Can a Hiatal Hernia Be Manually Adjusted? The Truth About Non-Surgical Options

[video transcript] Did you know that a hiatal hernia can be manually adjusted in the office? That's a good thing because usually the end game on hiatal hernias is some form of surgery. Today, I'm at the Gastro ANP Conference in Seattle, the annual convention of us "Gut Geeks" in the naturopathic world. I always love coming to this. In a little while, I'm going to retake a training from the great Dr. Steven Sandberg-Lewis on how to adjust hiatal hernias. This is something I do in the office on a regular basis. I always love hearing from him; he's been doing this a very long time.

So let's get into hernias and what those are, which ones can be adjusted safely, and what kind of relief it can provide.

Understanding Hiatal Hernias and Their Symptoms

A hernia is really just kind of an up-pouching of the stomach above the diaphragm. Sometimes it's where the esophagus will just kind of kick out into a little bubble on the side. But if you think about the structures that are there, your diaphragm is there, and so it can kind of sit on top of there and then eventually kind of "glug, glug, glug" will go down.

Well, while it's sitting up there, it creates a lot of horrible symptoms: nausea, vomiting, sometimes tons of mucus, a "globus sensation" up here. A lot of the same acid reflux-type symptoms: tight chest, tight throat, hoarse voice, a feeling of fullness in the stomach even though maybe you ate three or four hours ago. Well, it's that little pouch; it's just still sitting there. And that can be adjusted, but you've got to know what kind of hernia you have to do that.

Oftentimes when these conditions sit around for a while, they get chronic, and people go to the gastroenterologist and get an endoscopy, and they will see it and they will grade it. Now, if it's over like three or four centimeters of gap, then they would recommend surgery, usually a fundoplication. It's one of those words that is what it sounds like, which is they take the stomach and they kind of wrap it around the esophagus just to kind of pin everything in place so that this looping doesn't continue to happen.

Paraesophageal vs. Sliding Hiatal Hernias

There are two types of hernias:

Paraesophageal Hernia: This is the more serious one; they usually have a fundoplication for. It's just kind of like a loose piece of rope where, if my hand here is your esophagus, the hernia loops up. It's like "oop," like that. And there's a big gap there, and it just happens over and over again. So the surgery is really corrective. They flop the stomach over and just pin everything back down, which is really corrective, and it really works wonders for many people. But again, surgery is not without its risks.
Sliding Hiatal Hernia: Let's talk sliding hernia. Sliding hernias are the most common. 90 to 95% of people with hernias have this specific type of hernia, and this is the one that we can adjust. Why? Because it's usually anatomical and positional. So it's called a sliding hernia because it'll slide back and forth when you change positions. So if this is your stomach, and this is your diaphragm here, when you lay down, your stomach will kind of pouch up over the diaphragm, and then it kind of gets stuck there. Not the whole stomach, but just a little tiny bubble of it that has food in it usually, or air, and then it just kind of comes down. But while it's there, it creates a lot of uncomfortable symptoms.

Manual Adjustment: A Non-Surgical Solution

Well, that's the one that we can adjust. We can kind of go in here, you know, find the structures, and do some manual therapy and just kind of guide it back into place. And usually, when I'm doing this therapy on somebody, I will actually just feel it like go "pop" and go right back down. Oftentimes, we'll hear a noise; it'll kind of "gurgle, gurgle, gurgle," and then it's like, and then the patient feels a great deal of relief. And if you do this right, it is corrective in and of itself; you're almost like training your stomach to kind of go back into place and kind of tell itself, "Oh yeah, I'm not supposed to be up here."

And then, you know, there's coaching as well, so that we're eating appropriately. If you watch my channel a lot, I'm always talking about "20% less." You know, so 20% slower, 20% less volume, chew 20% more. If we're kind of nailing the basics and you're susceptible to a sliding hernia, you're creating situations with smaller amounts and less stress on the GI system that maybe that doesn't pop up. But if it does pop up and it is a sliding hernia, we can manually adjust it. And this is often corrective.

Seek a Holistic Approach to Your Gut Health

So if you need a manual adjustment or just want to talk a little bit more about hiatal hernias or your gastrointestinal problems with somebody who's going to take a big-picture approach and really get to the root cause for you – if that would be me – check out my website. It's drdanwool.com. I'm on all the socials at Dr. Dan Wool, and in the meantime, it is Dr. Wool. "Fix your gut, solve your health."