Hiatal hernia

The diaphragm is a large muscle that partitions your chest cavity from the abdomen. This muscle is useful when you are breathing. Normally, your stomach lies below the diaphragm, but in the case of a hiatal hernia, a portion of the stomach bulges and comes out through the diaphragm muscle. The opening which lets this happen is called hiatus. It is believed that age above 50 and 60 puts you at a risk of a hiatal hernia.


The main cause of a hiatal hernia is not clear. But in most of the patients, the cause would be any injury or damage to the diaphragm muscle.

When there is extra pressure on the muscles of the stomach, then there would be chances for a hiatal hernia, this happens when you:

  • Cough
  • Vomit
  • Lift heavy objects
  • Strain during bowel movements

You may have a large hiatus from the birth, which makes it easier for the stomach to move through the diaphragm.

When to call a doctor?

You must call your doctor if you experience nausea, vomiting, and difficulty in passing gas or pass stools.

You cannot always assume that the chest pain or discomfort is due to a hiatal hernia, but a heart disease or peptic ulcer disease can also pop up this sign. Therefore, it is important to see your doctor immediately.


Common symptoms associated with hiatal hernia include:

  • Belching
  • Chest pain
  • Difficulty in swallowing
  • Herat burns when you lie over

Types of hiatal hernia

Sliding hiatal hernia

Sliding hiatal hernia tends to be small and occur when your stomach and esophagus slide into and out of your chest. These types of hernias do not require treatment.

Fixed hiatal hernia

This type of a hernia is also called as a paraesophageal hernia. It is a rare type or a hiatal hernia. In such cases, there are chances that your blood flow to the stomach could become blocked. This can cause a serious damage and is considered as a medical emergency.

Risk factors

Increasing age, obesity, stress, heavy lifting, and smoking are the factors that may increase your risk for developing a hiatal hernia.

Lifestyle modifications

Following the below-listed lifestyle changes helps in controlling the signs and symptoms that are caused by a hiatal hernia.

  • Maintaining weight
  • Elevating the head of the bed
  • Avoiding smoking and alcohol consumption
  • Eating smaller meals more times in a day
  • Avoiding the foods that provoke heartburn or acidity
  • Eating the food at least two or three hours before going to bed

Your doctor would order for following tests to diagnose a hiatal hernia.

Barium X-ray

Before taking an X-ray, your doctor would ask you to drink barium liquid. This helps in providing a clear structure of digestive tract, which helps your doctor to see the location of your stomach. If it is found protruding from the diaphragm, then it is considered as a hiatal hernia.


The endoscope is a thin tube that slides into your esophagus and stomach. Your doctor then will be able to see if the stomach is pushing your diaphragm or the presence of any strangulation or obstruction.

The most bothersome symptom of a hiatal hernia is heartburn and acid reflux. Your doctor would prescribe the following drugs:

Antacids help to neutralize the stomach acids which may give instant relief. Medications to reduce acid production, block the acid secretion and heal your esophagus are prescribed.

Surgical intervention for repairing a hiatal hernia, rarely a hiatal hernia may require surgery, it is recommended for emergency situations. People who do not get relieved from medications are also recommended for surgery.

The surgery is performed by pulling the stomach down into the abdomen and by making the opening in the diaphragm smaller. Your surgeon would remove the hernia sac completely.

In some cases, a thoracotomy or laparotomy is performed by using a single incision in the chest wall. In some cases, your surgeon may insert a tiny camera and view the images on a video monitor and perform laparoscopic surgery.