Hiatal Hernia and Reflux: What Most People Miss
If you’ve been told you have a hiatal hernia, you may have also been told “There’s not much you can do” or that your reflux is simply something that will need to be managed. But, there is one thing that is often overlooked - pressure and function matter just as much as structure.
What Is a Hiatal Hernia?
A hiatal hernia occurs when part of the stomach moves upward through the diaphragm into the chest cavity, affecting:
The position of the stomach
The function of the lower esophageal sphincter (LES)
How pressure is managed in the abdomen
Why It Contributes to Reflux
The diaphragm and LES normally work together to keep stomach contents where they belong, in the stomach. When a hiatal hernia is present this coordination becomes disrupted causing the LES to not close as effectively and reflux to become more likely.
The Missing Piece: Pressure
Reflux symptoms are often driven by increased pressure in the abdomen. When pressure builds stomach contents are pushed upward, worsening symptoms - especially after eating. The most common contributors to pressure include gas and bloating, constipation, overeating (or large meals), and tight clothing or posture. Even a small hernia can become symptomatic when pressure is high.
The Gut Connection
Many people with hiatal hernia also experience gas, bloating, digestive discomfort - and can often lead to gut dysbiosis/imbalance, SIBO, and/or poor digestion. Addressing the gut can help reduce pressure, ultimately helping alleviate symptoms.
The Role of the Nervous System
Stress plays a key role in both reflux and hernia symptoms. When stress is elevated digestion slows, pressure increases, and muscle tension (including the diaphragm) changes. The gut-brain connection matters here too.
Why Symptoms Fluctuate
One of the most frustrating aspects of a hiatal hernia is inconsistency in symptoms; some days are more manageable, other days symptoms will flare. This is most often due to changes in pressure, stress, and digestion - not just the presence of the hernia itself.
An Integrative Approach to Hiatal Hernia & Reflux
At Sun Valley Natural Medicine, we don’t just focus on the diagnosis, we look at how your body is functioning. Our approach may include:
Reducing abdominal pressure (bloating, constipation)
Supporting digestion (acid, enzymes)
Addressing gut imbalance or SIBO
Improving motility
Supporting the nervous system
Lifestyle and postural considerations
The goal of treatment is not to just manage reflux, but to reduce the factors that may be driving the symptoms (i.e. structure, function, and pressure).
If you’ve been told “there’s nothing you can do,” that’s not the full picture. When you address pressure, digestion, and function,
symptoms can improve, and often with lasting outcomes.