Hiatal Hernia Information

A hernia refers to an internal part of the body that protrudes into another area. Hiatal hernias occur when part of the stomach enters the chest cavity through a break in the diaphragm called the hiatus.

Types

• The most common hiatal hernia is sliding, which occurs when the stomach and food pipe (esophagus) enter the chest via the hiatus. In more serious paraesophageal hernias, the esophagus and stomach remain in place, although the stomach protrudes through the hiatus and extends to the esophagus.

Causes

• Hiatal hernias develop when tissue around the hiatus weakens. They also occur in people injured near the hiatus or born with an abnormally large or weak hiatus.

Symptoms

• Small hiatal hernias often have no symptoms. Large hiatal hernias may produce belching, chest pain, heartburn and nausea. If the protruding stomach becomes twisted, esophageal blockage, intense chest pain and swallowing difficulty may result.

Treatment

• Treatment is often unnecessary with asymptomatic hiatal hernias. Otherwise, surgery (laparoscopic, laparotomy or thoracotomy) or medication (antacids, H-2 blockers or proton pump inhibitors) may relieve symptoms.

Complications

• GERD (gastroesophageal reflux disease) is a frequent complication of hiatal hernias. Larger ones may also cause bleeding stomach lesions that produce anemia or restricted blood flow to the stomach.