What Is a Hiatal Hernia?

This common problem occurs when the stomach bulges into the chest. Hiatal hernias aren't like hernias in your groin. Most hiatal hernias cause no symptoms and need no treatment. If you notice symptoms, usually you can control them easily.

What You May Feel

Most people with hiatal hernias have no symptoms. But if reflux (acid backup) occurs, you may notice the following:

• Heartburn or other chest discomfort

• Frequent burping

• Acid taste in the mouth

• Problems swallowing

• Nighttime choking, coughing, or wheezing

Treating Symptoms

If the hiatus is wide, part of the stomach may bulge above the diaphragm. This bulge is called a hernia. Stomach acid may move up into the esophagus and cause symptoms.

When you eat, the muscle at the hiatus relaxes to allow food to pass into the stomach. It tightens again to keep food and digestive acids in the stomach.

If you have symptoms from a hiatal hernia, the goal is to help you feel better. These suggestions may help:

• Lose excess weight. Excess weight puts pressure on the stomach and esophagus.

• Avoid cigarettes, alcohol, fatty foods, chocolate, and coffee.

• Avoid anything that causes symptoms. Stay away from any food or drink that gives you problems. Many medications can cause symptoms. Discuss your medications with your doctor.

• Try acid-reducing medications. Over-the-counter antacids may relieve heartburn. Talk to your doctor about other over-the-counter and prescription medications that can also help.

• Surgery is rarely needed. Surgery is usually needed only for severe symptoms. The diaphragm may be tightened. Or, the stomach may be placed back below the diaphragm.