Hiatus Hernia Hiatal Hernia


A hiatal or hiatus hernia happens when part of the stomach comes up through the diaphragm, the muscle that separates the chest area from the stomach area (abdomen). The tube that leads from the mouth to the stomach (esophagus) goes through a part of the diaphragm called the hiatus. If the muscle around the hiatus is weak, the top part of the stomach can press up through the diaphragm into the chest area.


Most hiatal hernias present no symptoms and need no treatment. Larger hiatal hernia symptoms may include trouble swallowing, heartburn, belching, tiredness and chest pain. Schedule an appointment with your doctor if you have these symptoms and they are causing you concern. If you are feeling chest pain, call you doctor immediately, as this may be a sign of a more serious condition.


To diagnose a hiatal or hiatus hernia, your doctor will perform a physical exam. He or she will talk to you about your symptoms and may order tests, including:

  • Endoscopy: A flexible tube equipped with a light and tiny camera (endoscope) is inserted down the throat to see inside the esophagus and stomach. If needed, a tissue sample (biopsy) can be done during an endoscopy. These samples are examined in a lab to check for problems.
  • pH monitoring: This test checks for stomach acid in the esophagus. 
  • Motility testing: This measures if the esophagus is working properly. A thin, flexible tube (catheter) is inserted into the nose, down the esophagus and into the stomach.

Services & Treatment

If you have a hiatal hernia, treatment may include:

Dietary and lifestyle recommendations:

  • Eat smaller more frequent meals
  • Avoid fatty foods, alcohol, chocolate, caffeine and peppermint
  • Don't smoke
  • Maintain normal weight
  • Do not lie down after eating
  • Do not eat for three to four hours before bedtime
  • Elevate your head by six inches with a pillow wedge

Over-the-counter medicines, such as:

  • Antacids. These will address symptoms but won't fix any damage stomach acid has caused in the esophagus.
  • H-2 receptor blockers. This heartburn medication reduces the amount of acid the body makes. They can help relieve symptoms for longer periods of time.
  • Proton-pump inhibitors. These block the acid the body makes, which allows the esophagus to heal.

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