Can A Hiatal Hernia Cause Shortness Of Breath
Shortness of Breath and Hiatal Hernia: The Anatomical Connection
What you will learn about
In this video, Dr. Vikki explains the connection between shortness of breath and hiatal hernia. Anyone experiencing shortness of breath or “air hunger” will be rattled off, especially when there’s no apparent reason for it. And yet this is a common condition: many individuals who once led active lives find themselves struggling to breathe… even during minimal activities. How does hiatal hernia, a condition where the stomach pushes up through the diaphragm, relates to shortness of breath? What are the various symptoms associated with hiatal hernia? Dr. Vikki also offers insights into the diagnosis and treatment of this condition.
- Hiatal hernia can cause acid reflux, as the stomach (which contains acid) shoots the acid up the esophagus, triggering GERD or heartburn.
- When the stomach pushes against it due to a hiatal hernia, it can lead to shortness of breath or “air hunger”.
- Many patients with hiatal hernia experience chest pressure, often mistaken for heart attack symptoms.
- The diaphragm’s spasming can cause sensations not only in the chest but also in the back.
- Hiatal hernia can trigger heart palpitations due to its proximity to the heart.
- Some treatments involve physically breaking the spasm of the diaphragm, but the root cause (often a digestive issue) needs to be addressed.
- Other possible symptoms of hiatal hernia: bloating, belching, a feeling of fullness, muscle weakness
- Hiatal hernia is treatable, often without resorting to drugs or surgery.
Transcript of the video
By Dr. Vikki Petersen
It can be scary to be short of breath or “air hunger” as patients often call it. And if you’re sitting around obviously not exercising and there’s no reason for you to be short of breath, why are you trying to get a deep breath and feeling like maybe you can’t get a deep breath or you’re kind of shallow breathing from your shoulders?
Hiatal hernia: anatomy
You are barely moving, maybe walking around the house, but prior to this problem which we’re about to go into, you are an athlete, you would work out and now suddenly you can’t even walk around the house without being short of breath. These are the stories I hear, and I was asked to go over how can it be that a hiatal hernia can cause shortness of breath.
So what is a hiatal hernia? Hiatal hernia is when your stomach, which is located just below your ribs on the left hand side, your heart is right above it, your stomach spasms and it gets pulled up. Between your mouth and your stomach is a tube called esophagus. As that stomach spasms and gets pulled up, it starts widening the opening at the level of the diaphragm and the esophagus.
A hiatus is just a hole. Your diaphragm has a hole of an appropriate size for your esophagus. A hernia is something coming through a hole that’s inappropriate. The diaphragm should be here [Dr. Vikki is showing on the video] and the stomach should be nicely relaxed below it, but now it’s not.
It’s spasmed and it’s pushing up and widening that opening. That, in its simplicity, is a hiatal hernia. So how could your stomach acting inappropriately and spasming? How could that cause shortness of breath?
If I said, “How would that cause acid reflux?“, you’d go, “Yeah, that makes sense. My stomach spasming, it’s a bag of acid, it’s shooting the acid up my esophagus and I’m having acid reflux or GERD or heartburn. That makes sense“. But what does it have anything to do with your lungs? That’s what we’re going to talk about. At the end of this video you’ll know exactly how and also know what to do about it.
So here’s the situation. As I mentioned, the stomach is here and your diaphragm is right above it [Dr. Vikki showing placement of organs]. As that stomach spasms and pushes up and widens that opening, it is running into your diaphragm if you will. The diaphragm is a nice dome shape muscle. You have it on both sides of your chest: above the liver on the right, and above the stomach on the left. [Dr. Vkki takes a question from the audience: “Does a hiatal hernia cause chest pressure and abdominal pain?” Absolutely. We’re going to go into that now, how it causes chest pressure].
Shortness of breath: Anatomical explanation
Again, the diaphragm — and I always think of opera singers when I’m describing this to patients because opera singers, boy can they get a deep breath and then they can expel a lot of air when they’re singing! That requires that diaphragm to bow down — as we exhale, the diaphragm bows up. That movement of the diaphragm is called the “diaphragmatic excursion”. And when it’s relaxed and the stomach’s not jammed up against it, it can get a lot of motion and you can breathe freely.
But when that stomach spasms and it’s pushing up against that diaphragm, the diaphragm is in spasm. So you’re still breathing clearly, but you’re not getting that effortless air that you should be getting. So you feel “air hunger”, you feel shortness of breath. And people, especially singers — and I do speak to patients who are singers, not necessarily professional opera singers, but people who sing in the church choir or actually we’ve worked with some professional singers as well — because they’re trained to belly breathe and really use that diaphragm, they can tell immediately they’re running out of air.
But can the average person, not singing just going through life, feel this shortness of breath? Of course! As soon as you’re not getting enough air, what do you wonder about? “Let me go see my doctor and get my lungs checked out“. And inevitably if the root cause is hiatal hernia, you’re told your lungs are fine and this cascades into other issues.
Chest pressure and other symptoms
Let’s go over that because the question that just came in is “What about chest pressure?” It’s that same reason that diaphragm is spasmed and because you’re not getting enough air and that spasming of the diaphragm, you can feel it all the way around. You can feel it in your chest. You can also feel it in your back because the diaphragm cuts right through just above that stomach, you’ve got the heart and lungs above. And then generally speaking, all the digestive organs below. And so the diaphragm cuts right through the middle again with a hiatal hernia.
Another thing happens: you can get heart palpitations because the heart sits right above the stomach. We get the diaphragm spasm. Also, another thing I want to mention is as that stomach is spasming, it’s pushing up on that diaphragm. So the diaphragm is going into spasm, but it’s also getting elevated and that’s what can give you the chest pressure and also heart palpitations because now the stomach is getting in the way of the heart itself as far as anatomy is concerned. [Dr. Vikki showing on video]. We should have the heart, we should have the diaphragm able to move nicely, and then the stomach is a nice relaxed bag of acid way below: they shouldn’t be encountering one another. That’s where the shortness of breath is coming from.
Misdiagnosing shortness of breath
Unfortunately, I have patients who keep complaining about shortness of breath and then their doctor puts them on an inhaler. That’s a problem because this is a drug that will tend to make you a little anxious. And having a hiatal hernia also creates anxiety. So [the drug] tends to exacerbate the problem instead of getting to the root of it because there’s not anything physically wrong with your lungs. Your diaphragm is in spasm, not bringing air in as well as it should. You get that air hunger or shortness of breath.
I hope that explained the how and the why. Now, of course, what’s the cure for this shortness of breath? What’s the root cause of the hiatal hernia? It is interesting that we have this cascade of symptoms, like shortness of breath, at the root of which is a digestive problem. Hopefully my little anatomy lesson made sense because that is absolutely the root of it.
Temporary relief vs. actual root cause resolution
Some people say, “What about this stomach pull-down I hear about?” — that’s where you’re sort of breaking the spasm of the diaphragm. Doctors of Chiropractic can do that. Some physical therapists do it. There’s nothing wrong with that. If you’ve had the problem for a very short time and it was brought about by something structural — meaning, you lifted an overly heavy couch, you ate a huge meal and then started doing sit-ups or something like that; so it’s acute, this is a new problem for you, and it came about from a physical activity that you did — then, that breaking the spasm physically going in there and breaking that spasm can relieve it and for good.
But if it’s something that keeps coming back, then you’re not getting to the root of it. And while we do work physically with patients as well, in our experience, the internal work with your stomach, your digestive tract, is very important. [Dr. Vikki takes a question from the online audience] “Is the chest pressure mainly on the left side? It feels like having a heart attack“. Yes, that’s exactly right. I’ll come to that question in just a second.
Just to finish what I was saying is that you have to get to the root of it. Again, if it’s just something physical, you did say you had a big meal and then, God forbid, you were in a car accident and the airbag deployed, that’s something that can elevate your stomach elevated and spasm your diaphragm. but it wasn’t like an acute injury type of thing. Then you can have somebody physically work on your diaphragm and it relaxes and you’re done. But most of the time [the real cause of the condition] is, at the root, a digestive issue that has to be dealt with. I’ve done a lot of different videos on how we deal with it.
So the question that just came in is the person said she feels most of the pressure on the left side. Of course that makes sense because your stomach is on the left side and it feels like you’re having a heart attack. And it does. And I can’t tell you how many patients I meet who’ve been to the ER multiple times, scared that they’re having a heart attack. And with heart disease being our #1 killer, there’s nothing wrong with taking that trip to the ER and making sure for peace of mind that you’re not having a heart attack. Because if you are having one, that’s the place to be.
However, after you’ve been told your heart is fine, now we have to get to the root of it. And more often than not, it’s this Hiatal Hernia Syndrome that we’ve been describing. I hope how those are related now makes sense to you. How “air hunger” and shortness of breath happen due to a digestive problem called Hiatal Hernia Syndrome.
The good news is: handling that, resolving it for good without drugs or surgery is absolutely available. [Taking a question from the audience] “Does it cause bloating too? I never felt bloated before. And recently, yes“. So yes, the bloating happens because again, that poor little stomach is spasmed and it should be a nice relaxed bag and accepting food in a relaxed fashion, and then it churns that food around with all the acid in the stomach, and that’s its job. But you get the bloat because actually the stomach is so spasmed, sometimes you can get full easily, you can belt, you can have air that’s trapped — once again because of the spasming and pushing on the diaphragm — then you get the bloat as well.
There are a lot of symptoms associated with this. As complicated as it sounds with this long list of symptoms — In my book “Hiatal Hernia Syndrome” I mention 20 different symptoms associated with this condition — it doesn’t mean it’s complicated. It doesn’t mean it’s hard to fix.
Treatments at Root Cause Medical Clinic
The way we [at Root Cause Medical Clinic] like to do it is tailor-made programs for each person. I don’t have (and I’m sometimes chastised for this), I don’t have “the one thing” that you can take and you can do to solve the problem. Because isn’t one thing that’s true for everybody. And what I want for you is resolution. So you can get plenty of “one things” on the internet. Unfortunately, they’re anecdotal and worked for somebody, it’s not likely going to work for you. And if it worked for that one person who’s saying “take blah“, it’s not going to be a resolution. It’s just they got relief.
Relief is great, but we’re all about resolution here at Root Cause Medical Clinic. So if you’re serious about it, it’s been bothering you for a while and you really want to get it resolved, that’s what we’re here for. Reach out, we’re happy to help.
Call the front desk for a consultation at 727-335-0400.
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