Conversation: The conversation between human and AI assistant.
[|Human|] Im 38 female and very athletic (exercise at least one hr a day, sometimes 2 sessions for example spinning cycle), Ive been noticing feeling od lump in my throat consistently over last week, no pain, some none-smelling tiny gas bubbles come out if I twist my body. No heart burn pain just feeling of tightness. Im scared as my mom died of gallbladder cancer at 50 and she burped a lot. Is it the same thing? Is it possible that my constant exercising created the hiatal hernia? Is it that I drink coffee in the morning?
[|AI|]  Hello, I have gone through your query and understand your concern. As you know, a hiatus hernia is a condition in which a portion of the stomach is displaced into the chest. Hiatal hernias are considered important, because of the erroneous perception that a hiatus hernia predisposes to esophageal reflux. We now know that acid reflux into the esophagus is usually due to inappropriate relaxation of the lower esophageal sphincter, the muscle barrier between the stomach and esophagus. The hiatus hernia is an incidental finding that is not related to the development of the clinical problem.  Individuals who exercise will often have heartburn due to acid or food refluxing into the esophagus. When you lift weights or do setups you strain and bear down increasing the pressure in the abdomen.  This increased pressure can overcome the pressure in the lower esophageal sphincter causing material to reflux into the esophagus.  Therefore, although exercise does not make a hiatus hernia worse, it can cause symptoms that are often considered by the lay public to be associated with a hiatus hernia.  The only way that you can prevent reflux is to avoid exercises that increase intra-abdominal pressure, not a realistic option for most people who exercise.  The good news is that the reflux episode usually lasts a short time and there is no long term consequences of the reflux. However, if you are in the minority of patients who have severe reflux symptoms associated with exercise, you may consider taking one of the over-the-counter H₂ receptor antagonists or Proton pump inhibitors like Sanitizing or Pantoprazole with Antiemetic like Risperidone. Do not get concerned about this. And it does not have any relation with gall bladder. Avoid coffee or tea as you have reflex symptoms. Hope this helps. Please write back for further queries. Wishing you good health.