Whenever an internal body part pushes through an opening and into an area where it does not belong, it is called a hernia. A hiatal hernia occurs when the upper portion of the stomach protrudes into the chest cavity through an opening of the diaphragm called the esophageal hiatus. Ordinarily this opening is only large enough to accommodate the esophagus. When it becomes weakened and enlarged, however, the opening can allow passage of part of the stomach. In some cases, that portion of the stomach may even become entrapped.

What is a hiatal hernia?

A hiatal hernia occurs when portions on the stomach creep through the esophagael hiatus.

There are two types of hiatal hernia:

The sliding type occurs when the junction between the esophagus and the stomach slides through the esophageal hiatus when there is increased pressure in the stomach. When the pressure is relieved, gravity causes the stomach to slide back into place.

The fixed type, or paraesophageal­, occurs when the upper portion of the stomach becomes entrapped and thus does not slide back into position. This is less common than the sliding variety, and is more apt to be symptomatic.

Hiatal Hernia Symptoms

The most common hiatal hernia symptoms are heartburn and/or GERD (gastroesophageal reflux disease). It should be noted that many patients are diagnosed with GERD, but do not have a hernia, while others have a hiatal hernia but do not suffer with GERD. Chest pains can also be symptomatic of hiatal hernia. The pains can be severe, and may be mistaken for a heart attack. Obviously, if such pains occur, one should consult with a physician right away. Getting to a doctor is essential to getting proper care in time.

Causes

While specific causes are not really known, hiatal hernias have been associated with the following:

1. Pregnancy and delivery

2. Weight gain

3. Increased abdominal pressure from chronic coughing

4. Straining during difficult bowel movements

Some people are predisposed to hiatal hernia due to congenital weakness or enlargement in the esophageal hiatus. Obesity and smoking have also been proven to increase the likelihood of hiatal hernia.

Treatment

Most people do not have symptoms and no treatment is needed. If symptoms do occur, initial treatment may include medication to control acid reflux (GERD), and a change in diet. Weight loss is often recommended as a means of reducing the pressure on the hernia. If symptoms are chronic and do not respond to diet and medication, surgery may become necessary. If the hernia is in danger of becoming restricted or strangulated, surgery becomes the likely treatment. Today, most surgeons elect to perform laparoscopic surgery, because it is minimally invasive and recovery time is reduced.

If a patient who has been diagnosed with hiatal hernia becomes nauseous, experiences severe chest pains, is vomiting, or is unable to have a bowel movement, it should be treated as a medical emergency. Consult with a physician immediately.

Hiatal hernia symptoms are commonly misunderstood, if you feel you may have a hiatal hernia you should contact a doctor to resolve a treatment method quickly.