Learn About Hiatal Hernia

What is the definition of Hiatal Hernia?

Hiatal hernia is a condition in which part of the stomach extends through an opening of the diaphragm into the chest. The diaphragm is the sheet of muscle that divides the chest from the abdomen.

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What are the alternative names for Hiatal Hernia?

Hernia - hiatal

What are the causes of Hiatal Hernia?

The exact cause of hiatal hernia is not known. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. The problem occurs often in people over 50 years.

This condition may be linked to reflux (backflow) of gastric acid from the stomach into the esophagus.

Children with this condition are most often born with it (congenital). It often occurs with gastroesophageal reflux in infants.

What are the symptoms of Hiatal Hernia?

Symptoms may include:

  • Chest pain
  • Heartburn, worse when bending over or lying down
  • Swallowing difficulty

A hiatal hernia by itself rarely causes symptoms. Pain and discomfort are due to the upward flow of stomach acid, air, or bile.

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What are the current treatments for Hiatal Hernia?

The goals of treatment are to relieve symptoms and prevent complications. Treatments may include:

  • Medicines to control stomach acid
  • Surgery to repair the hiatal hernia and prevent reflux

Other measures to reduce symptoms include:

  • Avoiding large or heavy meals
  • Not lying down or bending over right after a meal
  • Reducing weight and not smoking
  • Raising the head of the bed 4 to 6 inches (10 to 15 centimeters)

If medicines and lifestyle measures do not help control symptoms, you may need surgery.

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What is the outlook (prognosis) for Hiatal Hernia?

Treatment can relieve most symptoms of hiatal hernia.

What are the possible complications of Hiatal Hernia?

Complications may include:

  • Pulmonary (lung) aspiration
  • Slow bleeding and iron deficiency anemia (due to a large hernia)
  • Strangulation (closing off) of the hernia
When should I contact a medical professional for Hiatal Hernia?

Call your health care provider if:

  • You have symptoms of a hiatal hernia.
  • You have a hiatal hernia and your symptoms get worse or do not improve with treatment.
  • You develop new symptoms.
How do I prevent Hiatal Hernia?

Controlling risk factors such as obesity may help prevent hiatal hernia.

Hiatal hernia - X-ray
Hiatal hernia
Hiatal hernia repair - series
What are the latest Hiatal Hernia Clinical Trials?
The Total Wrapping of the Fundus of the Gastric Excluded Part (FundoRing) Versus Non- Wrapping (Non-banded) Standard Method of Laparoscopic One Anastomosis Gastric Bypass/Mini - Gastric Bypass: A Randomized Controlled Trial

Methods: Adult participants (n=100) are randomly allocated to one of two groups: Experimental surgical bariatric procedure in the first (A) group: patients (n=50) undergo the laparoscopic one anastomosis gastric bypass with the total wrapping of the fundus of gastric excluded part and suture cruroplasty if present hiatal hernia (FundoRingOAGB group); Active comparator surgical bariatric procedure in the se...

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Esophagogastric Junction Distensibility During Hiatal Hernia Repair

Summary: The investigators aim to ascertain the effects of hiatal hernia repair and fundoplication on the distensibility of the esophagogastric junction (EGJ) as measured by FLIP topography/impedance planimetry. The investigators also aim to assess for any correlation between values of EGJ distensibility and GERD related quality of life (QOL) and dysphagia scores.

What are the Latest Advances for Hiatal Hernia?
The Nissen-Hill Hybrid Repair: Experience With the First 500.
Efficacy of Combined Hiatal Hernia Repair and Transoral Incisionless Fundoplication for Giant Paraoesophageal Hernias: Technique and Early Results.
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Preliminary experience with double-tract reconstruction combined with π-shaped esophagojejunal anastomosis after total laparoscopic proximal gastrectomy for the treatment of adenocarcinoma of esophagogastric junction.
Who are the sources who wrote this article ?

Published Date: April 21, 2021
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

Lord KA, Williamson P. Hiatal hernia. In: Ferri FF, ed. Ferri's Clinical Advisor 2022. Philadelphia, PA: Elsevier; 2022: 760.e2-760.e5.

Schlottmann F, Patti MG. Management of paraesophageal hiatal hernia. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:30-34.

Yates RB, Oelschlager BK. Gastroesophageal reflux disease and hiatal hernia. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 43.