Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
An endoscopy report says hiatal hernia. A doctor says acid reflux. Another says GERD. Many people are not sure whether these are the same thing.
They are not, though they are closely linked. This page explains the difference and why it matters for treatment.
The food pipe passes through an opening in the diaphragm, the muscle sheet between the chest and the belly. In a hiatal hernia, this opening has widened. Part of the stomach slides up through it into the chest.
It is a change in the body's shape. On its own it may cause no symptoms at all.
A valve at the lower end of the food pipe normally keeps stomach acid down. When it is loose, acid flows back up. This causes heartburn, a sour taste or burping.
When reflux happens often enough to cause symptoms or harm the food pipe, doctors call it GERD, or reflux disease.
The diaphragm normally squeezes around the valve and helps it stay shut. When part of the stomach slides up, the valve loses that support. Acid then escapes more easily, more so when you lie down or bend.
So a hiatal hernia is a common cause of reflux. Larger hernias tend to cause more of it. But many people have reflux with no hernia, and many small hernias cause no reflux.
Hiatal hernia and acid reflux compared
| Point | Hiatal hernia | Acid reflux (GERD) |
|---|---|---|
| What it is | Part of the stomach slides up through the diaphragm | Acid and stomach fluid flow back up the food pipe |
| What kind of problem | A change in shape | A symptom and a disease of the food pipe |
| How it is found | Endoscopy, barium swallow or CT scan | Symptoms, endoscopy, pH test |
| Can occur alone | Yes, often with no symptoms | Yes, often with no hernia |
| What tablets do | Do not change it | Lower the acid and ease symptoms |
| What surgery does | Brings the stomach back and narrows the opening | Rebuilds the valve with a wrap |
Told you have a hiatal hernia and reflux, and not sure what that means for you? A review can explain your reports and your options.
Diet changes and acid tablets treat reflux. They ease the burning but leave the hernia as it is. For most people this is enough.
Surgery is considered when reflux is not controlled by tablets, when you do not want lifelong tablets, or when the hernia is large or causes other problems. The operation brings the stomach back down, narrows the opening and rebuilds the valve.
Yes. Many small hiatal hernias cause no reflux and no symptoms. They are often found by chance on an endoscopy or scan.
Yes. Reflux is common in people with no hernia at all. A loose valve, weight gain or large late meals can be enough.
No. They lower the acid and ease the burning, but the hernia stays the same shape. They treat the symptom, not the hernia.
No. Most are treated with diet, lifestyle and tablets. Surgery is for reflux that tablets do not control, large hernias or complications.
GERD means reflux that happens often enough to cause symptoms or damage. Occasional reflux after a big meal is common and not GERD.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
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