The stomach is normally completely below the diaphragm, the muscular sheet that separates the lungs and chest from the abdomen.
A hiatal hernia occurs when part of the stomach slides through the diaphragm and protrudes into the chest cavity. Hiatal hernias are fairly common and can affect people of all ages.
There are two types of hiatal hernias:
Most small hiatal hernias don’t cause any symptoms. Larger hiatal hernias can cause symptoms such as:
Your diaphragm is the large dome-shaped muscle that separates your chest from your abdomen. Your esophagus passes through the diaphragm into the stomach through an opening called the hiatus.
When the muscle around this opening becomes weak, the upper part of your stomach can bulge through it. It’s not always clear why this happens, but pressure on your stomach and age may be a factor.
Some risk factors include:
Hiatal hernias are often discovered during tests for the cause of heartburn or abdominal pain.
Some tests include:
If your hiatal hernia causes heartburn and acid reflux, your doctor may recommend medications, such as:
A small number of cases may require surgery to repair the hiatal hernia. This is generally reserved as a last resort for patients who aren’t helped by medications.
Most hiatal hernia surgeries involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing a weak esophageal sphincter, or removing the hernia sac.