Symptoms and Signs of Hiatal Hernia

Medical Author:
Medically Reviewed on 10/22/2021

Doctor's Notes on Hiatal Hernia

The esophagus is a tube that connects the throat to the stomach. It passes through the chest and enters the abdomen through a hole in the diaphragm, the breathing muscle beneath the chest that separates the chest and abdomen.  The term hiatal hernia describes the condition in which the upper part of the stomach that normally is located just below the diaphragm in the abdomen pushes through the esophageal opening in the diaphragm to rest within the chest cavity. This mean part of the stomach has risen up from its location in the abdomen into the chest. This is a fairly common condition, and in most cases, the cause is not known. 

In most cases a hiatal hernia does not cause symptoms. If symptoms do occur, they are due to gastroesophageal reflux disease (GERD) in which the digestive fluid containing acid from the stomach moves up into the esophagus. Associated symptoms can include heartburn, belching, nausea, and burping.

What Is the Treatment for Hiatal Hernia?

Treatments for hiatal hernia are similar to those for treating GERD due to any cause. These may include:

  • Weight loss if overweight
  • Eating smaller portions and eating at least 3-4 hours before lying down
  • Limiting alcohol and caffeine consumption
  • Limiting consumption of certain foods including acidic foods, carbonated beverages, and vinegar
  • Keeping the head higher than the body when lying down
  • Wearing loose clothing
  • Smoking cessation
  • Medications to decrease acid production in the stomach
  • Surgery in severe cases

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.