Hiatal hernia is a common condition in which the upper portion of the stomach protrudes into the chest cavity through an opening in the diaphragm. The diaphragm is a muscular structure that separates the chest and abdominal cavities.
Normally the stomach resides completely below the diaphragm in the abdominal cavity. A hiatal hernia often contributes to gastroesophageal reflux disease (GERD), the abnormal backflow of stomach contents and acid into the esophagus.
Although many patients with a hiatal hernia have no symptoms, others complain of heartburn, regurgitation, or bloating.
Rarely, a large hiatal hernia can twist on itself and cause severe abdominal pain.
A hiatal hernia can be diagnosed by x-rays, or with an endoscopy, which involves passing a flexible tube through the mouth into the esophagus to directly visualize the lining of the esophagus and stomach.
Symptoms from a hiatal hernia typically respond to acid-reducing medications and dietary modification. Large symptomatic hernias unresponsive to these measures can be repaired surgically.