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Quick Facts

Hiatus Hernia

By The Manual's Editorial Staff,

What is hiatus hernia?

A hernia is when an organ pushes through an opening in your body to someplace it doesn't belong.

Hiatus hernia is when part of your stomach moves up through your diaphragm into your chest. This occurs at the spot where your esophagus passes through your diaphragm. Your diaphragm is the muscle that separates your chest from your belly and that helps you breathe. Your esophagus is the tube that connects your throat to your stomach, passing through your diaphragm.

  • You're more likely to get a hiatus hernia if you're over age 50, overweight, or smoke cigarettes

  • Some people have no symptoms or only minor symptoms, such as heartburn

  • Other people have more serious symptoms, such as chest pain, bloating, burping, and problems swallowing

  • Doctors usually use a barium x-ray to test for hiatus hernia

  • Treatment includes medicines to ease symptoms or, rarely, surgery if medicines don't help

Understanding Hiatus Hernia

A hiatus hernia is an abnormal bulging of a portion of the stomach through the diaphragm.

There are 2 main types of hiatus hernia:

  • Sliding hiatus hernia—the part of your stomach that connects to your esophagus slides out above your diaphragm

  • Paraesophageal hiatus hernia—a part of your stomach bulges out through your diaphragm next to your esophagus

What causes hiatus hernia?

Doctors usually don't know the cause of hiatus hernia.

What are the symptoms of hiatus hernia?

Most sliding hiatus hernias are very small. You may have no symptoms, or you may feel like you have gas, a sense of fullness, or burning.

A paraesophageal hiatus hernia often causes no symptoms at first. Sometime later, the bulge can get trapped or pinched by the diaphragm, called strangulation. Strangulation can be very dangerous. Symptoms of strangulation may include:

  • Chest pain

  • Bloating

  • Burping

  • Problems swallowing

If you have symptoms of strangulation, you should see a doctor right away.

How can doctors tell if I have a hiatus hernia?

Doctors can often see a large hiatus hernia on a basic chest x-ray. If not, doctors may do an x-ray after having you drink barium, which makes the bulge easier to see on the x-ray.

How do doctors treat hiatus hernia?

If you have a sliding hiatus hernia that doesn't cause symptoms, you don't need treatment.

If you have indigestion, doctors will give you a medicine called a proton pump inhibitor. It lowers the amount of acid your stomach makes. Doctors may also have you:

  • Raise the head of your bed while sleeping

  • Eat small meals

  • Lose weight if you're overweight

  • Stop smoking

  • Not lay down or exercise after eating

  • Not wear clothes that are tight around your waist

  • Limit drinks that have acid in them, such as orange juice, soda, alcohol, or coffee

  • Limit certain foods, such as onions or spicy, acidic, and fatty foods

If you have a paraesophageal hiatus hernia that causes symptoms, you may need surgery.

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