Hiatal Hernias

Hiatal hernias are slightly different from other types of hernias because they are a weakness or opening in the diaphragm, which is the muscle the separates the chest cavity from the abdominal cavity. These hernias cause reflux of acid from the stomach into the esophagus, which can lead to heartburn, pain, and erosion of the esophagus. Surgery to repair hiatal hernias can be complex and require a longer hospital stay.

Most small hiatal hernias don't cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn and chest pain. Self-care measures or medications can usually relieve these symptoms, although very large hiatal hernias sometimes need surgical repair.

There are two main types of hiatal hernias: sliding and paraesophageal (next to the esophagus).  In a sliding hiatal hernia, the stomach and the section of the esophagus that joins the stomach slide up into the chest through the hiatus. This is the more common type of hernia.  The paraesophageal hernia is less common, but is more cause for concern. The esophagus and stomach stay in their normal locations, but part of the stomach squeezes through the hiatus, landing it next to the esophagus. Although you can have this type of hernia without any symptoms, the danger is that the stomach can become "strangled," or have its blood supply shut off.