Sliding Hiatal Hernia: Causes, Symptoms & Management in Canada

A sliding hiatal hernia occurs when a portion of the stomach moves upward through an opening in the diaphragm into the chest cavity. This opening (called the hiatus) is normally sealed by supportive tissues, but when weakened, part of the stomach can slide through.

This condition is more common as people age and is seen more often in individuals with excess body weight, chronic coughing, or long-term tobacco use. While many people do not experience noticeable symptoms, others may develop acid reflux or heartburn, especially after eating.

Common Symptoms

A sliding hiatal hernia may cause:

Heartburn or burning discomfort in the chest
Regurgitation or sour taste in the mouth
Bloating or belching
Symptoms that worsen when lying down or bending over

Some individuals have no symptoms at all and only discover the condition during routine imaging or medical assessment.

Diet & Lifestyle Considerations

Canadians living with a sliding hiatal hernia often benefit from small, more frequent meals rather than heavy or high-volume meals. Large meals can increase abdominal pressure and push acid upward into the esophagus.

Helpful strategies include:

✔ Eating 4–6 smaller meals daily
✔ Waiting 3–4 hours before lying down
✔ Maintaining a healthy body weight
✔ Avoiding clothing that compresses the abdomen

Foods and drinks commonly linked to reflux include:

Fatty or fried foods
Tomato-based products
Citrus fruits & juices
Carbonated beverages
Caffeine (coffee, tea, soft drinks)
Alcohol

Medications Commonly Used for Symptom Relief

Over-the-counter and prescription medications may reduce irritation from stomach acid:

H2 blockers (reduce stomach acid production for several hours)
Proton pump inhibitors (PPIs) (stronger, longer-lasting acid reduction)

A physician may recommend stronger therapy if symptoms persist.

When Surgery May Be Considered

Most sliding hiatal hernias are managed without surgery. However, surgical repair may be recommended when:

Symptoms remain severe despite medications
Reflux significantly affects daily life or sleep
There is concern for bleeding, choking, or aspiration
There are complications such as strangulation or obstruction (rare)

Modern repairs may be done using laparoscopic techniques, offering shorter recovery times and fewer complications. Maintaining a healthy weight and avoiding abdominal strain can lower the risk of recurrence.

Workplace & First Aid Relevance

While hiatal hernias are not a workplace injury, symptoms such as chest discomfort or reflux can cause distraction or discomfort during physical work. Awareness of symptoms is valuable in first aid training, particularly recognizing the difference between chest pain from reflux and more serious cardiac symptoms that require emergency care.

Key Takeaway

Sliding hiatal hernias are common, especially with age. Many individuals manage symptoms through diet, weight management, and medication, with surgery reserved for select cases.

Educational Disclaimer

This information is intended for general learning and public education in Canada. It does not replace medical assessment, diagnosis, or treatment. Individuals with persistent or worsening symptoms should speak with a qualified healthcare professional.