Hiatal Hernia in Older Adults: Treatments That Work

A hiatal hernia happens when part of the stomach pushes up through the diaphragm into the chest cavity. While it can affect people at any age, hiatal hernias are especially common in older adults due to age-related muscle weakening. Knowing the treatment options can help seniors manage symptoms, improve daily comfort, and protect long-term health.

Understanding Hiatal Hernias

Types of Hiatal Hernias

• Sliding hiatal hernia: The stomach and lower esophageal sphincter (LES) slide into the chest.
• Paraesophageal hiatal hernia: The LES stays in place, but part of the stomach bulges next to the esophagus.

Common Symptoms in Seniors

• Frequent heartburn or acid reflux
• Food or liquid regurgitation
• Chest pain or pressure
• Difficulty swallowing
• Shortness of breath

Because these symptoms often overlap with heart or lung conditions, seniors should always seek an accurate diagnosis.

Causes and Risk Factors in Older Adults

Hiatal hernias become more likely with age. Key risk factors include:

• Age-related diaphragm weakening
• Obesity or excess abdominal weight
• Chronic coughing or straining
• Smoking history
• Past abdominal surgery or injury

How Doctors Diagnose Hiatal Hernias

A specialist may start with a physical exam and symptom review, followed by one or more diagnostic tests:

• Endoscopy – a flexible camera views the stomach and esophagus.
• Barium swallow X-ray – outlines the hernia with imaging.
• Esophageal manometry – measures esophageal muscle pressure.

Non-Surgical Treatment Options

For many seniors, symptoms can be controlled without surgery.

Lifestyle changes:

• Eat smaller, frequent meals instead of large portions
• Avoid trigger foods like spicy, fatty, or acidic meals
• Elevate the head of your bed to reduce nighttime reflux
• Maintain a healthy weight to lessen abdominal pressure

Medications:

• Antacids to neutralize stomach acid
• H2 blockers to reduce acid production
• Proton pump inhibitors (PPIs) for stronger acid control

Breathing & exercise therapy:‍

Diaphragmatic breathing and gentle core-strengthening exercises may help reduce symptoms and improve quality of life.

Surgical Options for Seniors

If symptoms are severe or complications develop, surgery may be necessary.

• Laparoscopic repair: Minimally invasive, small incisions, quicker recovery
• Open repair: Larger incision, sometimes required for complex hernias
• Robotic-assisted surgery: High precision and faster healing in select cases

Seniors considering surgery should weigh the risks and benefits with their healthcare provider, especially if they have other medical conditions.

New & Supportive Treatments

• Advanced mesh materials – biologic or absorbable mesh reduces long-term complications
• Telemedicine follow-ups – allow remote monitoring after surgery
• Support groups – connect seniors with others managing hiatal hernias

When to Seek Medical Help

Contact your doctor immediately if you experience:

• Severe chest pain
• Vomiting blood or black stools
• Sudden difficulty swallowing
• Shortness of breath or fainting

These may indicate a complication such as strangulation or internal bleeding.

Conclusion

Hiatal hernias are common among seniors and older adults, but effective treatment is available. From lifestyle changes and medications to minimally invasive surgery, options exist to manage symptoms and restore comfort.

At Hernia Innovations, we specialize in hernia care tailored to seniors. Call (925) 940-1025 or schedule an appointment online to discuss your treatment options and start feeling better today.