Hiatus Hernia Cough: Causes, Symptoms, and Treatment (2024)

A hiatus hernia, commonly referred to as a hiatal hernia, occurs when part of the stomach pushes up through the hiatus, an opening in the diaphragm through which the esophagus passes.

This condition can be asymptomatic or result in symptoms like heartburn, chest pain, and regurgitation.

Another lesser-known symptom that some patients experience is a persistent cough, often known as a hiatus hernia cough.

This cough, typically dry and irritating, results from the reflux of stomach acid into the esophagus and the subsequent irritation of airway structures.

What is a Hiatus Hernia?

A hiatus hernia is a condition in which a part of your stomach pushes upward through your diaphragm. The diaphragm is a large muscle that separates your abdomen from your chest.

It has a small opening (hiatus) through which your food tube (esophagus) passes on its way to connect to the stomach.

Does a Hiatus Hernia Cause Coughing?

Yes, a hiatus hernia can cause coughing. This occurs when the condition leads to gastroesophageal reflux disease (GERD), where stomach acid backs up into the esophagus. The refluxed acid can reach the larynx and airways, irritating them and triggering a persistent, often dry, cough.

Why Does a Hiatus Hernia Cause a Cough?

The connection between a hiatus hernia and a cough can be explained by understanding gastroesophageal reflux disease (GERD), a common complication of a hiatus hernia.

In GERD, the weakened or impaired functioning of the lower esophageal sphincter allows stomach acid to flow back up into the esophagus, causing heartburn and other symptoms.

A persistent cough may develop as a secondary symptom of GERD.

When stomach acid refluxes into the esophagus, it can potentially reach the larynx and the airways, irritating these structures. This irritation can trigger a protective cough reflex, leading to what is known as a hiatus hernia cough.

The cough is typically dry and hacking, and it might worsen during or immediately after eating, at night, or when lying flat.

What Does a Hiatal Hernia Cough Sound Like?

A hiatal hernia cough is typically a dry and hacking cough. It’s usually non-productive, meaning it doesn’t bring up mucus or phlegm.

The cough can be more pronounced after eating, at night, or when lying flat.

However, it’s important to remember that the sound of a cough can vary significantly among individuals, and a persistent cough should always be evaluated by a healthcare professional.

Symptoms and Diagnosis

A hiatus hernia cough is often accompanied by other GERD symptoms such as heartburn, regurgitation, difficulty swallowing, and chronic sore throat.

If you experience these symptoms along with a persistent cough, it’s essential to consult a healthcare professional to get a comprehensive diagnosis.

To diagnose the condition, your doctor will typically begin with a thorough physical examination and a review of your medical history. They may order an upper GI (gastrointestinal) series or endoscopy to visualize the esophagus, stomach, and upper part of the small intestine.

A pH monitoring test may also be conducted to measure the acid levels in your esophagus and confirm if reflux is the cause of your cough.

How to Stop Hiatus Hernia Coughing

Stopping hiatus hernia coughing involves treating the underlying cause, which is usually GERD. Here are some strategies:

• Medication: Over-the-counter antacids, H2 blockers, and proton pump inhibitors can reduce stomach acid and relieve symptoms.
• Dietary Changes: Avoid foods and drinks that trigger heartburn, such as spicy foods, alcohol, and caffeine.
• Eating Habits: Eating smaller, more frequent meals and avoiding eating close to bedtime can reduce reflux.
• Elevate the head of your bed: This can help prevent acid reflux during sleep.
• Weight Management and Exercise: Maintaining a healthy weight and regular exercise can reduce pressure on the abdomen and prevent reflux.

Remember: Always consult with a healthcare professional for personalized advice. Severe cases might require surgical intervention.

Treatment Options

The treatment for a hiatus hernia cough primarily focuses on managing the underlying GERD. Over-the-counter antacids, H2 blockers, and proton pump inhibitors (PPIs) can help reduce the production of stomach acid and relieve symptoms.

It’s crucial to discuss this with your doctor before starting these medications, as they may have side effects.

Lifestyle modifications can also play a significant role in managing a hiatus hernia cough. This includes maintaining a healthy weight, quitting smoking, avoiding food and drinks that trigger heartburn, eating smaller meals, and not lying down or going to bed immediately after a meal.

Raising the head of your bed might also help prevent nighttime symptoms.

For severe cases of hiatus hernia causing significant symptoms, surgical intervention might be necessary. Procedures such as Nissen fundoplication or laparoscopic hiatus hernia repair may be performed to repair the hernia and strengthen the lower esophageal sphincter.

FAQs About a Hiatus Hernia Cough

How is a Hiatus Hernia Diagnosed?

A hiatus hernia is diagnosed through a combination of physical examination, a review of medical history, and specific diagnostic tests.

These tests might include an endoscopy, where a thin, flexible tube with a camera is used to examine the esophagus and stomach, or a barium swallow X-ray, which visualizes the digestive tract.

Additionally, a pH monitoring test may be conducted to measure acid levels in the esophagus, which can confirm if acid reflux is present.

Who is at Risk for a Hiatus Hernia?

Risk factors for a hiatus hernia increase with age, particularly for individuals over 50. Other risk factors include obesity, which increases abdominal pressure and can contribute to the formation of a hiatus hernia, and smoking, which can weaken the diaphragm.

A congenital hiatal weakness or an injury to the diaphragm area may also increase the risk.

What are the Possible Complications of a Hiatus Hernia?

While many people with a hiatus hernia experience mild or no symptoms, potential complications can arise. The most common complication is gastroesophageal reflux disease (GERD), characterized by heartburn, chest pain, and regurgitation.

If GERD is left untreated, it can lead to esophagitis, esophageal ulcers, and in severe cases, a condition called Barrett’s esophagus, which increases the risk of esophageal cancer.

In rare cases, a paraesophageal hernia can lead to a serious condition called strangulation, where the blood supply to the herniated portion of the stomach is cut off.

Can a Hiatus Hernia Cause a Tickly Cough?

Yes, a hiatus hernia can cause a tickly, or irritating, cough. This symptom occurs when the hernia results in gastroesophageal reflux disease (GERD).

The refluxed stomach acid can irritate the larynx and airways, leading to a persistent, often dry and tickly cough.

How Do You Perform a Hernia Cough Test?

A hernia cough test is a physical examination method often used to diagnose or confirm the presence of certain types of hernias, like inguinal hernias, but it’s not typically used for hiatus hernias.

During this test, the patient is asked to stand up and cough while the doctor feels for a bulge or movement in the area of concern. If a hernia is present, the increased abdominal pressure caused by coughing can make it more noticeable.

What is the Best Treatment for Hiatus Hernia?

The best treatment for a hiatus hernia depends on the severity of the symptoms. For mild symptoms, lifestyle modifications such as maintaining a healthy weight, quitting smoking, avoiding trigger foods, and adjusting eating and sleeping habits may be recommended.

Over-the-counter or prescription medications like antacids, H2 blockers, and proton pump inhibitors can help manage acid reflux symptoms. In severe cases or when complications arise, surgical intervention may be necessary.

Is a Hiatal Hernia Deadly?

While a hiatal hernia itself is typically not life-threatening, certain complications can be serious. For instance, a rare complication called strangulation, where the blood supply to the herniated stomach is cut off, is a medical emergency.

Additionally, untreated GERD can lead to conditions like esophagitis, esophageal ulcers, and Barrett’s esophagus, the latter of which increases the risk of esophageal cancer.

Therefore, any persistent symptoms associated with a hiatal hernia should be evaluated by a healthcare professional to prevent potential complications.

Final Thoughts

A hiatus hernia cough can be a distressing symptom, but understanding its link with GERD and seeking appropriate treatment can greatly improve the quality of life for those affected.

While over-the-counter medications may provide temporary relief, it’s important to consult a healthcare provider for a comprehensive management plan, which often involves lifestyle modifications and sometimes surgery.

Remember that each patient’s condition is unique, and what works for one may not work for another. Therefore, individualized medical advice is crucial.