Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
A hiatal hernia is an anatomical abnormality in which
part of the stomach protrudes through the diaphragm and up
into the chest. Although hiatal hernias are present in
approximately 15% of the population, they are associated with
symptoms in only a minority of those afflicted.
Normally, the esophagus or food tube passes down through
the chest, crosses the diaphragm, and enters the abdomen
through a hole in the diaphragm called the esophageal
hiatus. Just below the diaphragm, the esophagus joins the
stomach. In individuals with hiatal hernias, the opening of the
esophageal hiatus (hiatal opening) is larger than normal, and a
portion of the upper
stomach slips up or passes (herniates) through the hiatus and into
the chest. Although hiatal hernias are occasionally seen
in infants where they probably have been present from
birth, most hiatal hernias in adults are believed to have
developed over many years.
What causes a hiatal hernia?
It is thought that hiatal hernias are
caused by a larger-than-normal esophageal hiatus, the opening in the
diaphragm through which the esophagus passes from the chest into the
abdomen; as a result of the large opening, part of the stomach
"slips" into the chest. Other potentially
contributing factors include:
A permanent shortening of the esophagus (perhaps caused by inflammation
and scarring from the reflux or regurgitation of stomach acid) which pulls
the stomach up.
An abnormally loose attachment of the esophagus to the
diaphragm which allows the esophagus and stomach to slip
Medical Author: Dr. Jay W. Marks
Medical Editor Dr. Dennis Lee
A Viewer Asks: I am wondering if exercise will help with a hiatal hernia?
Dr. Marks Answers: Exercise has no effect on hiatal hernias.
Exercise, however, can increase
acid refluxin people who are prone to acid reflux, presumably those individuals with weak lower esophageal sphincter muscles. (Exercise increases intra-abdominal pressure and can force stomach acid back into the esophagus through a weak lower esophageal sphincter.)