Pronounced: High-AY-tal HER-nee-uh
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 and chest cavities.
Different types of hiatal hernias include:
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The exact cause of hiatal hernias is not clear. Some people are born with a hiatal hernia but others 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.
Hiatal hernias are more common in adults over 50 years of age. Other factors that increase your chance of getting hiatal hernia include:
Most people with hiatal hernias have no symptoms.
A hiatal hernia can make stomach acid move up into the esophagus. This is known as gastroesophageal reflux disease (GERD). Symptoms of GERD can include:
You will be asked 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.
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:
For people who are obese, losing weight may relieve symptoms.
Avoid foods that relax the lower esophageal sphincter (LES), a muscle that controls the opening between the esophagus and the stomach, including:
Avoid foods and beverages that can irritate the internal lining of the esophagus such as:
To minimize acid reflux:
If you smoke, talk to your doctor about ways to quit. Smoking weakens the LES.
Elevating the head of the bed on blocks or sleeping on a specially designed wedge reduces heartburn. This position helps prevent stomach contents from refluxing backward into the esophagus.
Your doctor may recommend over-the-counter antacids. These can neutralize acid and temporarily relieve heartburn.
For chronic reflux and heartburn, several types of medications may be prescribed to reduce acid in the stomach. These include H2 blockers and proton pump inhibitors.
Surgery may be needed if:
There are no current guidelines to prevent a hiatal hernia because the cause is unknown.
American College of Gastroenterology
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Institute for Health Information
Acid reflux (GER & GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults. Accessed March 23, 2018.
Gastroesophageal reflux disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116914/Gastroesophageal-reflux-disease-GERD. Updated September 14, 2017. Accessed March 23, 2018.
Hiatal hernia. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116557/Hiatal-hernia. Updated January 2, 2017. Accessed March 23, 2018.
Hiatus hernia. Merck Manual Professional Verson website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/hiatus-hernia. Updated October 2016. Accessed March 23, 2018.
Last reviewed March 2018 by
EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 5/1/2014
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