If you have ever researched bariatric surgery, you have probably heard the term “hiatal hernia.” A hiatal hernia occurs when part of the stomach slides into the chest through a hole in the diaphragm called the hiatus. When this happens, it places the stomach in an unnatural position, causing a range of problems from reflux (heartburn), to chest pain and vomiting. A hiatal hernia and obesity are strongly linked to one another meaning they can also be dealt with together.
The size of the hernia does not affect the severity of symptoms. Some patients may be very symptomatic with a small hernia, while others with a large hernia can have little-to-no symptoms.
Hiatal Hernia and Obesity
You may be wondering why the term “hiatal hernia” is a common medical concern within the bariatric field. Well, morbidly obese patients are at a higher risk of developing a hiatal hernia.
Hiatal hernia development is due to weakened muscle tissue that allows the stomach to bulge up through your diaphragm. Patients who carry around excess weight experience an increase in intra-abdominal pressure. Yet, aside from weight gain being one of the most common reasons people develop a hiatal hernia, heavy lifting and genetics can also play a role in the development.
Similarly, patients who experience weight regain after bariatric surgery can have the recurrence or even initial development of a hiatal hernia. And the development of a hiatal hernia after bariatric surgery will act the same way—causing reflux, chest pain, and in some cases, vomiting.
Depending on the type of bariatric procedure the patient had, the symptoms of a hiatal hernia may vary in intensity and type. For example, patients who have gastric sleeve surgery may have more problems than a patient who has the gastric bypass with the primary symptom being reflux (heartburn). Patients who experience reflux after gastric sleeve surgery almost always have more severe and hard-to-manage symptoms than patients who have a gastric bypass.
However, gastric bypass patients may still experience some heartburn and vomiting if they have a hiatal hernia.