What Is a Hiatal Hernia?
hernia occurs when the upper part of your stomach pushes up through your
diaphragm and into your chest region.
is a large muscle that lies between your abdomen and chest. You use this muscle
to help you breathe. Normally, your stomach is below the diaphragm, but in
people with a hiatal hernia, a portion of the stomach pushes up through the
muscle. The opening it moves through is called a hiatus.
mostly occurs in people who are over 50 years old. It affects up to 60 percent
of people by the time they’re 60 years old, according to the Esophageal Cancer Awareness
What Causes a Hiatal Hernia?
cause of many hiatal hernias isn’t known. In some people, injury or other
damage may weaken muscle tissue. This makes it possible for your stomach to
push through your diaphragm.
is putting too much pressure (repeatedly) on the muscles around your stomach.
This can happen when:
during bowel movements
are also born with an abnormally large hiatus. This makes it easier for the
stomach to move through it.
can increase your risk of a hiatal hernia include:
Types of Hiatal Hernia
generally two types of hiatal hernia: sliding hiatal hernias and fixed, or
Sliding Hiatal Hernia
This is the
more common type of hiatal hernia. It occurs when your stomach and esophagus
slide into and out of your chest through the hiatus. Sliding hernias tend to be
small. They usually don’t cause any symptoms. They may not require treatment.
Fixed Hiatal Hernia
This type of
hernia isn’t as common. It’s also known as a paraesophageal hernia.
In a fixed
hernia, part of your stomach pushes through your diaphragm and stays there.
Most cases are not serious. However, there is a risk that blood flow to your
stomach could become blocked. If that happens, it could cause serious damage
and is considered a medical emergency.
Symptoms of a Hiatal Hernia
It’s rare for
even fixed hiatal hernias to cause symptoms. If you do experience any symptoms,
they’re usually caused by stomach acid, bile, or air entering your esophagus.
Common symptoms include:
that gets worse when you lean over or lie down
pain or epigastric pain
or a strangulated hernia may block blood flow to your stomach. This is
considered a medical emergency. Call your doctor right away if:
can’t pass gas or empty your bowels
that a hiatal hernia is causing your chest pain or discomfort. It could also be
a sign of heart problems or peptic ulcers. It’s important to see your doctor.
Only testing can find out what is causing your symptoms.
What Is the Connection Between GERD and Hiatal Hernias?
reflux disease (GERD) occurs when the food, liquids, and acid in your stomach
end up in your esophagus. This can lead to heartburn or nausea after meals.
It’s common for people with a hiatal hernia to have GERD. However, that doesn’t
mean either condition always causes the other. You can have a hiatal hernia
without GERD or GERD without a hernia.
Testing for and Diagnosing Hiatal Hernias
can diagnose a hiatal hernia.
may have you drink a liquid with barium in it before taking an X-ray. This
X-ray provides a clear silhouette of your upper digestive tract. The image allows
your doctor to see the location of your stomach. If it’s protruding through
your diaphragm, you have a hiatal hernia.
may slide a thin tube in your throat and pass it down to your esophagus and
stomach. Your doctor will then be able to see if your stomach is pushing
through your diaphragm. Any strangulation or obstruction will also be visible.
Treatment Options for Hiatal Hernias
Most cases of
hiatal hernias don’t require treatment. The presence of symptoms usually
determines treatment. If you have acid reflux and heartburn, you may be treated
with medications or, if those don’t work, surgery.
your doctor may prescribe include:
antacids to neutralize stomach acid
or prescription H2-receptor blockers that lower acid production
or prescription proton pump inhibitors to prevent acid production, giving your
esophagus time to heal
don’t work, you might need surgery on your hiatal hernia. However, surgery is
not commonly recommended.
Some types of
surgery for this condition include:
weak esophageal muscles
your stomach back in place and making your hiatus smaller
surgery, doctors either make a standard incision in the chest or abdomen, or use laparoscopic surgery, which
shortens recovery time.
come back after surgery. You can reduce this risk by:
at a healthy weight
help lifting heavy objects
strain on your abdominal muscles
Lifestyle Changes to Address Your Symptoms
causes most hiatal hernia symptoms. Changing your diet can reduce your
symptoms. It may help to eat smaller meals several times a day instead of three
large meals. You should also avoid eating meals or snacks within a few hours of
going to bed.
There are also
certain foods that may increase your risk of heartburn. Consider avoiding:
made with tomatoes
Other ways to
reduce your symptoms include:
the head of your bed by at least 6 inches
bending over or lying down after eating
Reducing Your Risk of Hiatal Hernias
You may not
avoid a hiatal hernia entirely, but you can avoid making a hernia worse by:
straining during bowel movements
help when lifting heavy objects
tight belts and certain abdominal exercises