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Definition

A hiatal hernia occurs when the stomach pushes through the muscle between the abdomen and chest.

Rarely, a hiatal hernia can get trapped in the chest cavity. This is called strangulation. It needs care right away.

Hiatal Hernia
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Causes

This problem may be caused by:

  • Weakened muscles
  • An injury to the chest opening, such as a car accident
  • A buildup of pressure in the belly, such as from obesity or pregnancy
  • Recent surgery on the digestive system

Some babies are born with this problem. This is not common.

Risk Factors

Hiatal hernias are more common in older adults. Obesity also raises the risk.

Symptoms

Some people do not have symptoms. Those who do may have:

  • A burning feeling in the chest, especially after eating or lying down
  • Problems swallowing, such as food that comes back up
  • Pain or discomfort in the throat, chest, or stomach
  • Nausea and vomiting
  • Feeling very full after eating
  • Problems breathing
  • Burping

Diagnosis

Hiatal hernias are often seen on tests for other health problems. The doctor will ask about your symptoms and health history. A physical exam may be done.

Images may be taken of the stomach. This can be done with:

Treatment

Most hiatal hernias do not need treatment. The goal is to manage symptoms. Options are:

  • Dietary changes, such as staying away from foods that cause heartburn
  • Lifestyle changes, such as maintaining a healthy weight and not smoking
  • Medicines to control stomach acid, such as:
    • Over-the-counter antacids
    • H2 blockers and proton pump inhibitors (PPIs)

People with severe symptoms may need surgery. Surgery may also be needed for a hernia that is cutting off blood flow to the stomach.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Institute for Health Information
https://www.cihi.ca

Health Canada
https://www.canada.ca

REFERENCES:

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 January 8, 2021.

Gastroesophageal reflux disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gastroesophageal-reflux-disease-gerd. Accessed January 8, 2021.

Hiatal hernia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hiatal-hernia. Accessed January 8, 2021.

Hiatus hernia. Merck Manual Professional Verson website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/hiatus-hernia. Accessed January 8, 2021.

Sfara A, Dumistrascu, D. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019;92(4):321-325.

Last reviewed January 8, 2021 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 1/8/2021