A hiatal hernia attack can involve up to 20 different symptoms that seem unrelated to one another. 

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You can feel acid reflux, bloating, gas, pressure in your abdomen or chest, but you can also feel short of breath, have heart palpitations, feel anxious or have a panic attack. 

It this hits you suddenly or in the middle of the night it's pretty terrifying. You definitely want to rule out heart disease due to the symptoms of heart palpitations, shortness of breath and chest pain or pressure. But once you've done that and you continue to suffer, you're left perplexed with what's really going on.

A hiatal hernia, even if small, can cause a cascade of symptoms that begin with the stomach getting compressed, bringing acid up into your esophagus (tube that connects your mouth to your stomach) and the subsequent irritation/spasming of your diaphragm and irritation to your heart that sits directly above your diaphragm. This can cause shortness of breath and heart palpitations along with anxiety symptoms.

It's important to realize that these 3 organs (stomach, diaphragm, and heart) sit very close to one another anatomically and it's well researched that they can influence one another's function when a hiatal hernia or acid reflux occurs.

It's worth mentioning that 95% of hiatal hernias are sliding which means the symptoms can come and go, which can also be confusing because you're not sure what you're doing to cause it. 

At the root is increase intra-abdominal pressure which can worsen lying down at night to sleep as well as when bending over. This is why you can awaken in the middle of the night with a hiatal hernia attack, that is quite frightening.

Half of all reflux is silent, meaning it presents with symptoms that are less obvious than the "classic" heartburn. In silent relux the symptoms are more in the upper chest and throat such as trouble swallowing, having the feeling of a lump in your throat, hoarseness, a cough, or bitter taste in your mouth. You can still have the rest of the symptoms mentioned previously without the signs of heartburn and reflux.

The root of this problem is digestive in nature, with the rest of the symptoms occurring secondarily due to a cascade of effects.

If you'd like help we're here for you. The best next step is to contact us for a consultation and then we can determine if what we do is a good fit for you. Call 727-335-0400.

References:
Kahrilas PJ, et al. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601-616.

Schlottmann F, Patti MG. Hiatal hernia: a review on diagnosis and treatment. World J Surg. 2017;41(7):1626-1633.

Mittal RK, Balaban DH. The esophagogastric junction. N Engl J Med. 1997;336:924-932.

Roman S, et al. Gastroesophageal reflux disease: from pathophysiology to treatment. World J Gastroenterol. 2014;20(14):5275-5294.

Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67:1351-1362.

Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video.
The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary.