Hiatal Hernia

Medical Author: Jay W. Marks, MD
Medical Editor: Dennis Lee, MD

• What is a hiatal hernia?
• What causes a hiatal hernia?
• Are there different types of hiatal hernias?
• What are the symptoms of hiatal hernia?
• How does a hiatal hernia cause GERD?
• How is a hiatal hernia diagnosed?
• How is a hiatal hernia treated?
• Hiatal Hernia At A Glance
• Patient Discussions: Hiatal Hernia - Effective Treatments
• Find a local Gastroenterologist in your town

Hiatal Hernia and Exercise 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? I am also curious if alcohol or tobacco has any effects on (pantoprazole) Protonix? Dr. Marks Answers: Exercise has no effect on hiatal hernias. Exercise, however, can increase acid reflux in 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.) The effects of alcohol and tobacco on the effectiveness of Protonix or related drugs are... Read more about exercise, drugs, and hiatal hernias » Top Searched Hiatal Hernia Terms: symptoms, treatment, surgery, diet, sliding, acid reflux, esophagus, back pain, paraesophageal, shortness of breath

What is a hiatal hernia?

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:

1. 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.
   
   
2. An abnormally loose attachment of the esophagus to the diaphragm which allows the esophagus and stomach to slip upwards.

Hiatal Hernia - Effective Treatments

The MedicineNet physician editors ask:

What kinds of treatments have been effective for your hiatal hernia?

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