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Hiatal Hernia: Causes, Symptoms, and Treatment

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In the human body, the abdomen is separated from the chest cavity by a muscle called the diaphragm. The diaphragm is dome shaped and has an opening called the hiatus. The esophagus passes through the hiatus into the stomach. A hiatal hernia occurs when the muscle surrounding the hiatus becomes weak. The upper part of the stomach projects through the diaphragm into the chest cavity.

Experts concur that pressure on the stomach leads to the development of a hiatal hernia. Possible causes are an inherited weakness in the muscles surrounding the hiatus or having a very large hiatus. Injury to the area of the diaphragm can be a cause. Increased pressure on this area can result from coughing, vomiting, straining with a bowel movement, or lifting heavy objects. People over the age of 50 years, or who are obese, or have a history of smoking have an increased risk of developing a hiatal hernia.

A person with a small hiatal hernia will not experience symptoms. However, signs of a large hiatal hernia are recurrent heartburn and acid reflux, belching, chest pain, and nausea. After seeking the medical attention of a gastroenterologist, a person can expect to be evaluated with a barium x-ray or an endoscopy. Prior to the barium x-ray procedure, the patient drinks a chalky substance which coats the upper digestive tract. The barium in the substance acts to silhouette the esophagus, stomach, and upper part of the small intestines. During an endoscopy, a flexible tube is inserted through the patient’s mouth and gently passed to the esophagus and stomach. The gastroenterologist is able to look for signs of a hiatal hernia.

Three types of medication are prescribed to treat the associated acid reflux. Antacids provide quick relief. The H-2 receptor blockers work to reduce the production of stomach acid. Proton pump inhibitors actually block acid production and allow the esophagus to heal. Lifestyle changes such as eating several small meals throughout the day, limiting the intake of fatty foods, and avoiding foods that trigger heartburn can be beneficial.

Add a Comment3 Comments

I need to know what i can eat or what not to eat with this hiatal hernia?Can any 1 help me?

December 17, 2011 - 11:16am
(reply to jessica_122009)

Dear Jessica,

Hiatal hernias are usually treated only when there are symptoms. When GERD is present, the following measures may help:

Weight Loss

For people who are obese, losing weight may relieve symptoms.

Dietary Changes

Avoid foods that can relax the muscle that controls the opening between the esophagus and the stomach including:

  • Chocolate
  • Peppermint
  • Fatty foods
  • Coffee
  • Alcoholic beverages


Avoid foods and beverages that can irritate the internal lining of the esophagus, such as:

  • Caffeine
  • Citrus fruits and juices
  • Tomato products
  • Hot peppers
  • Carbonated beverages


To minimize acid reflux:

  • Consume smaller meals 4 to 6 times a day versus three large meals
  • Avoid drinking large amounts of fluids with meals
  • Do not eat within 2 to 3 hours of bedtime


Hope this helps,


December 17, 2011 - 2:13pm
EmpowHER Guest

I have a hiatal hernia which bothers me quite a bit and has for a few years now. Basically the pain I have generates on the rightside below the ribs. I have gotten control of my belching and acid reflux by taking what's called slippery elm (natural bark) made in liquid form. This has helped tremendously, however, the pain that I mentioned above sometimes is more evident when I'm sitting or lay down. At times it
generates to the right side of my shoulder blade, like gas trapped is the way I describe it....which is probably what it is. I believe my hiatal hernia has grown and wondered if it's this uncomfortable if surgery would be a good option or if anyone experiences this as well.

April 27, 2010 - 2:45pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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