated, tired, or sick after a meal
  • Chronic indigestion
  • Nausea and vomiting

Hiatal hernia causes the stomach to push up against the esophagus. Thus upsetting the digestive tract and the lower esophageal sphincter. This causes the backflow of acidic food materials from the stomach.

So these symptoms can be exaggerated by movement like bending over or lying down. If you find that the symptoms of Hiatal hernia are getting worse, contact your doctor immediately.

Does Hiatal Hernia Cause Back Pain?

A hiatal hernia can cause pain to spread from the chest to other parts of the body. This is called referred pain.

Hiatal Hernia Cause

People often complain of Hiatal hernia pain between the shoulder blades. It can also spread to the chest, jaw, and rarely, to the back. Back pain is not a common symptom of a hiatal hernia.

If you are experiencing back pain and hiatal hernia at the same time, the back pain is most likely being caused by some other factor. It might not be related to the hiatal hernia.

In any case, if you are experiencing back pain while suffering from a hiatal hernia, consult a doctor at once. The back pain may be the sign of something more serious that warrants immediate medical attention.

Heartburn, chronic abdominal pain or kidney diseases can show symptoms similar to a Hiatal hernia. It can also cause back pain. So be sure to go to a hospital and get yourself checked.

Treatment of Hiatal Hernia

As most Hiatal hernias tend to be harmless, treatments are designed mainly to reduce the symptoms rather than to correct the problem. Adopting a healthier lifestyle and taking some medication can be enough to bring a hiatal hernia completely under control.

But in more severe cases like strangulated or incarcerated hiatal hernia, surgery is recommended to prevent any life-threatening complications.

The three levels of Hiatal hernia treatment are as follows:

Lifestyle Changes

Lifestyle changes for Hiatal hernia mean adjusting everyday life to mitigate the factors leading to hiatal hernia or to minimize its effects.

For that, it’s important to know what kind of behaviors or activities worsen the Hiatal hernia or exaggerate its symptoms.

The target group most likely to develop a Hiatal hernia or GERD is above the age of 50. So people of this age group need to know what factors affect Hiatal hernia and what kind of lifestyle adjustments are necessary to combat them.

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Obesity is the number one factor responsible for hernia and back pain. So, it’s necessary to keep your weight under control.

Eat a balanced diet. Eat less and control the number of calories you take. Avoid fatty junk food, desserts, and sugary foods.

Hiatal hernia diet should consist of healthy meals with lots of vegetables rich in fiber. Taking green tea helps keep weight under control. 

There are also many alternative supplements you can add to your diet to help reduce fat build-up and weight gain. Check out Tox Flush, one of our favorites.

Try to get some exercise every day. Simple exercises like walking, cycling, yoga, etc. are great for keeping weight under control. But don’t take any undue stress on your body.

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Overextending yourself may lead to injury or even cause severe problems. Avoid lifting heavy weights and strenuous exercises as they can cause your hernia to get worse.

Talk to your doctor before starting any intense work-out regimen and discuss what Hiatal hernia exercises are safe for you.

The next step is to simply adjust your lifestyle in a way that accommodates for Hiatal hernia:

  • Don’t take foods that cause your symptoms to worsen.
  • Avoiding stooping down or bending over.
  • Don’t lie down immediately after eating.
  • Keep your head raised from the rest of your body while sleeping so the acid reflux does not travel back up your throat.
  • Avoid coughing violently as it may cause your hernia to weaken or rupture.
  • Avoid tight-fitting clothes.
  • Quit smoking. Tobacco is known to cause gastrointestinal irritation and may worsen your symptoms.

Over-the-counter Medication

Many kinds of drugs are available to help mitigate the symptoms of hiatal hernia and gastroesophageal reflux. These medications can be obtained by both prescription and over-the-counter.

These drugs are mainly advised to help minimize the symptoms of reflux like acidity and heartburn but only provide short-term relief. It should also be mentioned that for any long-term medication. You should always consult a doctor.

Three kinds of drugs are mainly prescribed: antacids, histamine blockers, and proton pump inhibitors.

Antacids counteract the acid produced in the stomach, neutralizing them. This provides relief from pain and diminishes symptoms like belching and heartburn.

Some popular antacids are

  • Aluminum hydroxide
  • Magnesium hydroxide
  • Calcium carbonate

Histamine blockers or H-2 blockers reduce the amount of acid secreted by the stomach. This reduces all other symptoms related to GERD and is a great choice to treat Hiatal hernia.

There are many kinds of histamine blockers available:

  • Ranitidine
  • Nizatidine
  • Cimetidine
  • Famotidine

Proton pump inhibitors block the production of acid in the stomach. So these meds are very effective and also help tissues damaged by stomach acid to heal. They are the medications of choice which are prescribed to patients suffering from acid reflux.

These proton pump inhibitors include:

  • Pantoprazole
  • Omeprazole
  • Lansoprazole

Surgery

Surgery is never the first choice for the treatment of a Hiatal hernia. It is most often regarded as a last resort. Surgery is recommended by the doctor only when the hernia is large or complicated.

Or if the symptoms of the hernia are not responding to any other form of treatment.

Hiatal hernia surgery can be conducted with minimal invasion by using techniques like laparoscopic surgery or ‘keyhole’ surgery. They can also be done openly if the condition of the hernia is too severe or complicated.

Hiatal hernia surgery

The surgery to correct Hiatal hernia may consist of the following procedures:

  • Pulling down the stomach to a level below the diaphragm, relieving the hernia.
  • Strengthening the esophageal opening of the diaphragm.
  • Strengthening the area of the diaphragm near where the stomach lies.
  • Fixing the stomach to a position below the diaphragm, to prevent recurring hernias.

After laparoscopic surgery, the patient generally doesn’t feel much pain, but there might be some discomfort while swallowing. The patient can walk the day after the surgery and may be allowed to go home when they recover from anesthesia.

The patient is also advised to follow some precautions in the following weeks after the surgery. They should avoid lifting heavy loads and drinking through a straw.

Patients should only take soft foods for a few days, take medications properly, and get adequate rest.

If all goes well, they should be completely free from any symptoms of Hiatal hernia.

Conclusion

You can manage Hiatal hernia quite easily. For that make the necessary lifestyle changes, take proper medication, and keep a positive mentality.

We hope this article helped answer your questions about hiatal hernia pain radiating to the back. You’ve also found the causes of hiatal hernia, and Hiatal hernia pain relief.

Let us know by commenting if our methods helped relieve your pain!

The FAQs About Hiatal Hernia Pain Radiating to Back

Q. What causes a Hiatal hernia to flare up?

Fatty foods, strenuous exercise, smoking, etc. are responsible for making Hiatal hernia symptoms worse.

Q. Can a hernia make your back hurt?

A hernia can cause chest pain, which can radiate to the shoulder, neck, or sometimes to the back. But back pain due to hernia is rare.

Q. How good is pantoprazole for Hiatal hernia?

Pantoprazole is a proton pump inhibitor. It stops the production of acid in the stomach and alleviates symptoms like irritation and heartburn, It is one of the best medications available for Hiatal hernia.

I'm a medical student from Bangladesh. As a doctor in the making, I'm fascinated by the regular advancements of medical science. This fuels my passion for trying to follow a health-conscious lifestyle. I love writing and sharing thoughts and ideas. I hope that my work can reach out and help people to enjoy a healthy, happy life. Muhtasim Munir MBBS (3rd year) Armed Forces Medical College

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