Hiatal Hernia

A hiatal hernia is a movement of part of the stomach up into the chest cavity. The stomach presses up through a small hole in the diaphragm muscle. The diaphragm is the muscular wall that separates the abdominal cavity from the chest cavity. Different types of hiatal hernias include:

  • Causes

    The exact cause of hiatal hernias is not clear. Some people are born with a hiatal hernia but most will develop it later in life.

    The diaphragm has an opening that the esophagus can pass through. A weakening or injury to this opening can allow a hiatal hernia to develop. Increased pressure in the abdomen can also push the stomach up into the chest cavity.

  • Definition

    A hiatal hernia is a movement of part of the stomach up into the chest cavity. The stomach presses up through a small hole in the diaphragm muscle. The diaphragm is the muscular wall that separates the abdominal cavity from the chest cavity.

    Different types of hiatal hernias include:

    • Sliding hiatal hernia—part of the stomach slides into and out of the chest cavity. This is the most common type.
    • Fixed hiatal hernia—upper part of the stomach remains in the chest cavity.
    • Complicated hiatal hernia—Several other types of stomach herniation may be seen. These are uncommon but more serious and may require surgery.
    Hiatal Hernia
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  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Because they often have no symptoms, hiatal hernias are sometimes only detected during a visit to the doctor for other reasons.

    Your doctor may recommend imaging tests to investigate your symptoms. Pictures of the stomach are taken with an upper GI series or endoscopy.

  • Prevention

    There are no current guidelines to prevent a hiatal hernia because it is not known what causes it.

  • Risk Factors

    Hiatal hernias are more common in adults over 50 years of age. Other factors that increase your chance of getting hiatal hernia include:

    • Obesity
    • Abdominal injury
    • Regular increased pressure in the abdomen from activities like:

      • Severe coughing
      • Vomiting
      • Straining
      • Sudden physical exertion such as weight lifting

  • Symptoms

    Most people with hiatal hernias have no symptoms.

    A hiatal hernia can make stomach acid moves up into the esophagus. This is known as gastroesophageal reflux disease (GERD). Symptoms of GERD can include:

    • Heartburn, especially after eating or lying down
    • Pain or discomfort in the stomach, chest, or esophagus
    • Belching
    • Hoarseness
    • Frequent clearing of the throat from irritation
    • Chest pain
    • Difficulty swallowing

  • Treatment

    Talk with your doctor about the best treatment plan for you. Hiatal hernias are usually treated only when there are symptoms. When GERD is present, treatment may include one or more of the following: