Hiatal Hernia – Symptoms and Causes

What is a Hiatal Hernia?

A hiatal hernia occurs when part of the stomach pushes upward through the diaphragm. The diaphragm is the large muscle separating the chest from the abdomen.

It normally has a small opening (hiatus) where the esophagus passes through before connecting to the stomach.

Small hiatal hernias often cause no symptoms and may go undetected until found during medical tests for other conditions. However, larger hernias can create problems by allowing stomach acid and food to flow back into the esophagus.

Common symptoms include:

• Heartburn
• Acid reflux
• Chest discomfort

Most people with hiatal hernias can manage their symptoms through lifestyle changes and medication. These treatments are usually effective for controlling discomfort. Surgery is typically reserved for very large hernias or when other treatments don’t provide relief.

The condition is relatively common, especially in people over 50, and doesn’t necessarily require intervention unless it causes persistent symptoms that affect daily life.

Signs and Symptoms

Most small hiatal hernias don’t cause symptoms. However, larger hiatal hernias may produce several noticeable problems, including:

• Heartburn
• Regurgitation (food or liquid flowing back into the mouth)
• Acid reflux (stomach acid flowing into the esophagus)
• Difficulty swallowing
• Pain in the chest or abdomen
• Early satiety (feeling full quickly when eating)
• Breathing difficulties
• Blood in vomit or black stools (signs of possible digestive tract bleeding)

When to Contact a Healthcare Provider

If you experience any ongoing symptoms that concern you, schedule an appointment with your doctor. Don’t ignore persistent discomfort or unusual digestive issues, as they might indicate a condition requiring treatment.

Why Hiatal Hernias Happen

Hiatal hernias develop when stomach tissue pushes upward through the diaphragm. Several factors may lead to this condition:

• Natural aging process that weakens diaphragm muscles over time.
• Physical trauma to the area or complications following certain surgeries.
• Congenital factors such as being born with an unusually large hiatal opening.
• Excessive pressure on surrounding muscles from:
  • Forceful coughing
  • Vomiting episodes
  • Straining during bowel movements
  • Strenuous exercise
  • Heavy lifting

The weakened muscle tissue allows the stomach to bulge abnormally, although the exact cause isn’t always identifiable in every case.

Risk Factors

People who are 50 years or older have a higher chance of developing hiatal hernias. Obesity is also a significant risk factor for this condition.