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 hernia is not known. 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 be linked to 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.
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:
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:
Call your health care provider if:
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-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.
Lord KA, Williamson P. Hiatal hernia. In: Ferri FF, ed. Ferri's Clinical Advisor 2022. Philadelphia, PA: Elsevier; 2022: 760.e2-760.e5.
Schlottmann F, Patti MG. Management of paraesophageal hiatal hernia. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:30-34.
Yates RB, Oelschlager BK. Gastroesophageal reflux disease and hiatal hernia. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 43.
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.