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Hiatal Hernia
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Digestive System

Hiatal Hernia

A hiatal hernia is when part of the stomach pushes through the diaphragm, making acid reflux more likely and producing symptoms such as heartburn, cough, and swallowing difficulties.

Overview

A hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in the diaphragm, the thin muscle that separates the chest from the abdomen. The diaphragm normally helps keep stomach acid from entering the esophagus. When a hiatal hernia occurs, acid can leak into the esophagus, a condition known as GERD (gastroesophageal reflux disease).

Symptoms

  • Heartburn
  • Problems swallowing
  • A dry cough
  • Bad breath
  • Nausea and/or vomiting
  • Breathing problems
  • The wearing away of teeth

Causes & Risk Factors

The exact cause of a hiatal hernia is often unknown, but it may involve weakness in the surrounding muscles. It can also result from injury or a birth defect. Risk increases with age—especially after 50—obesity, and smoking.

Diagnosis

People are usually diagnosed when they undergo tests for GERD, heartburn, chest pain, or abdominal pain. Common diagnostic tests include a chest X‑ray, an X‑ray with a barium swallow, or an upper endoscopy.

Treatment & Management

If a hiatal hernia is asymptomatic, no treatment is needed. For symptomatic cases, lifestyle changes can help: eating small meals, avoiding trigger foods, quitting smoking, limiting alcohol, and losing weight. Doctors may prescribe antacids or other medications. If these measures fail, surgical intervention may be necessary.

Frequently Asked Questions

Yes, hiatal hernias can cause chest pain that mimics a heart attack, which is why it is critical to seek immediate medical attention for new or severe chest pain. While the pain from a hiatal hernia is often related to acid reflux or pressure on the esophagus, it can be difficult to distinguish from cardiac issues without proper testing. If you experience chest pain accompanied by shortness of breath, sweating, or pain radiating to the arm or jaw, call emergency services immediately to rule out heart problems.
You do not necessarily need a permanent strict diet, but adopting long-term lifestyle changes is highly recommended to manage symptoms and prevent complications. This includes eating smaller, more frequent meals, avoiding trigger foods like spicy or acidic items, and not lying down immediately after eating. Maintaining a healthy weight and quitting smoking are also crucial, as these factors reduce abdominal pressure and lower the risk of acid reflux.
Warning signs of a worsening hiatal hernia include increased frequency or severity of heartburn, difficulty swallowing (dysphagia), unexplained weight loss, or persistent nausea and vomiting. In rare cases, the stomach can become trapped and twisted (incarcerated or strangulated), leading to severe, sudden abdominal or chest pain, inability to belch or vomit, and rapid heart rate. These are medical emergencies requiring immediate hospital care.
Recovery from hiatal hernia repair surgery typically takes four to six weeks, though full healing may take longer. Most patients return to light activities within two weeks, but heavy lifting (usually over 10-15 pounds) is restricted for at least four to six weeks to prevent the hernia from recurring. Your surgeon will provide specific guidelines based on the type of procedure performed, such as laparoscopic or open surgery, and your overall health.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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