A hiatal hernia is a condition in which a part of the stomach protrudes upward into the chest through an opening in the diaphragm.  It is more common in people who are obese, particularly upper middle-aged people as well as in smokers.  Most of those with a hiatal hernia are asymptomatic, but in some, spasms in the esophagus can result in acid reflux and bloating after meals.  A special chiropractic adjustment technique can help relieve hiatal hernia.

Western Treatments

If you experience heartburn or acid reflux as a symptom of hiatal hernia, your doctor may prescribe medications that include the following:

• Antacids that neutralize stomach acid.  Over-the-counter antacids, such as Gelusil, Maalox, Mylanta Rolaids and Tums, may provide quick relief.
• Medications to reduce acid productions.  Called H-2 receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) and ranitidine (Zantac 75).  Stronger versions of these medications are available as prescriptions.
• Medications that block acid production and heal the esophagus.  Proton pump inhibitors block acid production and give the esophageal tissue time to heal.  These inhibitors include lansoprazole (Prevacid 24HR), and omeprazole (Prilosec OTC).  Stronger versions of these medications are available as prescriptions.

Surgery

In a small number of patients, surgery is required to address hiatal hernia.  This option is generally reserved for emergency situations and for those who do not respond to medications meant to relieve heartburn and acid reflux.  Hiatal hernia repair surgery is often combined with surgery for gastro esophageal reflux disease.

An operation for a hiatal hernia may involve pulling your stomach down to your abdomen and making the opening in your diaphragm smaller, reconstructing a weak esophageal sphincter, or removing the hernia sac.  IN some cases, this is done using a single incision in your chest wall (thoracotomy) or abdomen (laparotomy).  In other cases, your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen.  The operation is then performed while your surgeon views images of the inside your body that are displayed on a video monitor (laparoscopic surgery).

A TCM Approach

To help move food through the digestive system and eliminate bloating, I have used a formula including the following:

• Poria sclerotium
• Coix seed
• Barley Shen Qu
• Magnolia Bark
• Angelica Root
• Pueraria root
• Plus eight other herbs

This mixture is sometimes combined with a formula including:

• Calcium carbonate
• Bupleurum root
• Ginseng root
• Ginger rhizome
• Pinellia rhizome
• Scute root
• Plus four other herbs

When phlegm signs are present, the following formula is useful:

• Pinellia rhizome
• Citrus peel
• Poria sclerotium
• Aurantium fruit
• Bamboo shavings
• Arisaema rhizome
• Plus three other herbs

To help address abdominal spasms, use:

• White Peony root
• Pueraria root
• Clematis root
• Spatholobus stem
• Licorice root
• Plus two other herbs

For spasms accompanied by loose stools, use the previous formula with the following:

• Bupleurum root
• Pueraria root
• Pinellia rhizome
• Cinnamon twig
• White Peony root
• Plus four other herbs