If you reach for an antacid every morning the way most people reach for their coffee, you may be dealing with a bigger problem than simple acid reflux. While millions of Americans manage daily heartburn with medications that reduce acid, many never realize the problem is structural: a hiatal hernia, a condition in which part of the stomach pushes up through a small opening in the diaphragm and into the chest, can actually break down the body's built-in barrier against reflux. 

Research finds that as many as 94% of patients diagnosed with GERD have a sliding hiatal hernia. That number raises a question: if the hernia is almost always there, why are so many treatment plans focused entirely on the acid? 

Read on to learn more about the connection between hiatal hernias and GERD, why medication often delivers only temporary relief, and how to find lasting relief with the best GERD doctor in Los Angeles.

How Can a Hiatal Hernia Cause GERD?

Your diaphragm is a dome-shaped muscle that separates your chest from your abdomen, and it has a small opening called the hiatus where your esophagus passes through on its way to your stomach. Normally, the lower esophageal sphincter (LES), a ring of muscle that acts like a one-way valve, sits just below the diaphragm and keeps stomach acid from flowing back up. When a hiatal hernia forms, the upper part of the stomach pushes through that opening and into the chest cavity, pulling the LES out of its correct position and weakening its ability to hold acid back. Over time, this structural problem can lead to GERD symptoms, including: 

  • Burning sensation in the chest, known as heartburn
  • Regurgitation of food or acid into the throat 
  • Bitter or sour taste in the mouth
  • Difficulty swallowing
  • Chronic sore throat or hoarseness
  • A feeling of a lump in the throat
  • Chronic cough
  • Nausea or bloating
  • Waking up at night with acid or chest discomfort

Signs a Hiatal Hernia May be the Cause of Your Acid Reflux Symptoms

One of the frustrating things about hiatal hernias is that their symptoms look almost identical to ordinary acid reflux, which makes them easy to miss or easy to blame entirely on food choices and stress. The most common symptoms of a hiatal hernia include: 

  • A burning sensation in the chest after eating
  • Regurgitation of food or acid into the throat
  • Difficulty swallowing
  • Chronic sore throat
  • Hoarseness
  • Recurring chest pain that can feel unsettlingly similar to a heart problem

Many people go years attributing their discomfort to acid reflux alone, never realizing that a hiatal hernia may be the underlying structural cause driving those same symptoms. 

Why Medications Alone Can’t Fix a Hiatal Hernia 

Proton pump inhibitors, commonly known as PPIs, are among the most prescribed medications for GERD because they are effective at reducing the acid content in the stomach and giving an irritated esophagus a chance to heal. But there is an important distinction between reducing acid and stopping reflux: Medications alone cannot stop the physical act of regurgitation, and they cannot stop a hernia from growing larger over time. Medication helps make the fluid that escapes the stomach less damaging, which is helpful, but it is not the same as fixing the leak. Hiatal hernia repair stops the reflux of both digestive enzymes and acid entirely. 

Hiatal Hernia Surgery: When You Need it & What to Expect

The most common procedure for repairing a hiatal hernia is a laparoscopic Nissen fundoplication, which is considered the gold-standard approach for GERD-related hiatal hernias. It involves wrapping the upper portion of the stomach around the lower esophagus to rebuild a functioning valve. This is done through several small incisions rather than one large opening, which significantly reduces both recovery time and post-operative discomfort. If a hiatal hernia is present, it is repaired during the same operation. 

After surgery, most patients spend one to two nights in the hospital, follow a temporary liquid and soft-food diet for a few weeks while swelling goes down, and are encouraged to start walking the very first day. Many patients report feeling noticeably better within days of the procedure. Hiatal hernia surgery carries a high success rate, and the majority of patients are able to stop taking reflux medications entirely and live free of acid reflux symptoms afterward. 

Finding the Best GERD Doctor in Los Angeles for Acid Reflux Relief and Minimally Invasive Hernia Repair Surgery

Chronic reflux is not something you have to learn to live with. Dr. Danny Shouhed is a board-certified gastrointestinal surgeon who specializes in minimally invasive and robotic surgical techniques for hiatal hernia repair, anti-reflux surgery, and complex foregut conditions, including cases where a previous GERD surgery has failed, and revision is needed. 

For those in and around Beverly Hills, we prioritize minimally invasive techniques whenever possible, which reduces your risk of infection, shortens recovery, and minimizes post-operative pain. 

If you have been managing reflux symptoms with daily medication and are not getting the relief you need, a thorough evaluation with the best GERD doctor in Los Angeles is the first step toward a personalized treatment plan. 

Ready to get permanent relief from acid reflux symptoms with the best GERD treatment in Los Angeles?