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What is the role of hiatal hernia in gastroesophageal reflux disease (GERD)?

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Some doctors believe a hiatal hernia may weaken the lower esophageal sphincter (LES) and increase the risk for gastroesophageal reflux. Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. (The diaphragm is the muscle separating the abdomen from the chest.) Recent studies show that the opening in the diaphragm helps support the lower end of the esophagus. Many people with a hiatal hernia will not have problems with heartburn or reflux, but having a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.

Coughing, vomiting, straining, or sudden physical exertion can cause increased pressure in the abdomen, resulting in hiatal hernia. Obesity and pregnancy also contribute to this condition. Many otherwise healthy people age 50 and over have a small hiatal hernia. Although considered a condition of middle age, hiatal hernias affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated (twisted in a way that cuts off blood supply) or is complicated by severe GERD or esophagitis (inflammation of the esophagus). The doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.

From: Gastroesophageal Reflux Disease (GERD) WebMD Medical Reference

Reviewed by Minesh Khatri on September 17, 2019

Medically Reviewed on 9/17/2019

SOURCES: 

National Institute of Diabetes and Digestive and Kidney Diseases: "Heartburn, Gastroesophageal Reflux, and Gastroesophageal Reflux Disease (GERD)."

Pluta, R. , May 18, 2011. Journal of the American Medical Association

American College of Gastroenterology: "Understanding GERD." 

Reviewed by Minesh Khatri on September 17, 2019

SOURCES: 

National Institute of Diabetes and Digestive and Kidney Diseases: "Heartburn, Gastroesophageal Reflux, and Gastroesophageal Reflux Disease (GERD)."

Pluta, R. , May 18, 2011. Journal of the American Medical Association

American College of Gastroenterology: "Understanding GERD." 

Reviewed by Minesh Khatri on September 17, 2019

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What other factors contribute to gastroesophageal reflux disease (GERD)?

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