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Hiatal hernia is when the upper part of the stomach protrudes up above the diaphragm into the chest. The diaphragm is the strong sheet of muscle that separates the organs of the chest from those of the abdomen. The diaphragm has an opening (hiatus) to allow the esophagus to pass through. Persistent coughing, vomiting, straining, or sudden physical exertion can cause part of the stomach to poke up through the opening. Obesity or pregnancy can make the condition worse.

The hiatal hernia makes it easier for acid to back up from the stomach to the esophagus. Hiatal hernia is very common in people older than 50 years. Most do not know they have it until they develop gastroesophageal reflux disease. The hernia can be repaired by surgery, but this usually isn't necessary unless the stomach becomes twisted or the GERD symptoms are very severe.

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