Hiatal hernia, GERD (gastroesophageal reflux disease, also known as acid reflux or chronic heartburn), and COPD (chronic obstructive pulmonary disease). You probably know the names. But did you know there may be a link between these three conditions?
The link between GERD and COPD: Up to 50% of people with COPD also have GERD, a condition that occurs when the gastric acid in your stomach flows up into your food pipe (esophagus) rather than down into your small intestine. This happens when the valve between your stomach and esophagus doesn’t close properly.
GERD can make it harder to manage COPD, which may lead to worsening symptoms and exacerbations.
The link between hiatal hernias and GERD: People can have a hiatal hernia without having GERD—or GERD without having a hiatal hernia. And some people may have both. But there is no definitive proof that one causes the other.
However, research does demonstrate that people with a hiatal hernia may be more likely to have GERD. And that hiatal hernias can also exacerbate the symptoms of GERD.
The link between all three: Studies also reveal that hiatal hernias occur in older, more obese people who have GERD. And that hiatal hernias occur significantly more often in people with COPD.
Lesley Williams, Apria’s Market Clinical Trainer and respiratory therapist says, “Now that we know hiatal hernias are linked to both conditions, it’s important to have a better understanding of hiatal hernias so that you can more effectively manage your COPD.”
A hiatal hernia happens when the upper part of your stomach bulges through an opening in the diaphragm (hiatus) and into your chest cavity. The diaphragm is the muscular wall separating the chest cavity from your abdomen. The opening in the diaphragm connects the esophagus and stomach, allowing food and liquid to pass.
A large hiatal hernia can allow food and acid to back up into your esophagus, causing GERD. It can also cause your stomach to put pressure on your diaphragm or lungs, causing shortness of breath.
People who are overweight, over 50 years old, and who smoke (also the risk factors for COPD) are more likely to develop a hiatal hernia. Pregnancy is also a risk factor for hiatal hernia.
It’s not always clear why hiatal hernias develop. But they can be caused by:
Often, there are none—especially with a small hiatal hernia. However, large hiatal hernias can cause the same symptoms as GERD:
If you are experiencing symptoms, there are a variety of effective treatments available.
Now that you have a better understanding of hiatal hernia, GERD, and how they affect COPD, you’ll be better prepared to deal with all three to ensure your overall health and well-being. Apria’s Lesley Williams adds, “If you have any questions, don’t hesitate to contact your healthcare team.”
References
1. Kim C, et al. Hiatal Hernia on Chest High-Resolution Computed Tomography and Exacerbation Rates in COPD Individuals. Chronic Obstr Pulm Dis. 2016;3(2):570-579.
2. Hiatal hernia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/symptoms-causes/syc-20373379.
3. Hiatal Hernia. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia.
4. Tricarico, E. (2018, April 27). Connecting the Dots: Understanding the Link Between Hiatal Hernia and GERD. Everyday Health. https://www.everydayhealth.com/gerd/gerd-and-hiatal-hernia.aspx.
5. Roth, E. (2020, April 13). Hiatal Hernias and Acid Reflux. Healthline.
https://www.healthline.com/health/gerd/hiatal-hernia.
6. Minimally Invasive and Gastrointestinal Surgery. Medical College of Wisconsin. https://www.mcw.edu/departments/surgery/divisions/minimally-invasive-and-gastrointestinal-surgery/patient-care/gerd-and-gastrointestinal-surgery-program/paraesophageal-hernia-hiatal-hernia.
7. Johnson, C. (2021, July 10). COPD and GERD: What is the link between the two? Carenity. https://www.carenity.us/condition-information/magazine/news/copd-and-gerd-what-is-the-link-between-the-two-1036.
8. Leader, D. (Updated 2022, June 12). Living With GERD and COPD. VeryWell Health. https://www.verywellhealth.com/how-common-is-gerd-in-copd-914675#:~:text=2%EF%BB%BF%20GERD%20also%20appears,exacerbation%20if%20you%20have%20COPD.
9. Bryson, S. (2020, March 12). Acid Reflux Linked to Higher Risk of COPD Exacerbations, Review Suggests. COPD News Today. https://copdnewstoday.com/news/gerd-acid-reflux-linked-higher-risk-acute-copd-exacerbations-review-suggests/.
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