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    Hiatal hernia

    Hernia - hiatal

    Hiatal hernia is a condition in which part of the stomach extends through an opening the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen.

    Causes

    The exact cause of hiatal hernias is unknown. The condition may be due to a weakening of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years old.

    This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.

    Children with this condition are usually born with it (congenital). It often occurs with gastroesophageal reflux in infants.

    Symptoms

    • Chest pain
    • Heartburn, worse when bending over or lying down
    • Swallowing difficulty

    A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile.

    Exams and Tests

    • Barium swallow x-ray
    • Esophagogastroduodenoscopy (EGD)

    Treatment

    The goals of treatment are to relieve symptoms and prevent complications. Treatments may include:

    • Medicines to control stomach
    • Medicine to strengthen the muscles in the lower esophagus that keeps stomach contents from backing up
    • Surgery to repair the hiatal hernia

    Other measures to reduce symptoms include:

    • Avoiding large or heavy meals
    • Not lying down or bending over right after a meal
    • Reducing weight and not smoking
    • Raising the head of the bed 4 to 6 inches

    If medicines and lifestyle measures do not help control symptoms, you may need surgery.

    Outlook (Prognosis)

    Treatment can relieve most symptoms of hiatal hernia.

    • Pulmonary (lung) aspiration
    • Slow bleeding and iron deficiency anemia (due to a large hernia)
    • Strangulation (closing off) of the hernia

    When to Contact a Medical Professional

    Call your health care provider if:

    • You have symptoms of a hiatal hernia.
    • You have a hiatal hernia and your symptoms get worse or do not improve with treatment.
    • You develop new symptoms.

    Prevention

    Controlling risk factors such as obesity may help prevent hiatal hernia.

    References

    Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 43.

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    • Hiatal hernia - X-ray

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    • Hiatal hernia

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    • Hiatal hernia repair - ...

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      • Hiatal hernia - X-ray

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      • Hiatal hernia

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      A Closer Look

        Self Care

          Tests for Hiatal hernia

            Review Date: 7/18/2013

            Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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