A hiatal hernia is when part of your stomach pushes up through your diaphragm because of weakness of a muscle. The diaphragm has a small opening, called hiatus, where the esophagus passes and below, connects to the stomach. The push up of the stomach through this opening causes a hiatal hernia.

In most cases, hiatal hernias are small and don't cause problems. A swelling or lump may be noticed in the abdomen. This disappears when you lie down or it can be pushed back. Large hiatal hernia can allow food and acid, which go back to the esophagus, leading to heartburn. Over-the-counter medications can relieve these symptoms; in case of a very large hiatal hernia, surgery may be required.

 

Types of hernia

Hernias most often develop between the chest and hips. The following are some of the more common types:

1. Inguinal hernias – when fatty tissue or a part of the bowel pokes through into the groin at the top of the inner thigh. This is the most common type of hernia, mainly affecting men; it is often associated with ageing and repeated strain on the abdomen.

2. Femoral hernias – same as inguinal hernia, but these are less common and affect more women than men.

3. Umbilical hernias – when fatty tissue or a part of the bowel pokes through the abdomen near the belly button (navel). This type occurs in babies if the umbilical cord passes don't seal properly after birth. In adults, it can result from repeated strain on the abdomen.

4. Hiatus hernias – described in this article

5. Other types of hernia are: incisional – when tissue pokes through a surgical wound in not fully healed abdomen; epigastric – when fatty tissue pokes through the abdomen, between the navel and the lower part of the breastbone (sternum); Spigelian – when part of the bowel pokes through the abdomen at the side of the abdominal muscle; diaphragmatic – when organs in the abdomen move into the chest through the diaphragm opening. This can affect babies if their diaphragm does not develop properly in the womb, but can also affect adults; muscle hernias – when part of a muscle pokes through the abdomen (these can occur in leg muscles, too, from a sports injury).

 

Causes

The cause for hiatal hernia is not quite clear, but it may result from weakening diaphragm with age or pressure on the abdomen.

Other causes could be:

  • Injury to the area
  • Born with a large hiatus
  • Persistent and intense pressure on the surrounding muscles, when coughing, vomiting, straining during a bowel movement or lifting heavy objects

 

Symptoms

Most small hiatal hernias cause no signs or symptoms.

Larger hiatal hernias can have the following symptoms:

  • Heartburn
  • Belching
  • Difficulty swallowing
  • Fatigue

 

Risk factors

Hiatal hernia is most common in people who are:

  • Age 50 or older
  • Obese