Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Hiatus Hernia


The Manual's Editorial Staff

Reviewed/Revised Aug 2021 | Modified Sep 2022
Get the full details
Topic Resources

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.

Understanding Hiatus Hernia

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

Understanding Hiatus Hernia

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.

quiz link

Test your knowledge

Take a Quiz!