Hiatal Hernia
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Hiatal Hernia

What is a hiatal hernia?

A hernia occurs when part of the body bulges into another. Your chest and abdomen are separated by your diaphragm - a large dome-shaped muscle that is responsible for a major part of breathing. A hiatal hernia occurs when the top portion of the stomach pushes through a weakened opening in the diaphragm where the food pipe (esophagus) joins your stomach (called the hiatal opening).

What causes a hiatal hernia?

The exact cause of hiatal hernias is not known. Some people develop hiatal hernias after an injury to the chest or abdomen. But anything that puts intense pressure on your abdomen - including pregnancy, straining while going to the bathroom, severe coughing, vomiting, or lifting heavy objects - can contribute to a hernia.

What are the symptoms of a hiatal hernia?

Most small hiatal hernias don't cause problems and you may never know you have a hiatal hernia unless your doctor discovers it while checking for another condition. But a large hiatal hernia can allow food and stomach acid to back up into your esophagus, leading to heartburn, chest pain, belching and nausea.

How is a hiatal hernia diagnosed?

Your doctor may find a hiatal hernia during an endoscopy (EGD) or barium swallow x-ray while trying to determine the cause of heartburn, chest pain or upper abdominal pain.

How is a hiatal hernia treated?

Hiatal hernias that don't cause symptoms probably will not require treatment. However, if you experience frequent gastroesophageal reflux (GERD), your doctor may recommend the following treatments:
  • Weight loss: Losing weight alone may relieve your symptoms.
  • Medications: Over-the-counter antacids (Maalox, Mylanta, Tums); Acid reducing medications called H-2 blockers (Pepcid, Tagamet, Zantac, Axid); Acid blocking medications called proton pump inhibitors (Prevacid, Prilosec, Dexilant, Nexium, Protonix, Zegerid, Aciphex)
  • Diet Modification: Avoid fatty, spicy foods, caffeine, chocolate, onions and citrus. Eat smaller meals. Avoid eating 3 hours before bed.
  • Surgery: Few people require surgery to repair a hiatal hernia. This option is usually considered only when medications and lifestyle changes fail to reduce reflux symptoms.
  • Seeking medical advice for hiatal hernia?
If your symptoms are severe, occur often or are accompanied by coughing, wheezing, asthma, a sore throat, difficulty swallowing or chest pain, contact your health care provider.