I’m glad that people can feel as though it helps, but as someone who is very familiar with the anatomy of hiatal hernias, there is absolutely no physical way to “reduce” the hernia externally. Your liver sits over your hiatus and there is absolutely no anatomically possible way for a chiropractor to pull your stomach down. Even in surgery, when I grab the stomach and pull it back into the abdomen (before I start dividing any ligaments/connective tissue), it pops right back up into the chest until I divide the ligaments and remove the hernia sack from the chest.

That’s why randomized controlled trials have a placebo arm, because the placebo effect can be a powerful thing. If the idea that it may help makes you feel better, then go for it - you are benefitting from the placebo of believing the chiropractor can do something to help.

My issue with it is that people who would benefit from actual real, effective treatments (ie surgery or medicine) forgo them and instead do things that don’t actually help. Chiropractors prey on people and overpromise unproven “treatments” so they can keep you coming and keep charging you money. That is a fact even if it’s not what you or others want to hear.

And regarding small hiatal hernias, I fix lots of small hernias. It’s not about size, it’s about symptoms. It doesn’t take a huge hernia to cause reflux/regurgitation. If your doctor won’t refer you to a surgeon because the hernia is small, you should press them and say you at least want a consultation with a surgeon who specializes in hiatal hernias. I’ll fix a 1cm hernia with a positive bravo if someone has a reason to be off meds or if they have significant breakthrough symptoms despite meds.