A hiatal hernia occurs when the upper part of the stomach pushes up through a small opening in the diaphragm (the muscle that separates the chest and abdomen) into the chest area. This opening is called a hiatus. Many people have small openings in their diaphragm, but in some cases, the stomach can slip through, causing a hiatal hernia. While small hernias are common and often go unnoticed, larger ones can cause issues.
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- Heartburn (a burning sensation behind the breastbone)
- Regurgitation (food or liquids flowing back into the chest or mouth)
- Chest or abdominal pain
- Difficulty swallowing
- Nausea and vomiting
- Shortness of breath
- Gastrointestinal bleeding
If you experience symptoms that could be due to a hiatal hernia, your doctor might suspect its presence. To confirm the diagnosis, they can perform:
- Endoscopy: A procedure using a thin tube with a camera to visualize the esophagus and stomach.
- Imaging: Methods like CT scans or barium upper GI X-rays to get a clearer picture.
In general, hernia-related symptoms respond at least partially to a combination of diet and lifestyle measures. For example, we instruct patients to remain upright for two hours after eating and to avoid certain foods, such as heavy, fatty suppers. Over-the-counter acid reducers may help, as do prescription-strength acid reducers. Rarely do we need to intervene mechanically to fix the hernia;often, surgeons and advanced endoscopy specialists can return the stomach to its native position and anchor it there during a minimally invasive endoscopic or laparoscopic repair.