Digestive Disorders

By Qineng Tan, L.Ac., Ph.D. and Xiaomei Cai, L.Ac., Ph.D.

Heartburn and acid reflux? Chest pain or abdominal pain? Vomiting blood, black stool, dark poop? These can be hiatal hernia symptoms. Acupuncture and TCM offer an adjunct or alternative hernia treatment to help relieve hernia pain.

A hernia is what happens when an organ, usually in the abdomen or groin area, pushes through the muscle tissue that surrounds it.

A hiatal hernia occurs when the stomach pushes through the diaphragm—the large muscle that separates your abdomen from your chest. 

There is a small opening in the diaphragm—called the “hiatus”— that allows the esophagus to pass through the muscle wall before it connects to the stomach. When a hiatal hernia occurs, the upper part of the stomach pushes through that opening.

It is possible to have a mild hernia and not know it, as it may not cause any pain or other hernia symptoms. A more serious hiatal hernia, though, will cause stomach acid and undigested food to move back up into the esophagus, causing heartburn and possibly chest pain or abdominal pain.

Sometimes it is possible to actually see a hernia, as it may bulge out of the abdomen. Sometimes you can only see it when you cough, or do something strenuous, or even simply stand up.

Hiatal Hernia Symptoms

The most common signs of hiatal hernia include:

• Heartburn and acid reflux: One of the most common symptoms of a hiatal hernia is a burning sensation in the chest due to the regurgitation of stomach acid into the esophagus.

• Chest pain: Some people with a hiatal hernia may experience chest pain that can mimic the symptoms of a heart attack. The pain is often described as a dull, squeezing, or pressure-like sensation.

• Difficulty swallowing: A hiatal hernia can lead to a narrowing of the esophagus, making it difficult to swallow. Individuals may feel a sensation of food getting stuck or feel like they’re choking.

• Belching and hiccups: burping or persistent hiccuping can occur, due to pressure on the diaphragm.

• Regurgitation: In addition to heartburn, people with a hiatal hernia may experience the backflow of food or sour liquid into the mouth.

• Chest discomfort after eating: Some people may experience a burning sensation, pressure, or feeling of fullness in the chest area after eating, because the stomach is pressing into the chest cavity.

• Shortness of breath: Larger hiatal hernias can put pressure on the diaphragm and lungs, leading to difficulty breathing, especially during physical exertion.

• Fatigue and weakness: Chronic symptoms of a hiatal hernia can disrupt sleep, resulting in fatigue.

Hiatal hernias are quite common; they may affect as many as half of all people over 50. Hernias may happen because of a generally weakening of muscle tissues.

Hernias can also occur because of some trauma or injury to the area; some hernias happen after a surgical procedure, due to incisions or scar tissue. 

It is also possible to develop a hernia during pregnancy or after giving birth.

In many cases, hernia surgery is considered necessary to treat a hernia that is causing symptoms. Acupuncture and TCM treatment offer a way to treat hiatal hernias that may, in some cases, help people avoid a hernia operation.

Top 10 Types of Hernia

While hiatal hernia and inguinal hernia are the most common types of hernia, there are several other types of hernia, classified mainly according to where in the body they occur.

1. Hiatal Hernia: a portion of the stomach protrudes through the diaphragm into the chest cavity, often leading to symptoms like heartburn, chest pain, and difficulty swallowing.
2. Inguinal Hernia: Inguinal hernias are the most common type and occur when part of the intestine or abdominal tissue pushes through a weak spot or tear in the lower abdominal wall, often in the inguinal canal. The inguinal canal acts as a passageway for the round ligament of the uterus in women and for the gonadal vessels in men. Inguinal hernias are more common in men and may cause a bulge or swelling in the groin or scrotum.
3. Umbilical Hernia: Umbilical hernias occur when the tissue or intestines protrude through a weak spot near the navel (belly button). This type of hernia is more common in infants but can also occur in adults, especially those who are overweight or have had multiple pregnancies.
4. Ventral Hernia: Ventral hernias develop in the abdominal wall, often at the site of a previous surgical incision. They can occur when the tissue or intestines push through weakened abdominal muscles, causing a bulge or protrusion.
5. Epigastric Hernia: Epigastric hernias appear in the upper abdomen, between the navel and the breastbone. They occur when fatty tissue pushes through weak areas in the abdominal muscles, resulting in a small bump or bulge.
6. Groin Hernia or Femoral Hernia: This term is often used to refer to inguinal hernias, which are the most common type of groin hernia. However, it can also encompass other hernias that occur in the groin area, such as femoral hernias. Femoral hernias can sometimes happen due to straining while having a bowel movement.
7. Spigelian Hernia: Spigelian hernias are relatively rare and occur along the edge of the abdominal wall, typically below the navel. These hernias may be difficult to diagnose due to their location and can cause pain and discomfort.
8. Incisional Hernia: An incisional hernia occurs at the site of a previous surgical incision, where the tissue or intestines protrude through the weakened area. It is more common in individuals who have undergone abdominal surgery.
9. Diaphragmatic Hernia: Diaphragmatic hernias occur when abdominal organs, such as the stomach or intestines, protrude through a defect in the diaphragm. This type of hernia can be congenital or acquired and may cause symptoms such as difficulty breathing and chest pain.
10. Sports Hernia: Also known as athletic pubalgia, a sports hernia refers to soft tissue injuries or tears in the groin area, specifically affecting the muscles, tendons, or ligaments. It is commonly associated with sports that involve sudden twisting movements, such as soccer or hockey.

Another type of hernia can occur in the back part of the body. You have probably also heard of a “herniated disc.” This condition, which is also known as a “bulging disk,” “prolapsed disc,” “ruptured disc,” or “slipped disc,” is a herniation that occurs between the spinal vertebrae.

There are discs made of cartilage that sit between the vertebrae, which provide cushioning. Sometimes, when there is damage to outer layers of these discs, the gel-like substance that is inside oozes out, breaching the outer wall. This type of hernia can put pressure on the nerves of the spinal column, causing pain.

Hernia Treatment

When a person seeks medical care for a suspected hernia, the diagnostic process typically involves first a physical exam; the doctor will check for swelling or a bulge in the abdomen or groin. Imaging tests, including X-rays or endoscopy, can help a physician see where there is a hernia, and how severe it is.

Initial treatment for hiatal hernia may be conservative, and involve monitoring and making lifestyle changes such as avoiding spicy foods and elevating the upper body during sleep.

Pharmacological solutions might involve antacids, proton pump inhibitors (PPIs) and H2 blockers, which reduce the production of stomach acids.

If these methods do not resolve symptoms of heartburn and reflux, then hernia surgery may be recommended. The most common type of hernia operation is called Nissen fundoplication, which involves wrapping the upper part of the stomach around the lower esophagus to reinforce the lower esophageal sphincter and prevent acid reflux. In some cases, minimally invasive techniques, such as laparoscopic hernia repair, may be used to reduce recovery time and minimize scarring.

Acupuncture and TCM may, in some cases, offer an alternative treatment for hiatal hernia that can help relieve pain, heartburn, and regurgitation.

Can Acupuncture Help Hiatal Hernia?

According to TCM theory, abdominal hernias usually occur due to an imbalance in the middle or lower jiao. The three jiaos are sometimes referred to or translated as the “triple burner,” which illustrates how they keep the center of the body warm and nourished.

In TCM, the upper jiao, middle jiao, and lower jiao correspond to the visceral structure of the midsection, and each one helps to control and harmonize the organ systems contained within it. The middle jiao houses the spleen, stomach, liver and gallbladder, while the lower jiao contains the small intestine, large intestine, kidneys, and bladder.

In Chinese Medicine, heat, cold, dampness, and dryness can be considered pathogenic forces that can cause problems. If there is an accumulation of cold or damp in the upper or lower abdomen, it can cause muscle weakness that leads to the formation of a hernia.

The middle jiao and lower jiao help keep fluids balanced in the abdomen. If the jiaos are not functioning well, then muscle weakness may be the result. Stagnant Qi can also be a factor. Acupuncture treatment helps to strengthen Qi and get it moving.

TCM takes the view that physical, mental, and emotional health are all inextricably linked. Strong emotions and stress can also contribute to the formation of hernias. Repressed feelings of anger or rage are associated with hiatal hernia. It is as if a person is swallowing those feelings, but the body rebels to force them back up.

Acupuncture treatment can help address the effects of prolonged stress and emotional upset. Finding stress relief and relaxation can have a significant effect on the central nervous system, the muscles of the abdomen, and the diaphragm. 

Both acupuncture treatment and Chinese herbs can help to reduce acid reflux and GERD symptoms.

If a hernia is severe, then a hernia operation may be required. In these cases, acupuncture and herbs can still help with the healing process. One study showed that electroacupuncture treatment helped to relieve postoperative pain for patients who had undergone hernia surgery.

Regular acupuncture treatment can help to prevent the recurrence of reflux, while helping to reduce the physical effects of emotional stress.

Acupuncture Near Me for Hiatal Hernia in Los Angeles

TCM is an excellent modality for helping to relieve both gastrointestinal disorders and muscular problems. In some cases, a hiatal hernia is a serious mechanical problem that requires surgical intervention. However, in many cases, hernias can be relieved with changes in lifestyle that will help to reduce acid and relieve stress. Acupuncture is worth considering as an adjunct or alternative hernia treatment.

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.