Discusses three main types of hiatal hernia: sliding, paraesophageal, and mixed. Covers symptoms such as heartburn and gastroesophageal reflux disease (GERD). Looks at treatment with lifestyle changes, medicines, and sometimes surgery.
Is this topic for you?
If you have been told that you have a hiatal hernia, this topic will give you some basic information about it. A hiatal
hernia sometimes happens along with gastroesophageal reflux disease
(GERD). And the symptoms of a hiatal hernia are usually caused by GERD. For more information about the symptoms of GERD and how to treat it, see the topic Gastroesophageal Reflux Disease (GERD).
What is a hiatal hernia?
A hiatal hernia (say "hi-AY-tul HER-nee-uh") happens when part of your
stomach bulges up through the diaphragm and into your chest. The
diaphragm is a sheet of muscle that separates your
belly (abdomen) from your chest.
The hernia bulges through the
diaphragm at a place called the hiatus. This is the opening in the diaphragm
that the esophagus passes through. The esophagus is the tube
that connects the throat to the stomach.
If you have pain behind your breastbone, it is
important to make sure it is not caused by a problem with your heart. The
burning sensation caused by GERD usually occurs after you eat. Pain from the
heart usually feels like pressure, heaviness, weight, tightness, squeezing,
discomfort, or a dull ache. It occurs most often after you are active.
How is a hiatal hernia diagnosed?
A hiatal hernia
often is diagnosed when you see your doctor or have tests for another health
If you have symptoms, your doctor will ask you questions
about them. If your symptoms happen often and are severe, you may have
gastroesophageal reflux disease (GERD). If this is the case, your doctor may do
more tests or give you medicine for GERD.
How is it treated?
If you have no symptoms, you don't need treatment.
If you have mild symptoms, your doctor may suggest lifestyle changes and
nonprescription medicines. Here are some things to try:
Change your eating habits.
It’s best to eat several small meals
instead of two or three large meals.
After you eat, wait 2 to 3
hours before you lie down. Late-night snacks aren't a good
Chocolate, mint, and alcohol can make GERD worse. They relax
the valve between the esophagus and the stomach.
Spicy foods, foods
that have a lot of acid (like tomatoes and oranges), and coffee can make GERD
symptoms worse in some people. If your symptoms are worse after you eat a
certain food, you may want to stop eating that food to see if your symptoms get
Do not smoke or chew tobacco.
you get heartburn at night, raise the head of your bed
6 in. (15 cm) to
8 in. (20 cm) by putting the
frame on blocks or placing a foam wedge under the head of your mattress.
(Adding extra pillows does not work.)
Do not wear tight clothing
around your middle.
Lose weight if you need to. Losing just 5 to 10 pounds can
If you often have symptoms or have severe symptoms, you may have GERD. Lifestyle changes may help, and your doctor
may prescribe medicine. In severe cases, surgery can be used to pull the hernia
back into the belly.
Other Places To Get Help
National Digestive Diseases Information Clearinghouse (NDDIC) (U.S.)
Jeyarajah DR, Harford WV (2010). Abdominal hernias and gastric volvulus. In M Feldman et al., eds., Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 9th ed., vol. 1, pp. 379–395. Philadelphia: Saunders.
How this information was developed to help you make better health decisions.