Hiatal Hernia vs. Acid Reflux

After eating a large meal, if you have ever felt a burning pain in your chest, it is likely that you are experiencing acid reflux. If you consult a doctor to diagnose what you have, many times they might check for a hiatal hernia. You may be asking, what is acid reflux? What is Hiatal Hernia? How are they related? How are they different? By the end of this article, you will be able to answer all of these.

What is Acid Reflux?

Food travels through a feeding tube (esophagus) into our stomach where acids break it down further. In order to keep these acids within the stomach, a muscular flap between the esophagus and the stomach (LES) opens and closes as food enters the stomach. If this flap weakens, acid can enter the esophagus creating a burning sensation in the chest.

What is Hiatal Hernia?

A hiatal hernia is a condition in which the top of the stomach pushes into the hole that the esophagus enters the diaphragm (muscle between stomach and chest) through (esophageal hiatus). Normally, the hiatus squeezes the stomach to keep acids from going up into the esophagus. If you have a hiatal hernia, this pressure is reduced or lost, and acid can enter the esophagus.


Many times, if a patient consults a professional on chronic acid reflux, the patient is tested for a hiatal hernia first. A hiatal hernia by itself does not have any noticeable symptoms. In fact, in certain cases, the hiatal hernia can be left untreated. However, the hiatal hernia can be a potential cause of chronic acid reflux. As a result, acid reflux symptoms can be an indirect indication of a hiatal hernia. However, there are many other different causes of acid reflux. The key to understanding the difference between the two is understanding that while chronic acid reflux and hiatal hernia both deal with an ill-functioning LES, the reason behind the poor functionality sometimes differs.


Taking a few antacids and eating smaller meals can usually treat acid reflux. A mild hiatal hernia can also be treated in the same way. While the condition still exists, the symptoms (acid reflux) can be combatted with these self-induced treatments. For more severe forms of a hiatal hernia, the best available treatment is a Nissen fundoplication in which the stomach is wrapped around the esophagus to restore that natural squeeze.

Dr. Gary Alexander is board certified by the American Board of Surgery and a Fellow of the American College of Surgeons. Dr. Alexander is the co-founder of Surgical Associates of Mansfield in Mansfield, Texas. He specializes in minimally invasive surgery including Da Vinci robot-assisted surgery. Dr. Alexander has been named Top10MD since 2016 an honor only 1-in- 3 doctors succeed within the United States. To schedule a consultation with Dr. Alexander link to his profile or call his office today at 682.518.8619.