Hiatal hernia is a condition in which part of the stomach sticks upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.
Causes
The cause is unknown, but hiatal hernias may be due to a weakening of the supporting tissue. Increasing age, obesity, and smoking are known risk factors in adults.
Children with this condition are usually born with it (congenital). It often occurs with gastroesophageal reflux in infants.
Hiatal hernias are very common, especially in people over 50 years old. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.
A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are usually due to the reflux of gastric acid, air, or bile.
Treatment
The goals of treatment are to relieve symptoms and prevent complications.
Reducing the backflow of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain. Medications that neutralize stomach acid, decrease acid production, or strengthen the lower esophageal sphincter (the muscle that prevents acid from backing up into the esphagus) may be prescribed.
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
If these measures do not control the symptoms, or you have complications, you may need surgery to repair the hernia.
Outlook (Prognosis)
Treatment can relieve most symptoms of hiatal hernia.
When to Contact a Medical Professional
Call 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, or new symptoms develop
Prevention
Controlling risk factors such as obesity may help prevent hiatal hernia.
Update Date: 8/11/2011
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
