3 Reasons Hiatal Hernia Persists

Have you rushed to the ER convinced you were having a heart attack?  You had heart palpitations, shortness of breath and anxiety out the roof? You also suffer with acid reflux, bloat, gas, and/or constipation.Educational content reviewed by licensed APRN medical staff. Not personal medical advice.Every test comes back normal, but your heart still races, the shortness of breath impacts your day to day life and your gut is a mess.Your cardiologist assures you there's nothing wrong, yet you feel "off" and keep suffering.In the video, Dr Vikki Petersen explains what the 3 missing "pieces" of Hiatal Hernia Syndrome are and why they need to be evaluated in order to achieve successful relief.We utilize a patient-tailored approach - Personalized medicine, because there isn't a "one size fits all" solution.Diet, posture, breathing - why “one size doesn’t fit all”Symptoms influenced by: diet, digestion efficiency, motility within the gut, microbiome health, diaphragmatic breathing, and vagal nerve tone1. DIET  Recent work highlights that diet composition—not just acid suppression—matters for reflux and hiatal hernia symptom burden. Interventions focusing on reduced overall sugar intake, increased fiber, and mindful eating patternsSMOKING & WEIGHT  Risk factor data indicate abdominal pressure, physical workload, smoking, and central adiposity are risk factors.2. MOTILITY & MICROBIOME  Current GERD/hiatal hernia literature recognizes the influence of gut motility and possibly microbiome interactions on reflux patterns.PPIs, given for reflux, can make it worse - can’t be the only treatment. You can’t feel the reflux but it’s still there. It doesn’t correct motility or pressure issues3. STRESS  Stress reduction and vagal nerve influenceTIPSEat smaller mealsStop eating 3–4 hours before bedAvoid tight clothingChew thoroughlyAvoid large mixed meals late at nightPay attention to early fullness, bloating, or nauseaWalk after mealsStay upright for at least 20–30 minutes after eating.Belly breathing - before meals and practiced during the dayDiaphragm part of anti-reflux barrier so needs to be exercisedAddress constipation and gas - increases pressureReferences:Martinucci I et al., “Esophageal motility abnormalities in gastroesophageal reflux disease,” 2014, World Journal of GastroenterologyVoulgaris T et al., “Is there a direct relationship between hiatal hernia size and reflux events,” 2023, Annals of GastroenterologyBucan JI et al., “Updates in Gastroesophageal Reflux Disease Management,” 2025, Medicines (MDPI)Lin S et al., “Esophageal Motor Dysfunctions in Gastroesophageal Reflux Disease,” 2019, Journal of Neurogastroenterology and MotilityFreedberg DE et al., “The impact of proton pump inhibitors on the human gastrointestinal microbiome,” 2014, GutTian L et al., “Proton pump inhibitors may enhance the risk of digestive complications,” 2023, Frontiers in PharmacologyRemes-Troche JM, “PPIs Have It: Does Tegoprazan Affect Gastric Emptying and Produce Dyspeptic Symptoms?,” 2025, Digestive Diseases and SciencesAndrews WG et al., “The relationship of hiatal hernia and gastroesophageal reflux,” 2021, Annals of the American Thoracic Society#hiatalhernia #acidreflux #guthealth #rootcausemedicine Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video.The views expressed ar