Hiatal Hernia

What is hiatal hernia?

During the swallowing and digestive process, food and liquid passes through the esophagus. The esophagus is a long tube that extends from the throat down through an opening, or hiatus, in the diaphragm (thin layer of muscle separating chest from abdomen) and into the stomach. Sometimes the stomach can push up into the opening—the stomach bulging into the chest area—causing a hiatal hernia.

Causes of hiatal hernia

Certain people may be more likely to have this condition, including pregnant women and people who are obese or overweight because of the additional strain and pressure this puts on the stomach area. Excessive straining from bowel movements and coughing may also cause hiatal hernia. Some people are born with a larger hiatal opening, which may also make them more likely to experience a hiatal hernia at some point in their lives.

In general, the condition is more common in women, and in people who are over 50 years old and who are overweight.

Types of hiatal hernia

There are two types of hiatal hernias:

  • Sliding – referring to the stomach and the esophagus “sliding” up through the opening into the chest area, which is more common and less problematic
  • Paraesophageal – when only the stomach squeezes through the opening, causing a potentially dangerous situation because its blood supply can be cut off

In mild cases, a person may have no symptoms at all and may not know about the condition unless a doctor discovers it during some other type of examination.

In more severe cases, food and stomach fluid can back up into the esophagus. This may cause symptoms such as heartburn and eventually gastroesophageal reflux disease (GERD). Other types of symptoms may include chest pain, similar to heart attack, which is why it’s important to get checked by your doctor to rule out life-threatening illness.

Some people also experience:

  • Belching
  • Black stool (which may indicate intestinal bleeding)
  • Difficulty swallowing

Diagnosis and testing of hiatal hernia

To diagnose a hiatal hernia your doctor will perform a physical exam and review of your medical history. Certain tests, such as barium swallow (upper GI series), endoscopy, and esophagogastroduodenoscopy (EGD) test.



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