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If you have been told that you have a hiatal hernia, this topic will give you some basic information about it. A hiatal
hernia sometimes happens along with gastroesophageal reflux disease
(GERD). And the symptoms of a hiatal hernia are usually caused by GERD. For more information about the symptoms of GERD and how to treat it, see the topic Gastroesophageal Reflux Disease (GERD).
A hiatal hernia (say "hi-AY-tul HER-nee-uh") happens when part of your
stomach bulges up through the diaphragm and into your chest. The
diaphragm is a sheet of muscle that separates your
belly (abdomen) from your chest.
The hernia bulges through the
diaphragm at a place called the hiatus. This is the opening in the diaphragm
that the esophagus passes through. The esophagus is the tube
that connects the throat to the stomach.
There are three main
types of hiatal hernia: sliding,
paraesophageal, and mixed. Most people who have a hiatal hernia have a
sliding hiatal hernia.
A hiatal hernia often
is caused by weak muscles and tissue within and around the hiatus.
In a sliding hiatal hernia, a small part of the stomach pushes through
the diaphragm and into the chest. A valve between the esophagus and the stomach
also moves up and away from the diaphragm.
Most people who have a hiatal hernia have no symptoms.
One symptom you may have
heartburn, which is an uncomfortable feeling of
burning, warmth, or pain behind the breastbone. It is common to have heartburn
at night when you are trying to sleep.
If you often have symptoms
or they are severe, you may have
gastroesophageal reflux disease (GERD). A
hiatal hernia can lead to GERD, and people often have both conditions at the
If you have pain behind your breastbone, it is
important to make sure it is not caused by a problem with your heart. The
burning sensation caused by GERD usually occurs after you eat. Pain from the
heart usually feels like pressure, heaviness, weight, tightness, squeezing,
discomfort, or a dull ache. It occurs most often after you are active.
A hiatal hernia
often is diagnosed when you see your doctor or have tests for another health
If you have symptoms, your doctor will ask you questions
about them. If your symptoms happen often and are severe, you may have
gastroesophageal reflux disease (GERD). If this is the case, your doctor may do
more tests or give you medicine for GERD.
If you have no symptoms, you don't need treatment.
If you have mild symptoms, your doctor may suggest lifestyle changes and
nonprescription medicines. Here are some things to try:
If you often have symptoms or have severe symptoms, you may have GERD. Lifestyle changes may help, and your doctor
may prescribe medicine. In severe cases, surgery can be used to pull the hernia
back into the belly.
Other Works Consulted
Jeyarajah DR, Harford WV (2010). Abdominal hernias and gastric volvulus. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 379–395. Philadelphia: Saunders.
Current as of:
June 4, 2014
Adam Husney, MD - Family Medicine & Peter J. Kahrilas, MD - Gastroenterology
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