Hiatal Hernia

What is a Hiatal Hernia?

A hernia is a protrusion of one body part into an area it doesn’t belong, and a hiatal hernia involves the stomach bulging upward into the chest cavity.

The stomach is supposed to stay in the abdomen, but intense coughing fits, pregnancy, and unusual straining can cause some of it to rise up around the base of the esophagus and pass through the esophageal opening (hiatus). The protruding part of the stomach may slide up and down or stay stuck next to the esophagus, potentially cutting off its blood flow.

What are the Symptoms of a Hiatal Hernia?

Heartburn is the most common symptom, but it can have many other symptoms as well.

Other signs you’re having stomach issues include:

  • Uncomfortable fullness after eating
  • Trouble swallowing or keeping food down
  • Belching, even after you take anti-gas medication
  • Pain
  • Blood in vomit in rare cases

Basic hiatal hernias often create no symptoms at all. You may never know you have this kind of protrusion, or your doctor may discover it during a routine inspection.

Hiatal Hernia Causes

When the stomach develops an area of weakened muscle tissue, it allows part of the stomach to be displaced through the diaphragm and enters the chest cavity. The result of this displacement is a hiatal hernia. This condition can be caused by many lifestyle factors and medical conditions, and there may be a genetic component as well. Sometimes, there is no clear cause for this condition to develop in a patient. In others, the changes to the body that occur with age can result in this weakened tissue and the resulting hernia. Sometimes, there is pressure on the stomach, creating this hernia type.

An injury to the area that results in weakened tissue can be one cause. For others, being born with an unusually large hiatus, an opening in the diaphragm, makes this condition more likely. It is common for frequent, intense pressure being put on the area to cause this hernia type. This can happen when the patient coughs often, frequently vomits, regularly lifts heavy objects or strains with bowel movements. This condition is more common in obese patients and those who are over 50 years of age.

How is a Hiatal Hernia Treated?

In paraesophageal hernias, the loss of blood flow makes it necessary to resort to surgery. The trapped section of the stomach is freed so it can receive a steady supply of blood again and stay within the abdominal cavity.

For sliding hernias with no symptoms, no treatment is necessary. Non-threatening hernias that are uncomfortable due to swallowing problems and heartburn are usually managed with medication. Changing your diet and other habits can also help you reduce the strain on your stomach. Your doctor will determine the type of hiatal hernia you have and recommend a treatment after a contrast x-ray to examine the upper abdomen and chest.

Hiatal Hernia Prevention

To prevent a hiatal hernia from developing, avoid clothing that fits too tightly. Loose clothing will stop pressure being placed on the stomach and the surrounding tissues. Avoid lying down or bending over when you have a full stomach. This can put pressure on the abdomen and cause heartburn. After eating a meal, wait at least two hours before lying down or bending over. Sleep in an elevated position. By raising the head of the bed, you can keep your stomach elevated and prevent heartburn and its related conditions. To raise the head, simply place wooden blocks under the posts at the head of the bed and keep it at six to eight inches above the other bedposts.

Last Reviewed:
September 14, 2016
Last Updated:
January 12, 2018