





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.