Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
A Viewer Asks: I am wondering if exercise will help with a hiatal hernia?
Dr. Marks Answers: Exercise has no effect on hiatal hernias.
Exercise, however, can increase
acid reflux in people who are prone to acid reflux, presumably those individuals with weak lower esophageal sphincter muscles. (Exercise increases intra-abdominal pressure and can force stomach acid back into the esophagus through a weak lower esophageal sphincter.)
A hiatal hernia is an anatomical abnormality in which
part of the stomach protrudes through the diaphragm and up
into the chest. Although hiatal hernias are present in
approximately 15% of the population, they are associated with
symptoms in only a minority of those afflicted.
Normally, the esophagus or food tube passes down through
the chest, crosses the diaphragm, and enters the abdomen
through a hole in the diaphragm called the esophageal
hiatus. Just below the diaphragm, the esophagus joins the
stomach. In individuals with hiatal hernias, the opening of the
esophageal hiatus (hiatal opening) is larger than normal, and a
portion of the upper
stomach slips up or passes (herniates) through the hiatus and into
the chest. Although hiatal hernias are occasionally seen
in infants where they probably have been present from
birth, most hiatal hernias in adults are believed to have
developed over many years.
What causes a hiatal hernia?
It is thought that hiatal hernias are
caused by a larger-than-normal esophageal hiatus, the opening in the
diaphragm through which the esophagus passes from the chest into the
abdomen; as a result of the large opening, part of the stomach
"slips" into the chest. Other potentially
contributing factors include:
A permanent shortening of the esophagus (perhaps caused by inflammation
and scarring from the reflux or regurgitation of stomach acid) which pulls
the stomach up.
An abnormally loose attachment of the esophagus to the
diaphragm which allows the esophagus and stomach to slip
upwards.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
GERD is a condition in which the acidified liquid
content of the stomach up into the esophagus.
The causes of GERD include an abnormal lower
esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and
slow emptying of the stomach.
GERD may damage the lining of the esophagus, thereby
causing inflammation (esophagitis), although usually it does not.
The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea.
Complications of GERD include ulcers and strictures of
the esophagus, Barrett's esophagus,
cough and asthma, throat and laryngeal
inflammation, inflammation and infection of the lungs, and collection of fluid
in the sinuses and middle ear.
Barrett's esophagus is a pre-cancerous condition that
requires periodic endoscopic surveillance for the development of cancer.
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