Many people explore alternative therapies, such as chiropractic care, to manage the symptoms of a hiatal hernia using non-invasive, hands-on methods. This article examines the methods, theoretical basis, and safety considerations surrounding the use of chiropractic manual techniques to address hiatal hernia discomfort.
Understanding Hiatal Hernias
A hiatal hernia occurs when a portion of the stomach bulges upward through the diaphragm, the large muscle that separates the chest and abdomen. This muscle contains a small opening, called the hiatus, through which the esophagus passes before connecting to the stomach below. When the supporting tissue around the hiatus weakens, the upper part of the stomach can protrude into the chest cavity.
The most common form is the sliding hiatal hernia, where the gastroesophageal junction and a small part of the stomach slide up into the chest and then may slide back down. A less common but more concerning type is the paraesophageal hernia, where a part of the stomach pushes up alongside the esophagus. While small hernias may cause no symptoms, larger ones often allow stomach acid and food to backflow into the esophagus, resulting in heartburn, acid reflux, chest discomfort, and difficulty swallowing.
Chiropractic Manual Techniques for Diaphragmatic Adjustment
Chiropractic care focuses on manually guiding the stomach back into its proper position below the diaphragm, a maneuver often referred to as the hiatal hernia technique. Practitioners use gentle, non-spinal soft tissue work directly on the upper abdomen to physically encourage the stomach to descend. The patient is often positioned to facilitate this movement, sometimes standing or reclining.
A specific application of pressure is performed while the patient exhales, which helps the chiropractor reposition the stomach. This manual reduction aims to alleviate the mechanical pressure on the hiatus and surrounding nerves, which may contribute to digestive distress and reflux symptoms. The goal is to physically reduce the hernia and relieve tension in the diaphragm muscle.
The chiropractic approach also considers the neurological connection between the spine and the digestive system. Adjustments may be made to the thoracic spine, particularly in the mid-back region, which houses nerve roots that supply the diaphragm and stomach. Correcting spinal misalignments is theorized to reduce nerve interference, thus improving the overall function and tension of the diaphragm and surrounding soft tissues. This comprehensive approach includes soft tissue manipulation to relax the diaphragm, preventing chronic tension that could pull the stomach upward.
Safety Considerations, Evidence, and Medical Integration
It is necessary to receive a formal medical diagnosis, typically confirmed through procedures like an endoscopy or a barium swallow, before seeking chiropractic treatment. This initial medical evaluation is important to rule out complex or urgent issues, such as a large paraesophageal hernia or strangulation, which require immediate surgical attention. Chiropractic adjustments are generally considered a complementary approach aimed at symptomatic relief, not a definitive cure.
The current body of evidence supporting the effectiveness of these manual techniques is largely limited to case studies and anecdotal reports, and the approach is not universally accepted. Patients should be aware of contraindications that preclude the use of the hiatal hernia maneuver, including:
- Recent stomach surgery.
- The presence of an abdominal aortic aneurysm.
- Severe acute pain.
- Use of anticoagulant therapy or an unhealed rib fracture, as manual pressures could pose a risk.
Any chiropractic treatment should be integrated with the patient’s primary care physician to ensure a coordinated and safe management plan. If a patient experiences severe symptoms like vomiting blood, passing black stools, or sharp, unrelenting chest pain, they must seek emergency medical attention immediately, as these can indicate a serious complication. Chiropractic care, when used appropriately and safely, serves as a non-pharmacological option for patients seeking relief from the mechanical discomfort associated with a simple hiatal hernia.