In a video published on Instagram on September 30, 2026, Dr Alexandre Mensier, visceral surgeon specializing in the digestive tract (@thefrench_chirurgien) explains the link between hiatal hernia And gastroesophageal reflux. The key idea: they are often associated, but one does not always imply the other.
Two disorders related, but not interchangeable
Hiatal hernia corresponds to the rise of part of the stomach into the thorax, through the orifice of the diaphragm through which the esophagus passes. In his video, the surgeon emphasizes this anatomical reminder: the stomach can “protrude” through the esophageal hiatus, that is to say pass above its usual position.
Gastroesophageal refluxor GERD, means something else: the rise of stomach contents towards the esophagus. It manifests itself mainly by burns that go up behind the sternum, called heartburn, and by acid regurgitation. A chronic cough or hoarseness can sometimes be associated, especially after meals or when lying down, but these signs are not specific to reflux.
The link between the two is real, but must be nuanced. A hiatal hernia, especially by sliding, can disrupt the anti-reflux barrier located between the esophagus and the stomach. This is what the video describes when it explains that the lower esophageal sphincter may function less well, allowing acidic contents to come back up. But a hiatal hernia can also give no symptoms. Conversely, GERD can exist without a significant hiatal hernia.
What symptoms may indicate
In practice, the two situations can therefore look similar. Burning after a meal, an acid taste in the mouth or regurgitation are more likely to indicate GERD. Hiatal hernia is often discovered during examinations carried out to explore these symptoms or another digestive problem.
The expert also mentions a possible complication of large hiatal hernias: stomach volvulus, when the stomach twists on itself. This point is important, but it does not concern all hernias. This complication is especially feared in paraesophageal hernias, also called rolling hernias, or in certain major hernias.
Another necessary nuance: chronic or complicated reflux can promote inflammation of the esophagus, called esophagitis. In some patients, it may also be associated with Barrett’s esophagus, a lesion that increases the risk of esophageal adenocarcinoma. But it should not be concluded that
any banal reflux strongly or automatically exposes you to cancer.
Certain signs should lead to seeking medical advice, and quickly if they are marked: difficulty swallowing, digestive bleeding, repeated vomiting, unexplained weight loss, anemia, or symptoms that persist despite treatment. They do not allow you to make a diagnosis yourself, but justify not trivializing the situation.
Useful everyday actions, and when a treatment is discussed
To limit reflux symptoms on a daily basis, the simple measures cited in the text accompanying the video remain the first ideas to discuss and adapt with a health professional:
- Avoid very copious meals, especially in the evening;
- Do not lie down immediately after eating;
- Raise the head of the bed when symptoms occur at night;
- Identify situations that aggravate burning or regurgitation in order to better describe them in consultation.
Proton pump inhibitors, often called PPIs, may be prescribed to reduce stomach acid secretion. They can relieve symptoms related to acidity, but they do not mechanically correct the rise of gastric contents nor a hiatal hernia. You should therefore not start, stop or modify this type of treatment without medical advice.
Surgery is not an automatic step “if the drugs don’t work”. It can be discussed on a case-by-case basis after a specialized assessment, particularly in cases of well-documented GERD, complications, dependence on treatments, or large hiatal hernia. In this context, the intervention aims to restore an anti-reflux barrier and/or to correct the hernia, most often by laparoscopy with fundoplication. Dr Alexandre Mensier mentions two techniques, Nissen and Toupet, which correspond to valves made around the esophagus using different methods.
To relieve a hiatal hernia on a daily basis, the most useful thing is to clearly distinguish what you feel: burning, regurgitation, discomfort after meals, nocturnal symptoms or unusual signs. This description helps the doctor decide whether symptomatic treatment is sufficient, whether tests are necessary, or whether specialist advice should be considered.