Hiatal Hernia

What is a hiatal hernia?

A hiatal hernia is a condition in which part of the stomach pokes through the diaphragm from the abdomen into the chest. The diaphragm is a thin sheet of muscle that is involved in breathing. It separates the abdomen from the chest.

Hiatal hernias are common after middle age. They do not often cause problems.

How does it occur?

The cause of hiatal hernias is not known. What is known is that they occur more often in people after middle age, in overweight people (especially women), and in smokers.

What are the symptoms?

Many people with a hiatal hernia never have any symptoms. However, in some people, stomach acid and digestive juices move up into the esophagus via the bulge of the stomach through the diaphragm. This is called gastroesophageal reflux disease (GERD) and can cause:

• heartburn, especially after you eat large meals or lie down
• a bitter or sour taste in the back of your throat
• bloating and belching
• discomfort or pain in your stomach or esophagus
• vomiting.

How is it diagnosed?

Because many hiatal hernias do not cause symptoms, they are often found during exams for other problems.

If you have symptoms, your healthcare provider will make the diagnosis from your medical history and a physical exam.

You may have tests to confirm the diagnosis and rule out other causes of your symptoms. These tests might include:

• esophagoscopy (an exam with a viewing tube to check for signs of acid in your esophagus)
• biopsy (to check for cancer)
• barium X-ray (to see if stomach contents are escaping into the esophagus).

How is it treated?

Your healthcare provider may recommend a change in your diet. If you are overweight, you may also be given suggestions for losing weight.

Your provider may prescribe medicine to reduce the acidity in your esophagus. Antacids are also helpful in giving immediate relief to symptoms.

Sometimes surgery is needed.

How can I take care of myself?

• Follow the treatment recommended by your healthcare provider.
• If you smoke, quit.
• If you usually eat 1 or 2 large meals a day, try to eat 3 or 4 smaller meals instead. Do not eat during the 2 to 3 hours before you go to bed.
• Avoid drinks containing alcohol or caffeine (tea, coffee, cocoa, colas, etc.) before you go to bed.
• Sit up during meals and for 1 hour after the meals.
• Elevate the head of your bed 6 inches by placing blocks under the bed frame.
• Wear clothes and belts that are loose around your waist.
• If you are overweight, try to lose some weight. Ask your healthcare provider for help.