A hiatal hernia occurs when a portion of the stomach pushes upward through an opening in the diaphragm, the muscle separating the chest from the abdomen. This can lead to uncomfortable symptoms. Palpitations are a sensation of a racing, pounding, or irregular heartbeat. A connection can exist between a hiatal hernia and these heart sensations.
Understanding the Link Between Hiatal Hernia and Palpitations
A hiatal hernia can influence heart rhythm due to the close anatomical relationship between the esophagus, stomach, and heart. When the stomach protrudes into the chest, it can press on nearby structures. This physical pressure may directly affect the heart, leading to palpitations.
Another mechanism involves the vagus nerve, which extends from the brainstem to various organs, including the heart and digestive system. Irritation or compression of the vagus nerve by a hiatal hernia, or by associated acid reflux, can disrupt normal heart rhythm. Acid reflux, where stomach acid flows back into the esophagus, frequently accompanies hiatal hernias. The irritation from this acid can stimulate the vagus nerve, indirectly triggering palpitations.
Lifestyle and Dietary Strategies to Alleviate Palpitations
Managing a hiatal hernia and its associated palpitations often begins with lifestyle and dietary adjustments. Eating smaller, more frequent meals can prevent the stomach from becoming overly full, reducing pressure on the diaphragm and minimizing reflux. Avoiding large meals, especially close to bedtime, is beneficial, as lying down with a full stomach can worsen reflux and potentially trigger palpitations. Wait at least two to three hours after eating before lying down.
Certain foods and beverages trigger heartburn and acid reflux, which can contribute to palpitations. These include fatty or fried foods, spicy dishes, acidic foods like citrus fruits and tomato-based products, chocolate, caffeine, and alcohol. Limiting or avoiding these can significantly reduce symptoms. Focus on a diet rich in non-acidic, minimally processed foods such as lean proteins, whole grains, and non-citrus fruits and vegetables.
Elevating the head of the bed by six to eight inches uses gravity to help keep stomach contents down during sleep, reducing nighttime reflux. Maintaining a healthy weight can lessen abdominal pressure on the stomach and diaphragm, improving symptoms. Practicing proper posture and avoiding activities that strain the abdominal area, such as heavy lifting, can prevent exacerbation of the hernia. Stress management techniques, including relaxation exercises and deep breathing, may also help, as stress can worsen digestive issues and trigger palpitations.
Medical Approaches for Managing Hiatal Hernia Symptoms
When lifestyle and dietary changes are not enough, medical interventions can help manage hiatal hernia symptoms that contribute to palpitations. Over-the-counter antacids provide quick relief by neutralizing stomach acid, though they are generally for occasional use. For persistent symptoms, healthcare professionals may recommend medications that reduce acid production.
H2-receptor blockers, such as cimetidine or famotidine, decrease stomach acid production, offering longer-lasting relief. Proton pump inhibitors (PPIs), including omeprazole and lansoprazole, are more potent acid blockers that prevent acid production and allow esophageal tissue to heal. Both H2-receptor blockers and PPIs are available in over-the-counter and stronger prescription forms.
In severe cases where other treatments have failed, surgical options might be considered. A common procedure is fundoplication, such as Nissen fundoplication. This involves wrapping the upper part of the stomach around the lower esophagus to reinforce the weakened sphincter and pull the stomach back into the abdomen. Surgery aims to repair the hernia and address severe reflux, which can indirectly alleviate associated palpitations. However, surgery is typically reserved for cases not responding to medication and lifestyle changes.
When to Consult a Healthcare Professional
Seek professional medical evaluation for persistent palpitations or suspected hiatal hernia symptoms. While palpitations can be benign, they can also signal more serious underlying heart conditions. A healthcare provider can accurately diagnose the cause of your symptoms.
Certain “red flag” symptoms warrant immediate medical attention. These include chest pain, particularly if it feels like pressure, tightness, or squeezing, or if it radiates to the arms, back, neck, or jaw. Shortness of breath, dizziness, lightheadedness, fainting, or severe and worsening palpitations also require prompt medical assessment. These symptoms could indicate a cardiac emergency, and self-treatment should not delay seeking professional care.