What Is a Hiatal Hernia?

Outline of woman showing mouth, esophagus, diaphragm, and stomach.

Hiatal hernias aren’t like hernias in your groin. This common problem occurs when part of the stomach slides up through a hole in the diaphragm (the hiatus) into the chest cavity. The esophagus passes through this hole into the stomach. When you eat, the muscle at the hiatus relaxes to allow food to pass into the stomach. It tightens again to keep food and digestive acids in the stomach. If the hiatus is wide, part of the stomach may bulge above the diaphragm. This bulge is called a hernia. Stomach acid may move up into the esophagus and cause symptoms.

What You May Feel

Most people with hiatal hernias have no symptoms. But if reflux (acid backup) occurs, you may notice the following:

  • Heartburn or other chest discomfort

  • Frequent burping

  • Acid taste in the mouth

  • Problems swallowing

  • Nighttime choking, coughing, or wheezing

Treating Symptoms 

Most hiatal hernias cause no symptoms and need no treatment. If you notice symptoms, usually you can control them easily. If you have been diagnosed with hiatal hernia, these suggestions may help improve symptoms:

Closeup cross section of top part of stomach, lower esophagus, and diaphragm showing hiatal hernia.

  • Lose excess weight. Excess weight puts pressure on the stomach and esophagus.

  • Avoid cigarettes, alcohol, fatty foods, chocolate, coffee, peppermint, and spearmint.

  • Avoid anything that causes symptoms. Stay away from any food or drink that gives you problems. Many medications can cause symptoms. Discuss your medications with your health care provider.

  • Try acid-reducing medications. Over-the-counter antacids may relieve heartburn. Talk to your health care provider about these other over-the-counter or prescription medications may also help.

  • Surgery is usually needed only for severe symptoms or when other options have not helped the condition. Your health care provider will help you determine if surgery is an option for you.