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Our Health Information Database is provided by A.D.A.M. the leading provider of electronic and printed information for professionals and consumers in healthcare and industry. It provides authoritative, reliable content written and reviewed by an editorial board who represent a variety of specialty areas. This board reviews and evaluates all healthcare information to ensure it is accurate, reliable, and can be used with complete confidence. And now you have access to the same authoritative, trusted clinical information relied upon by health professionals around the world.

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This article may contain information on medical procedures that are not recommended or endorsed by Catholic Health Partners. Promotion of this topic is prohibited by the Ethical and Religious Directives for Catholic Health Services. In the Ethical and Religious Directives, Catholic health institutions are prohibited from condoning contraceptive practices. Married couples should be given information about natural family planning as well as the church’s teachings on responsible parenthood. The information in this article is designed for educational purposes only. It is not provided as a professional service or as medical advice for specific patients.

Hiatal hernia

Definition

Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.

Alternative Names

Hernia - hiatal

Causes, incidence, and risk factors

The cause is unknown, but hiatal hernias may be the result of a weakening of the supporting tissue. Increasing age, obesity, and smoking are known risk factors in adults.

Children with this condition are usually born with it (congenital). It is often associated with gastroesophageal reflux in infants.

Hiatal hernias are very common, especially in people over 50 years old. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus.

Symptoms

A hiatal hernia by itself rarely causes symptoms -- pain and discomfort are usually due to the reflux of gastric acid, air, or bile. Reflux happens more easily when there is a hiatal hernia, although a hiatal hernia is not the only cause of reflux.

Signs and tests

Treatment

The goals of treatment are to relieve symptoms and prevent complications.

Reducing the backflow of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain. Medications that neutralize stomach acidity, decrease acid production, or strengthen the lower esophageal sphincter (the muscle that prevents acid from backing up into the esphagus) may be prescribed.

Other measures to reduce symptoms include:

  • Avoiding large or heavy meals
  • Not lying down or bending over immediately after a meal
  • Reducing weight and not smoking

If these measures failure to control the symptoms, or complications appear, surgical repair of the hernia may be necessary.

Support Groups

Expectations (prognosis)

Most symptoms are alleviated with treatment.

Complications

Calling your health care provider

Call your provider if symptoms indicate you may have developed a hiatal hernia.

Call your provider if you have a hiatal hernia and symptoms worsen or do not improve with treatment, or if new symptoms develop.

Prevention

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

References

Orlando RC. Diseases of the esophagus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 140.

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Review Date: 8/1/2009

Review By: Reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2010 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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