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.

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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.

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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.

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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.