Hiatal Hernia

Hiatal Hernia Summary
A hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest. Causes of hiatal hernia are a larger than normal esophageal hiatus. There are two types of hiatal hernias, sliding, or para-esophageal. When symptoms of hiatal hernia appear, they are similar to GERD symptoms. Hiatal hernia treatment is generally surgery.
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Hiatal hernia facts

  • A hiatal hernia is an anatomical abnormality of the esophagus.
  • Hiatal hernias contribute to gastro-esophageal reflux disease (GERD).
  • The symptoms in individuals with hiatal hernias parallel the symptoms of the associated GERD.
  • The treatment of most hiatal hernias is the same as for the associated GERD.

What is a hiatal hernia?

A hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest. Although hiatal hernias are present in approximately 15% of the population, they are associated with symptoms in only a minority of those afflicted.

Normally, the esophagus or food tube passes down through the chest, crosses the diaphragm, and enters the abdomen through a hole in the diaphragm called the esophageal hiatus. Just below the diaphragm, the esophagus joins the stomach. In individuals with hiatal hernias, the opening of the esophageal hiatus (hiatal opening) is larger than normal, and a portion of the upper stomach slips up or passes (herniates) through the hiatus and into the chest. Although hiatal hernias are occasionally seen in infants where they probably have been present from birth, most hiatal hernias in adults are believed to have developed over many years.

What causes a hiatal hernia?

It is thought that hiatal hernias are caused by a larger-than-normal esophageal hiatus, the opening in the diaphragm through which the esophagus passes from the chest into the abdomen; as a result of the large opening, part of the stomach "slips" into the chest. Other potentially contributing factors include:

  1. A permanent shortening of the esophagus (perhaps caused by inflammation and scarring from the reflux or regurgitation of stomach acid) which pulls the stomach up.
  2. An abnormally loose attachment of the esophagus to the diaphragm which allows the esophagus and stomach to slip upwards.
  3. Any condition causing or leading to intraabdominal pressure; for example, ascites, small bowel obstructions, adhesions, colonic obstrucation (tumor), or obesity.
Picture of Hiatal Hernia
Picture of Hiatal Hernia
Medically Reviewed by a Doctor on 2/7/2014

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