A hiatal hernia occurs when a small portion of the stomach pushes
upward through the diaphragm, a sheetlike muscle that separates the lungs from
the abdomen. Usually this doesn't cause any symptoms, but it increases the risk
of stomach acid backing up into the esophagus (reflux), which can lead to
Normally the entire stomach sits below the diaphragm. The esophagus
passes through an opening in the diaphragm called the hiatus before it enters
the stomach. Weakened tissues within and around the hiatus allow a hiatal
hernia to develop.
A hiatal hernia that is not causing symptoms does not usually need
any treatment. Treatment for a hiatal hernia that causes heartburn is the same
as for gastroesophageal reflux disease (GERD). This may include home treatment
with lifestyle changes; nonprescription antacids, acid reducers, or acid blockers; prescription
medicines; or, in severe cases, surgery.
Adam Husney, MD - Family Medicine & Peter J. Kahrilas, MD - Gastroenterology