Hiatal Hernia

(Hiatus Hernia)

Definition

A hiatal hernia is a movement of part of the stomach up into the chest cavity. The stomach presses up through a small hole in the diaphragm muscle. The diaphragm is the muscular wall that separates the abdominal cavity from the chest cavity.Different types of hiatal hernias include:
  • Sliding hiatal hernia—part of the stomach slides into and out of the chest cavity. This is the most common type.
  • Fixed hiatal hernia—upper part of the stomach remains in the chest cavity
  • Complicated hiatal hernia—several other types of stomach herniation may be seen. These are uncommon but more serious and may require surgery.
Hiatal Hernia
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Causes

The exact cause of hiatal hernias is not clear. Some people are born with a hiatal hernia but others will develop it later in life.The diaphragm has an opening that the esophagus can pass through. A weakening or injury to this opening can allow a hiatal hernia to develop. Increased pressure in the abdomen can also push the stomach up into the chest cavity.

Risk Factors

Hiatal hernias are more common in adults over 50 years of age. Other factors that increase your chance of getting hiatal hernia include:
  • Obesity
  • Abdominal injury
  • Regular increased pressure in the abdomen from activities like:
    • Severe coughing
    • Vomiting
    • Straining
    • Sudden physical exertion such as weight lifting

Symptoms

Most people with hiatal hernias have no symptoms. A hiatal hernia can make stomach acid moves up into the esophagus. This is known as gastroesophageal reflux disease (GERD). Symptoms of GERD can include:
  • Heartburn, especially after eating or lying down
  • Pain or discomfort in the stomach, chest, or esophagus
  • Belching
  • Hoarseness
  • Frequent clearing of the throat from irritation
  • Chest pain
  • Difficulty swallowing

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