What is a Hiatal Hernia?

A hiatal hernia happens when part of the stomach moves upward through an opening in the diaphragm into the chest. The diaphragm is the muscle that helps separate your chest from your abdomen and plays a role in breathing.

This condition can affect how your stomach and esophagus work together, sometimes allowing stomach acid to flow backward.

 In more serious cases, especially with certain types of hernias, symptoms may include chest pain, anemia, or difficulty eating.

A hiatal hernia may develop due to increased intra-abdominal pressure or diaphragmatic weakness. Contributing factors can include:

• Aging
• Excess weight
• Pregnancy
• Heavy lifting or straining
• Chronic coughing
• Smoking

Symptoms

Some people with a hiatal hernia don’t notice any symptoms. When symptoms do occur, they’re often related to acid reflux.

Common symptoms include:

• Heartburn or burning in the chest
• Acid coming back up into the throat
• Trouble swallowing
• Nausea or vomiting
• Frequent burping
• Feeling full quickly when eating

How is it diagnosed?

Your provider will begin with a physical exam and ask about your symptoms. If a hiatal hernia is suspected, imaging or specialized tests may be used.

Common tests include:

• Upper endoscopy to view the esophagus and stomach
• Barium swallow X-ray to track how food moves
• Chest X-ray
• Esophageal manometry to measure muscle function

These tests help confirm the diagnosis and screen for related conditions, such as reflux.

How is it treated?

Treatment depends on your symptoms and the type of hernia.

Many people don’t need treatment if they don’t have symptoms. When care is needed, it usually starts with simple steps:

• Eating smaller meals
• Avoiding lying down after eating
• Losing excess weight
• Elevating the head during sleep
• Quitting smoking

Medications may also be recommended to reduce stomach acid and relieve discomfort. These can include antacids, H2 blockers, or proton pump inhibitors.

If symptoms are severe or complications develop, surgery may be needed. Surgical treatment helps reposition the stomach and repair the opening in the diaphragm.