A hiatal hernia happens when the stomach pushes through the muscle between the abdomen and chest.
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A hiatal hernia may be caused by:
- Weakened muscles
- An injury to the chest opening, such as a car accident
- A buildup of pressure in the belly, such as from obesity or pregnancy
- Recent surgery on the digestive system
Some babies are born with this problem. This is not common.
Hiatal hernias are more common in older adults. Obesity also raises the risk.
Some people do not have symptoms. Those who do may have:
- A burning feeling in the chest, especially after eating or lying down
- Problems swallowing, such as food that comes back up
- Pain or discomfort in the throat, chest, or stomach
- Nausea and vomiting
- Feeling very full after eating
- Problems breathing
Hiatal hernias are often seen on tests for other health problems. The doctor will ask about your symptoms and health history. A physical exam may be done.
Pictures may be taken of the abdomen. This can be done with:
Most hiatal hernias do not need treatment. The goal is to manage symptoms. Options are:
- Dietary changes, such as staying away from foods that cause heartburn
- Lifestyle changes, such as maintaining a healthy weight and not smoking
- Medicines to control stomach acid, such as:
- Over the counter antacids
- H2 blockers and proton pump inhibitors (PPIs)
People with severe symptoms may need surgery. Surgery may also be needed for a hernia that is cutting off blood flow to the stomach.
There are no current guidelines to prevent hiatal hernias.
- Acid reflux (GER & GERD) in adults. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults.
- Gastroesophageal reflux disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gastroesophageal-reflux-disease-gerd.
- Hiatal hernia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hiatal-hernia.
- Hiatus hernia. Merck Manual Professional Verson website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/esophageal-and-swallowing-disorders/hiatus-hernia.
- Sfara A, Dumistrascu, D. The management of hiatal hernia: an update on diagnosis and treatment. Med Pharm Rep. 2019;92(4):321-325.
- Elizabeth Margaret Prusak, MD
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