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A hiatal hernia occurs when the upper part of the stomach pushes through the hiatus -- an opening in the diaphragm (the muscle separating the chest from the abdomen) through which the esophagus passes. This condition is extremely common, affecting an estimated 60% of adults over age 60, although many people are unaware they have it because it often causes no symptoms.
There are two main types: sliding hiatal hernias (Type I), which account for about 95% of cases and involve the gastroesophageal junction sliding above the diaphragm; and paraesophageal hernias (Type II-IV), where part of the stomach herniates alongside the esophagus. Sliding hernias are usually associated with GERD symptoms, while paraesophageal hernias, though less common, can occasionally lead to serious complications such as gastric volvulus (stomach twisting) or strangulation.
Dr. Jing Tong diagnoses hiatal hernias during upper endoscopy at his Flushing, Queens office. His thorough evaluation determines the type and size of the hernia and assesses any associated esophageal damage. Most hiatal hernias are managed medically through acid suppression and lifestyle modifications. Dr. Tong's Johns Hopkins training ensures he can distinguish between hernias requiring conservative management and those rare cases that may benefit from surgical referral.
Burning chest pain, especially after meals or lying down
Acid or food backing up into the throat
Food feeling stuck in the chest area
Pain in the chest area that may mimic heart problems
Excessive belching and bloating after eating
Worsening reflux when lying flat at night
Dr. Tong evaluates the hernia during upper endoscopy, determining its type, size, and associated complications such as esophagitis, ulceration, or Barrett's esophagus.
Elevating the head of your bed, eating smaller meals, avoiding late-night eating, losing excess weight, and avoiding trigger foods can significantly reduce symptoms associated with hiatal hernia.
PPIs or H2 blockers effectively control acid reflux symptoms caused by hiatal hernia. Dr. Tong optimizes your medication regimen for maximum symptom relief with minimal side effects.
Large paraesophageal hernias with risk of complications or hernias not responding to medical therapy may require surgical repair (fundoplication). Dr. Tong coordinates referral to experienced surgeons when needed.
Expert evaluation distinguishing between hernia types and identifying associated complications.
From endoscopic diagnosis to medical management and surgical referral coordination when needed.
Clear explanations in English, Mandarin, and Shanghainese for the Flushing community.
Roosevelt Avenue location, accessible by 7 train, LIRR, bus, and car with nearby parking.
Most hiatal hernias (sliding type) are not dangerous and can be managed with lifestyle changes and medication. Large paraesophageal hernias carry a small risk of serious complications and may require closer monitoring or surgery.
Hiatal hernias do not heal on their own, but symptoms can often be effectively managed without surgery. Weight loss, dietary changes, and medication can significantly reduce or eliminate symptoms for most patients.
Surgery is considered for large paraesophageal hernias at risk of complications, hernias causing severe symptoms unresponsive to medication, or when emergency complications (strangulation, volvulus) occur. Dr. Tong will advise if surgery is recommended.
Hiatal hernias can contribute to GERD by weakening the lower esophageal sphincter and trapping acid above the diaphragm. However, not everyone with a hiatal hernia has GERD, and not everyone with GERD has a hiatal hernia.
Avoid heavy lifting, sit-ups, and exercises that increase abdominal pressure. Gentle activities like walking and swimming are generally safe. Dr. Tong can provide specific activity recommendations based on your hernia type.
Schedule an appointment with Dr. Jing Tong at our Flushing, Queens office.
