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 Treatment

Hiatal hernia is a condition that produces one or more of the following symptoms:

• Pain/discomfort behind the breast bone (sternum), usually towards the bottom of the chest wall
   
• Difficulty swallowing - a feeling that an obstruction in the lower chest wall is making it hard for food to pass through to the stomach
   
• Heartburn
   
• Chronic burping

Anatomical Considerations
Your chest cavity is separated from your abdominal cavity by a large, flat muscle called your diaphragm. Your diaphragm sits about halfway down your torso, just below the border of your lowest ribs.

Your stomach sits just below your diaphragm, so is technically considered to be in your abdominal cavity. Your esophagus (food pipe) sits above your diaphragm, and is therefore considered to be in your chest cavity. Your diaphragm has a hole, called your esophageal hiatus, that allows your esophagus to travel from your chest cavity into your abdominal cavity, where it immediately meets up with your stomach.

A hiatal hernia is when a portion of the top of your stomach slides up through the esophageal hiatus in your diaphragm towards your chest cavity. The result is pressure on the walls of your esophagus, which can lead to one or more of the symptoms listed above.

What Causes A Hiatal Hernia?

Some people are born with one. But most commonly, a hiatal hernia is caused by any lifestyle factor that causes weakening of the diaphragm and the connective tissue that is in place in and around the esophageal hiatus to help prevent a hernia. Emotional stress, physical stress, lack of adequate rest, being overweight for your height, and smoking cigarettes are the most common lifestyle factors that can contribute to the development of a hiatal hernia.

Hiatal Hernia Treatment Options

The symptoms of heartburn that can accompany a hiatal hernia often respond positively to one or more of the following measures:

1.Avoid smoking cigarettes.
2.Avoid or limit caffeine intake.
3.Avoid alcohol, especially hard liquor.
4.Do not overeat.
5.Wear loose, comfortable clothing around your torso.