Hiatal hernia occurs when a portion of the stomach pushes up through the diaphragm’s opening into the chest. If the hiatal hernia is small, it rarely causes problems, and can be relieved by eating the correct foods.  If it is large, however, acid and food can go into the esophagus, making it difficult to swallow, cause belching, fatigue and lead to heartburn. Other symptoms include hoarseness, throat irritation, and pain in the esophagus, chest and stomach. See a doctor if these symptoms persist.

There are three kinds of hiatal hernia. The sliding hiatal hernia is the most common type where a portion of the stomach is sliding in and out of the chest through the hiatal (a gap); the diaphragm’s opening into the chest cavity. The fixed hiatal hernia is when a portion of the stomach remains fixed in the chest. The complicated hiatal hernia is an uncommon type that is more serious and requires hiatal hernia repair surgery.

Hiatal hernia can be caused by injury to its area, a large hiatus, pregnancy, old age, obesity and pressure on the muscles, like when vomiting and coughing. Smokers are at a higher risk. It is sometimes inborn, but the cause is unknown.

Hiatal hernia is often identified during a barium x-ray, upper GI x-rays or endoscopy when diagnosing chest pain, heartburn or abdominal pain. A biopsy may be done to check complications like scar tissue, inflammation or abnormal cells.

Surgery is usually only performed in emergency cases and when proper diet or medications fail to relieve acid reflux and heartburn.

To control its symptoms, eat properly.  Try eating frequent small meals and avoid foods that can cause heartburn like onions, citrus fruits, chocolate, spicy and tomato-based foods. It is also advisable to eat no less than two hours before going to sleep, losing weight if overweight, stop smoking and avoid alcohol.