Hiatal Hernia
The esophagus sphincter muscle normally closes tightly. With a hiatal hernia, the sphincter’s new position may keep it from completely closing. The back flow of digestive juices may damage the esophagus.

What is a hiatal hernia?

A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm and into the chest cavity. The diaphragm is the thin muscle wall that separates the chest cavity from the abdomen. The opening in the diaphragm is where the esophagus and stomach join.

Who is at risk for developing a hiatal hernia?

A hiatal hernia can develop in people of all ages and both sexes, although it frequently occurs in people age 50 and older. Hiatal hernia occurs more often in overweight people and smokers.

What causes a hiatal hernia?

The most common cause of a hiatal hernia is an increase in pressure in the abdominal cavity. (The abdomen consists of the lower part of the esophagus, stomach, small intestine, colon, rectum, liver, gallbladder, pancreas, spleen, kidneys, and bladder.) Pressure can come from coughing, vomiting, straining during a bowel movement, heavy lifting, or physical strain. Pregnancy, obesity, or extra fluid in the abdomen can also lead to a hiatal hernia.

Increased pressure in the abdomen (arrows) causes part of the stomach to push through the diaphragm and into the chest cavity.

What are the symptoms of hiatal hernia?

Many people with a hiatal hernia never have symptoms. Some people with hiatal hernia have some of the same symptoms as gastroesophageal reflex disease (GERD). GERD occurs when digestive juices move from the stomach back into the esophagus. Symptoms of GERD include:

  • Heartburn
  • Bitter or sour taste in the back of the throat
  • Bloating and belching
  • Discomfort or pain in the stomach or esophagus

Although there appears to be a link between hiatal hernia and GERD, one condition does not seem to cause the other. Many people have a hiatal hernia without having GERD, and others have GERD without having a hiatal hernia.

Another symptom of a hiatal hernia is chest pain. Since chest pain can also be a symptom of a heart attack, it’s important to contact your doctor or go to the emergency room if you experience any chest pain.