BACK
    TO
    TOP
    Print-Friendly
    Bookmarks
    bookmarks-menu

    Hiatal hernia

    Hernia - hiatal

    Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen.

    Causes

    The exact cause of hiatal hernia is not known. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years of age.

    This condition may be linked to reflux (backflow) of gastric acid from the stomach into the esophagus.

    Children with this condition are most often born with it (congenital). In infants, it often occurs with gastroesophageal reflux.

    Symptoms

    Symptoms may include:

    • Chest pain
    • Heartburn, worse when bending over or lying down
    • Swallowing difficulty

    A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile.

    Exams and Tests

    Tests that may be used include:

    Treatment

    The goals of treatment are to relieve symptoms and prevent complications. Treatments may include:

    Other measures to reduce symptoms include:

    • Avoiding large or heavy meals
    • Not lying down or bending over right after a meal
    • Reducing weight and not smoking
    • Raising the head of the bed 4 to 6 inches (10 to 15 centimeters)

    If medicines and lifestyle measures do not help control symptoms, you may need surgery.

    Outlook (Prognosis)

    Treatment can relieve most symptoms of hiatal hernia.

    Possible Complications

    Complications may include:

    • Pulmonary (lung) aspiration
    • Slow bleeding and iron deficiency anemia (due to a large hernia)
    • Strangulation (closing off) of the hernia (very uncommon)

    When to Contact a Medical Professional

    Contact your health care provider if:

    • You have symptoms of a hiatal hernia.
    • You have a hiatal hernia and your symptoms get worse or do not improve with treatment.
    • You develop new symptoms.

    Prevention

    Controlling risk factors such as obesity may help prevent hiatal hernia.

    Open References

    References

    Battafarano RJ. Esophagus: Management of paraesophageal hernia repair. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:3-80.

    Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

    Lord KA, Lippincott J. Hiatal hernia. In: Ferri FF, ed. Ferri's Clinical Advisor 2023. Philadelphia, PA: Elsevier; 2023:749.e2-749.e5.

    Yates RB, Oelschlager BK. Gastroesophageal reflux disease and hiatal hernia. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 43.

      • Hiatal hernia - X-ray

        Hiatal hernia - X-ray - illustration

        This X-ray shows the upper portion of the stomach protruding through the diaphragm (hiatal hernia).

        Hiatal hernia - X-ray

        illustration

      • Hiatal hernia

        Hiatal hernia - illustration

        A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.

        Hiatal hernia

        illustration

      • Hiatal hernia repair - series

        Hiatal hernia repair - series

        Presentation

        • Hiatal hernia - X-ray

          Hiatal hernia - X-ray - illustration

          This X-ray shows the upper portion of the stomach protruding through the diaphragm (hiatal hernia).

          Hiatal hernia - X-ray

          illustration

        • Hiatal hernia

          Hiatal hernia - illustration

          A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.

          Hiatal hernia

          illustration

        •   Hiatal hernia repair - series

          Hiatal hernia repair - series

          Presentation

        Review Date: 5/2/2023

        Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
        © 1997- adam.comAll rights reserved.

         
         
         

         

         

        A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.
        Content is best viewed in IE9 or above, Firefox and Google Chrome browser.