Disclaimer: I’m not a doctor, just someone interested in self-care, anatomy, physiology, and wellness who is relating her personal experience working on her own issues. If you are in a similar situation, the techniques described below may or may not be helpful. Always pay attention to your body’s yes and no, and seek medical care when needed.
A couple of years ago, I woke up in the middle of the night with chest pain. I didn’t know what it was. I sat up, just feeling it, trying to figure out what was causing it and whether I needed to call an ambulance. That I was having a heart attack was my big fear. From the top of my solar plexus, the pain ran up through the middle of my chest underneath my sternum and up my throat. It was very unpleasant.
It went away, and I went back to sleep. I woke up feeling fine. Although scary, it didn’t seem to be any kind of an emergency. I put it out of my mind and went about my business.
Then it happened again a couple of times. This seemingly random chest pain sent me to the doctor, who through testing was able to rule out heart disease, possibly pancreatic cancer, and stomach ulcer. She wanted me to go to a gastroenterologist and do a barium swallow with x-rays.
I didn’t want to do that procedure, and by then, being the curious researcher that I am, I had figured out that it was very likely a hiatal hernia. See the images below.
So I began self-treating, starting with reading online. I learned:
- hiatal hernias are more common in older people
- obesity can be a factor
- acid reflux can be a factor
- overeating can make it worse
- you can avoid symptoms by not eating 2-3 hours before bedtime
- posture plays a role
Yes, even though I’m a yogi and usually have pretty decent posture, I was sitting on my sofa using my laptop all hunched over for a few hours several times a week. My fix for that was to sit cross-legged with my back straight, with my laptop on a thick pillow.
I am 64, and although not obese, I’ve put on a few pounds in the last few years. I’ve been guilty of eating late after a busy day and occasional overeating. I haven’t felt any symptoms of acid reflux, though, but learned you can have acid reflux without symptoms.
I learned more about the anatomy of a hiatal hernia. Simply put, the diaphragm separates your chest cavity from your abdominal cavity and moves when you breathe. The hiatus is an opening in your diaphragm where your esophagus passes through to your stomach.
When the hole is enlarged, a little bit of your stomach can protrude upward through the hole, crowding your chest cavity. Thus…lying down or bending over with a full stomach brings the pain on.
There is reportedly no cure, and in severe cases, drugs or surgery may be needed.
My favorite quick relief for hiatal hernia pain? Drink a glass of water, 8 to 12 ounces. Then stand on your tiptoes and quickly drop your heels, repeating this several times. The weight of the water in your stomach combined with the quick downward motion will jostle your stomach back down into its proper place beneath the diaphragm. Here’s a video showing the technique.
I also read about yoga poses to avoid: cobra, inversions like downward facing dog, and other poses I was doing every day. This was a drag. I wasn’t liking this at all.
I still had occasional esophageal spasms and finally did get the barium swallow. The diagnosis confirmed my intuition: I have a small “sliding hiatal hernia”.
Not long after, I was meditating, and I suddenly had an insight that a yogic breathing practice I’d learned decades ago called Breath of Fire (Sanskrit kapalabati or “skull shining breath”) might be helpful. I hadn’t practiced it in years. This technique pumps the diaphragm through rapid breathing, and since the diaphragm is a muscle, it can be strengthened through training.
Watch this video if Breath of Fire is new to you. Actual instruction starts at 2:50.
I started doing Breath of Fire for a minute a day. It was hard at first to breath rapidly in a steady rhythm, but it got easier. I worked up to 3, then 5, and then 10 minutes a day, building strength and stamina while maintaining a steady rhythm.
The diaphragm is a muscle that can be strengthened like any other muscle. At first, I felt some muscle soreness around the bottom of my rib cage, front, sides, and back, where the diaphragm attaches. After a few days, the soreness went away.
Not only does Breath of Fire strengthen your diaphragm, it also floods your body with oxygen, massages your organs, pumps your lymphatic system, and has other benefits. Since I started doing this three months ago, I’ve noticed a gradual increase in energy, mental clarity, positivity, and motivation. I feel more on top of things and happier.
I now do Breath of Fire for 3 minutes every morning for maintenance, and I haven’t had any hiatal hernia discomfort since I started. (I avoid eating near bedtime and lying down after eating.)
I do the yoga poses I want to do without any problems. I’ve long been a hatha yogini, but now I’m interested in learning more kundalini, where this practice originates, as far as I know.
It would take a truly open-minded, yoga-trained Western doctor to tell you to do this very simple technique, so I’m sharing. If you have a hiatal hernia and try these techniques, please share your experience in the comments.
Addition, April 11, 2018. If you have a hiatal hernia, it’s important to know that you may have acid reflux, where you don’t produce enough stomach acid to break down the protein in food and to stimulate the production of digestive enzymes. You may burp, have gas, and/or feel bloated. You may also have acid reflux without any symptoms.
Low stomach acid signals the lower esophageal sphincter to stay open, making it more likely for a hiatal hernia to develop, and the stomach acid you do produce can splash up into the esophagus and possibly cause scarring and thickening. Not good.
The remedy for low stomach acid — which becomes more common with age — is to take a supplement containing Betaine HCl and pepsin. It helps you digest protein and absorb amino acids from food. Protein is in all animal-derived food sources — meat, fish, poultry, eggs, and dairy — and legumes, including soy, tofu, and tempeh, and other foods. Protein helps your body build and repair tissues, especially important in building muscle, bone, blood, cartilage and skin. You definitely want to assimilate the protein you eat.
HCl also helps kill off pathogens in food.
There are some cautions about taking this. I found this article very helpful in explaining who should not take HCl and why.
It also explains how to find out how much you need to take, so as not to take too little to be effective or too much and experience discomfort. (If that happens, take 1/2 tsp of baking soda in water to neutralize the excess acid, and then cut back on the amount you’re taking.)
If you can’t take Betaine HCl before eating protein, drink a tablespoon of apple cider vinegar or lemon juice (shoot or dilute) to help acidify your stomach. These won’t help you break down the protein but may prevent acid reflux.
You can also take digestive bitters. Bitter tastes stimulate digestion. Our ancestors knew this and ate bitter foods every day — such as citrus, greens, cruciferous veggies, artichokes, ginger and other herbs, pepper, chocolate, and red wine.
Herbalists have been making bitter elixirs since at least the Middle Ages. I like this brand and carry it in my purse for those times when I forget to refill my little pill container with Betaine HCl and digestive enzymes.
You may also want to take digestive enzymes to help your stomach break down substances in food into molecules that you can absorb. If you are eating a healthful diet, you want your body to actually absorb the nutrients in that healthy (and possibly expensive or laborious-to-grow) food. Enzymes help further break down protein and also fats and carbohydrates. Low stomach acid goes hand-in-hand with low digestive enzymes.
A note on the timing: my doctor, who is working with me on my digestive issues, recommends taking 3 digestive enzymes at the beginning of meals and 3 Betaine HCl capsules after. I aim at taking the latter about 20 minutes after I finish eating so the HCl won’t deactivate the digestive enzymes.
You can take a dropperful of bitters before, during, or after meals.
Let me know in the comments what your experience is with any of this, please.
The video is ok, but she doens’t talk about the breath being in and out through the nostrils like it’s mostly done. She demonstrates it through an open mouth a lot and then she does it with the nostrils. That’s an important pt that she missed.
Thanks for your comment, Helene. The original link has been replaced with a link to a better demo of Breath of Fire that shows the technique with a closed mouth, which is how I do it. I appreciate your perspective on this since you are a long-time teacher of yoga. ❤
What do you like to do in your spare time?
If “not working for money” is spare time, I like to meditate. Read. Spend time with friends and family. Plant trees. Cook. Work on home improvement. Dance. Do Aikido, yoga, qigong, tai chi. Get out in nature. Camp. Take classes. And you?
I am curious to know how long after starting practising breath of fire did you notice an improvement in your hiatal hernia symtoms?
I don’t remember exactly, but maybe a week. I also worked on my posture, didn’t eat within a couple of hours of bedtime, and didn’t lie down after eating. All of that helped.
Nice article, thank you. Namaste.
Does the breath of fire have to be done when the hernia is down or will this eventually force it down on its own?
Yes. To force the stomach down through the herniated opening on its own, drink a glass of water to put weight in your stomach. Then stand on your tiptoes and come down hard on your heels. You may need to do this several times to jostle the stomach down below the diaphragm.
Thanks for the article. Do you drink water before doing the breath of fire? Or the stomach should be empty? Also, (as of 2020 ) I wonder if you still do the breath and how is your hernia?
I don’t drink water before doing breath of fire, and I often did breath of fire when driving to and from work. My hernia rarely gives me problems now, so I rarely do breath of fire. Not eating after about 6:30 pm has also helped a great deal, so when I lie down my stomach is empty. Thanks for asking!
I mean 2021, sorry 🙂
Could you clarify your comment for me? Is that yes you can do the breath of fire while the stomach is up or only when the stomach is down? It seems like if you wait until only when it’s down it might be hard to make progress. Thank you!
Hi, Ron. Do breath of fire while the stomach is down to strengthen the diaphragm and build muscle tone, which makes it a little harder for the stomach to protrude up. You can try doing it when the stomach is up but it seems like it could be painful. It might work — I haven’t tried that. The water weight in the stomach method avoids pain and is very effective.
Just wanted to thank you immensely for posting this information. The water technique worked instantly, as well as doing self massage pushing the stomach down after taking deep breaths. I have been spreading the word among my massage clientele and friends. Thanks again!
Stumbled upon this blog because I started taking a betaine supplement and due to both probably having really low levels of stomach acid and a hiatal hernia, I’ve been experiencing some burning sensations after eating. Did you experience this and did it go away? Don’t want to worsen the hernia or further irritate the esophagus. Also appreciate the breath of fire and will try it!
I’ve rarely had burning sensations, but I have scarring in my esophagus (apparently from low stomach acid not closing the lower esophageal sphincter) along with a hiatal hernia. I take HCl after meals — If I take too much, I experience burning, and I take a little baking soda in water to neutralize. Breath of Fire, plus never lying down with food in the stomach, should keep the hernia from getting worse. Wishing you luck!
Thank you. I have been suffering for a few weeks. I thought at first I had indigestion, but there was no burning or other normal symptoms. Just a feeling of something stuck in my chest. That’s how I described it to my chiropractor, who I will see next week. In the meantime, I’m excited to start the fire meditation to cure myself.
Thank you so much for sharing your experience.
I have a hiatal hernia and thought the exact same thing you did: The diaphragm is a muscle so how can I strengthen it? Modern medicine is finally starting to explore the science behind ancient medicine, such as manual manipulation (massage, etc), breathing, microbes, and the mind-body connection, but it has yet to become mainstream.
Hi there, I’m in a totally opposite situation! I’ve been doing breathe of fire for about 5 years as part of an off and on regular kundalini yoga practice. I love kundalini yoga. Its changed my emotional and physical health for the better in so many ways. And I regularly use HCl after finding out that low stomach acid was causing reoccurent H. pylori infections (Zypan has been my favorite, about 3 years on it). And then this past summer (its winter now) I found out that I’ve been dealing with chronic Epstein Barr for the past 10 years, IGG levels off the testing charts, my chronic health situations finally made sense. So my PCP recommended I take anti-virals for it — Valocyclovir. The protocol included taking a stomach acid blocker with every Valocylclovir, so that meant 3 times per day.. And since I’d been so big into stomach acid as the base for a good gut system, I said no-way to the stomach acid blocker (a histamine blocker called Zantac). And I kept taking the HCl supplement. And I added in Lysine, an amino acid that fights viruses, except that was coated in HCl, but I didn’t think twice on that. And the antiviral, Valocyclovir, is also coated in HCl, but that seemed like a bonus. So I was getting my HCl at 3x what had become my normal amount everyday. I didn’t think this could be an issue, in fact I thought it would just help my digestion. Well, add in my copious love of ginger, both dried and fresh, and black pepper, and spicy foods, and I started getting severe cramping in upper and lower abdomen, and I thought it was H. pylori, except my usual herbs for treating Hy. pylori weren’t working. My chinese medical doc adjusted herbal formulas a bunch, and then I was okay, but it took about 2 weeks to heal and feel okay in my belly again. I realized that since the symptoms started dissapating fast after I stopped the anti-virals, that I had overdid the HCl, so I backed off totally, no more HCl at all, let my body heal. (I don’t do good with moderation…) But I started back up my kundalini practice as my body healed and I had more energy. 1.5 months after I’d felt healed, I started getting upper abdominal pain, like super bad, just below my sternum, like I was being knifed there, and pain in my stomach and colon. I just got an endoscopy today, and the early results are showing “Barrett’s esophagus without dysplasia” and “Diaphragmatic hernia without obstruction or gangrene”… So now I”m in an odd place… the anti-virals and all the HCl had thrown my body for a loop — a body that was once vata-pitta had become pitta… and then became vata again, or is it still pitta? Did breath of fire help create the hernia when my stomach was really weak and not ready to do it? I have no idea… but it seems like I’m in a tightrope situation. Did the heightened levels of HCl cause damage that lead to the Barrett’s esophogas? Could it happen that fast, in just a month of being on the anti-virals? Or was it not having HCl in the 1.5 months after healing my belly, the low levels of stomach acid, that led to the Barretts esophogas and then the hernia? I’m so lost. My intention in sharing is to underscore how important having the right amount of stomach acid is… too low, and it leads to fatigue, food allergies, small intestine and colon issues, H. pylori infections, potentially GERD and Barrets esophagas? And too high it leads to GERD and Barrett’s esophogas? Its a tightrope. I’ve learned HCl is not the panacea that I thought it was. I mean it is, but dosage is important. And when to do breathe of fire also feels important — not when there’s food in the stomach (I never ate before kundalini, but I sure did usually have a cup of tea with a splash of soymilk!). Just sharing my experience in case it helps anyone out, moderation is key!
Thanks for sharing your experience here.