Hiatal Hernia

Hiatal Hernia

What is a hiatal hernia? This condition occurs when a part of the abdominal organs slips up through the hiatus (opening in the diaphragm). In this condition, the lower part of the esophagus or stomach may end up in the chest region.

At the beginning, this pathology does not have any obvious manifestations. In the course of the disease run, the patient may experience symptoms similar to gastrointestinal tract disorders. In general, it doesn’t have any serious impact on the quality of life. Sometimes, the treatment requires surgical interference. However, this disease usually can be treated with a diet and medication.


In modern medicine, three types of hiatal hernia are distinguished:

  •     Axial, or sliding, hernia: this condition happens when the esophagus lower part can easily go up through the hiatus into the chest cavity, and then slide back.
  •     Para-esophageal, or fixed, hernia: this is a relatively rare case, when the upper part of the stomach stays in normal condition, while its lower part goes up. As a result, the stomach turns upside down.
  •     Combined hernia is a condition, defined by a combination of axial and para-esophageal hernias.


There are many factors leading to the disease, and they are quite diverse. We can classify them into congenital and acquired. Both axial and para-esophageal hiatal hernias are caused by the same factors.


  •     Hernia developed in the intrauterine period;
  •     Underdevelopment of the diaphragm.


  •     Chest injuries and traumas;
  •     Inflammatory processes in the diaphragm region;
  •     Age-related changes;
  •     Increased intra-abdominal pressure.

Quite often, the disease is triggered by several factors at a time.


Early stages run almost asymptomatic, which troubles the diagnosing and delays the treatment. However, being attentive to particular signs may help you to detect the disease. Each disease type has its certain manifestations:

Stage 1 of axial hernia is manifested by heartburn after eating, and pain in the epigastric region after long-term sitting. Stage 2 causes heartburn regardless of having a meal. It also causes nausea, swallowing disorders, and abdominal pain.

Para-esophageal (fixed) hernia is characterized by a stomachache after eating (especially when leaning forward), nausea, heartburn, and belching. In some cases, the patient may experience increased heart rate, wheezing.


In most cases, the patient is prescribed to follow a certain diet. It includes splitting meals into small portions and eating 5-6 times during a day. It is recommended to avoid sour, salty and spicy food. The medications include drugs that sedate the secretion of digestive juice. Antacid drugs and pain-killers are often used to relieve the symptoms.