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A large muscle separates the belly and chest spaces. A small opening in the muscle lets the esophagus pass from the chest into the belly. There it connects to the stomach. A hiatal hernia occurs when the stomach presses up into the chest through this hole.
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. Others will develop it later in life.
An injury to this opening can allow a hiatal hernia to start. This can happen in a trauma like a car accident. Increased pressure in the belly can also put a lot of stress on the area. Over time the area may weaken and allow the stomach to move up.
Hiatal hernias are more common in adults over 50 years of age. Other factors that increase your chance of getting hiatal hernia include:
Hiatal hernias do not always cause symptoms.
Pressure on the stomach may push stomach acid move up into the throat. It can cause:
Hiatal hernias are often accidentally found. It may be seen on tests for other issues. If you have symptoms, you will be asked about your past health. A physical exam will be done.
Images may be taken of your stomach. It will show the stomach in the chest. Test options include:
Hiatal hernias do not always need treatment. Symptoms may need to be managed.
If acid is pushing up into esophagus often, the doctor may recommend:
Certain foods increase chance of heartburn. Try cutting out:
Avoid foods and beverages that can irritate the area such as:
Other habits that may help include:
Surgery may be needed if:
There are no steps to prevent a hiatal hernia. The cause is mostly 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 October 26, 2018. Accessed March 23, 2018.
Hiatal hernia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116557/Hiatal-hernia. Updated August 29, 2018. 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: 1/7/2019