What signs indicate that GERD can lead to a hiatal hernia?

Question

Hello doctor,

I am a 45-year-old woman with a history of gastroesophageal reflux disease (GERD), but my symptoms have recently changed. I have started experiencing severe bloating and sharp pains in my abdomen, particularly after meals. The nausea has also become more frequent, and it has started to interfere with my daily routine. I am concerned that it might be something more complicated, like a hiatal hernia or delayed gastric emptying. How can I differentiate between these conditions, and what kind of tests or treatments would you recommend to get to the bottom of this?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand that anything that disrupts quality of life is a source of concern. You are right, as symptoms of hiatal hernia and gastroesophageal reflux disease (GERD) can sometimes be confusing as they are similar and can sometimes overlap.

GERD results from physiological weakness of the upper sphincter (valve) of the stomach, so it’s major symptoms are acid reflux and heartburn.

Hiatal hernia result from anatomical defect in the diaphragm (the muscle layer that separate the chest cavity from the abdominal cavity). Thus, apart from acid reflux and heartburn, you would also experience some chest pressure, and some times difficulty in swallowing and shortness of breath.

With the symptoms you are having, it is more likely, a delay in your gastric emptying is the cause. This is commonly precipitated by choice of food (highly spicy food, caffeine, amongst other causes, a delay in gastric emptying).

I advise you to follow below mentioned things. These include:

Proper choice of diet.
Weight loss.
Small frequent meals, and avoiding of lying down immediately after meals.

These would help relieve some of your symptoms.

To definitively differentiate hiatal hernia from GERD, an upper gastrointestinal (GI) endoscopy is necessary. I recommend you to do it, as your symptoms have worsen.

In the meantime, Follow the advice on dietary and lifestyle modifications mentioned.

The probable diagnosis is GERD.

I advise you to take following medicine: Capsules Rabeprazole (proton pump inhibitor) 20 mg one capsule, 12 hourly for two weeks.

Kindly consult a specialist doctor, talk with them, and take medications with their consent.

I hope this helps.

Thank you.