Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen.
Hernia - hiatal
The exact cause of hiatal hernias is unknown. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years.
This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.
Children with this condition are most often born with it (congenital). It often occurs with gastroesophageal reflux in infants.
Symptoms may include:
A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile.
Exams and Tests
Tests that may be used include:
The goals of treatment are to relieve symptoms and prevent complications. Treatments may include:
Other measures to reduce symptoms include:
- Avoiding large or heavy meals
- Not lying down or bending over right after a meal
- Reducing weight and not smoking
- Raising the head of the bed 4 to 6 inches
If medicines and lifestyle measures do not help control symptoms, you may need surgery.
Treatment can relieve most symptoms of hiatal hernia.
Complications may include:
- Pulmonary (lung) aspiration
- Slow bleeding and iron deficiency anemia (due to a large hernia)
- Strangulation (closing off) of the hernia
When to Contact a Medical Professional
Call your health care provider if:
- You have symptoms of a hiatal hernia.
- You have a hiatal hernia and your symptoms get worse or do not improve with treatment.
- You develop new symptoms.
Controlling risk factors such as obesity may help prevent hiatal hernia.
Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 138.
Ferri FF. Hiatal hernia. In: Ferri FF, ed. Ferri's Clinical Advisor 2015. Philadelphia, PA: Elsevier Mosby; 2015:p. 571-2.
Petersen RP, Pellegrini CA, Oelsclanger BK. Hiatal hernia and gastroesophageal reflux disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 44.
Reviewed By:Subodh K. Lal, MD, Gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency
or for the diagnosis or treatment of any medical condition. A licensed medical professional
should be consulted for diagnosis and treatment of any and all medical conditions. Call 911
for all medical emergencies. Links to other sites are provided for information only -- they
do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.
Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.