What Is a Hiatal Hernia?

A hiatal hernia occurs when the upper part of the stomach moves up through a small opening in the diaphragm muscle into the chest. Hiatal hernias are in the upper abdomen, not the lower abdomen.

Background

• The esophagus, which carries food from your mouth to stomach, runs through an opening (called the esophageal hiatus) in the diaphragm (which separates the abdomen from the chest) to the stomach. If the stomach protrudes upward through the esophageal hiatus, you have a hiatal hernia.

Types

• The most common type of hiatal hernia is the sliding hiatal hernia, where the herniated part of the stomach moves into and out of the chest. With a fixed hiatal hernia, the herniation stays fixed in the chest. The uncommon complicated hiatal hernia may consist of more than one herniation.

Symptoms

• According to the Langone Medical Center, most people with hiatal hernias have no symptoms. However, if stomach acid moves up into the esophagus, it's called gastroesophageal reflux disease (GERD). Symptoms of GERD include heartburn, pain or discomfort in the stomach, chest, or esophagus, belching, chest pain, trouble swallowing and bleeding from the stomach or esophagus.

Treatment

• Treatments for hiatal hernias include losing weight if needed, changes in diet, stopping smoking, reducing pressure on the abdomen and prescription medications.

Surgery

• According to the Langone Medical Center, surgery for hiatal hernia may be necessary if severe GERD symptoms do not respond to other treatments or if the hernia is at risk for twisting. A twisted hernia could cut off the blood supply to part of the stomach, causing that part to die.